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Old 08-03-2008, 09:53 PM   #1
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Efnes HB User
Angry Chronic rectal fissures that refuse to go away even after surgery, help

Need some help here, but a little backstory first.

My fissures came about by my own doing. Crappy diet as a kid, lots of non-fibrous food, little water, long periods of time on the john, sitting a lot, weight lifting all led to the day when blood started coming out every time I used the bathroom (in addition to hemorrhoids). About 1tblsp or more came out each time I used the toilet, this didn't bother me that much as it only came up when I used the bathroom and never caused me pain.

I went to the Dr. about it and he prescribed me docusate, it began to heal (I assume) as the bleeding stopped and the pain started. It became really really bad a few months after that. As in, I'd use the bathroom and would be immobilized in bed for hours afterwards until the pain subsided and I could walk/sit down again. At this point I was still not staying on a strict diet or anything, just using the bathroom less.

I finally got fed up and after an attempt at curing it with a 0.1% nitro and 2% dibucaine I went to a surgeon and had a lateral sphincterotomy. It took a good week for the major pain to subside. What I noticed was that the fissure (at 6 o'clock if you think of a cross-section of your rectum with 12 being forward) pain was basically gone, but I had pain at the point of the incision, a constant dull pain.

I vowed to get this over with and stuck to a strict diet of high fiber foods, lots of water (over 100oz a day), and 24g of acacia fiber daily spread across 4 doses. I did/do not sit except to drive places and on rare occasions at restaurants and movies.

That was nearly a year ago, the dull pain is still there and I seemed to have developed 2 or 3 new small fissures. They not nearly as painful as it was the one I had in the beginning but it is still painful enough to keep me from sitting unless needs be.

Needless to say I'm growing tired of this limiting condition as I'm in my early 20s now and it has eaten up 2 years of my life. What else can I do?
Could I have Crohn's (the thought of a colonoscopy makes me wince)?
Could my hemorrhoids be complicating things?
Why new fissures after so much effort to eat/drink right?
Could the kneeling be aggravating things?
What gives with the incision constantly hurting? My surgeon said he can't see anything and to just "give it time"

I still maintain the same diet, lots of water and tea and fiber.
I aim to use the bathroom only once daily, twice if I eat too much.
I use an OTC prep h cream.
I kneel a lot at the computer and sit little at all. I do not do much physical exercise as it all seems to aggravate the fissures.
I have a botox appointment scheduled for a month from now.
OTC and Rx painkillers only do so much.

Any suggestions would be great, thanks.

 
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Old 08-05-2008, 08:06 AM   #2
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Re: Chronic rectal fissures that refuse to go away even after surgery, help

Anyone? Any ideas?

 
Old 08-05-2008, 10:22 PM   #3
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Re: Chronic rectal fissures that refuse to go away even after surgery, help

Sorry to hear of all you suffering....believe me I can relate.

I suffered 6 months with severe pain....tried diet change, creams, softners etc....nothing worked. Finally I had the surgery (sphincterectomy). Post surgery, intense pain for a week, then better for a week but then back to the chronic pain. Another colorectal surgeon felt the first surgery was "incomplete" so he repeated the operation 2 months later cutting even more of the muscle.

Its been 5 months since surgery #2. The intense daily burning pain was gone right away but I still deal with discomfort daily. The original fissure area (posterior) pinches and stings once in a while throughout the day but the opposite side is constantly sore daily.... I'm not sure if its the incision site or just irritated tissues or perhaps an irritated hemoroid due to all the surgery.

The doc after my 6 week follow up simply said wait and it should get better and not to obsess (easy to say when you're not in pain daily)...if it doesn't improve soon I may have to go see him again. I am VERY grateful things are not as severe as before and can function but it is still difficult to live this way.

Perhaps your other pains are not fissures but a hemoid or two...

Did you have a sigmoidoscopy at the time of surgery...this allows docs to see into the first part of the colon and they can usually detect crohns or colitis this way???

If things don't get better maybe you should get a second opinion with another specialist...sometimes they can offer a fresh perspective.

Good luck

 
Old 08-08-2008, 01:56 PM   #4
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Efnes HB User
Re: Chronic rectal fissures that refuse to go away even after surgery, help

Thanks for your story, glad to see I'm not the only one stuck in a rut like this (not to wish ill upon you ).

As I said I'm going in for the botox injection as I didn't want to risk more complications from a second surgery, and this time it is with a different doc so I'll get another opinion. I'll definitely ask about the sigmoid, I really need to rule this stuff out.

Another question for those who've used the 0.2% nitro ointment, I just recently started reusing it and it has made the fissure pain spots really itchy. Not generally itchy, just those tiny little sore spots. Is this it healing up or contact dermatitis?

Last edited by moderator2; 08-08-2008 at 03:47 PM. Reason: please delete the huge quotes!

 
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