View Full Version : Anal Fissure management?

08-31-2010, 07:53 PM
Dear all,

I am a 20 year old female recently diagnosied with anal fissure (about 3 weeks ago). I did have haemorroids beforehand too, likely due to a traumatic injury about 10 years ago when I fall on a table's edge and hit me in the anus.

I think I was trying too hard to pass some hard stool which caused the fissure.

The pain was unbearable of course...with me screaming in agony and my legs shaking from the pain. Was not able to go to sleep too. i was getting the spasms of course....can feel it throbbing. Plus I get really cold afterwardws, my body just go into this shock.

I saw a doctor about 2 weeks ago...and since then I have been using the Proctosedyl. I just tried to apply it just outside or slightly inside tha anus as I tried using the tube once and it hurted.

I also had a lot of blood in the toilet bowl which totally freaked me out. I saw my doctor again last week. He reassured me it's not something more "sinister" like cancer. I did have a colonoscopy done about 1.5 years ago already.

I actually felt better about 3-4 days ago over the weekend...as my stools came out easier over the weekend.

I also started taking a lot of fibres too.....but for some reason was constipated again in the last three days with very hard stool. Why is this so? I drank a lot of fluid and took fibres? I read that fibres can be a double edge sword...but why?

I did manage to have a little bit of stool to come out...hard ones yesterday, as i didn't wanna force them out.

However, this morning, I tried a little harder and I was able to pass stool but got blood again. Does this means i hurt my fissure again? Or a new fissure? :confused:The location of the pain seem to have changed a bit.

I just want to recover without operations. My doctor did write me a referral to see a surgeon but I don't wanna do that yet.

What should i do to manage this? I mean, I was getting better until i got constipated again these few days and having blood in my stool again this morning. Plus, It's no where near as sore as it was...so I don't wanna go the operation option if i don't have to.

Finally, i have been abstining myself from exercise but I did have sex (vaginal only) a few days ago....when I came....i felt my anal muscles constricting really hard...should i abstine from sex as well?

Your advice is very much appreciated.

Thank you.


09-01-2010, 11:32 AM
From my anal fissure and cirurgy experience I would advise you to try all the treatments possible before the last option (cirurgy); It's important to keep regular (daily) bowel movements, with soft stool ( lactulose will help you this) and try to keep the anal area clean ( washing after bowel movements is important and avoid toillete paper); You should not push or force stool to come out, otherwise the fissure will not heal; Regarding sex, it's normal that climax makes your spfhincter contract and this (sphincter spasm) is one of the main reasons why fissures are so hard to heal.

09-01-2010, 03:27 PM
Hi dcarvalho,

Thank you for your feedback.
I do keep it clean and dry, as well as avoids using toilet paper.

I guess, it's not as painful as it was....but the cuurent problem is i don't have the urge to go, so it's hard to go daily (I used to go 1-2 times a day).
I tried yesterday and nothing. Like you said, I don't want to force it.

Maybe my lack of desire to go is due to my enhanced fibre intake? I heard if you increase the amount consumed too quickly, you get constipated.

Or maybe I've stopped drinking coffee or tea? Which usually helped me to want to go?

Well, I guess I will wait a couple more days...and worry if i still don't go.

Finally, I won't be doing any physical activity, including intimate activity for a while until i get better......as yeah, as you would agree, i want to get better natually. ^^

Thanks Again....


09-01-2010, 03:34 PM
things you can take to help with passing bowels:

magnesium, flax seed oil capsules, stool softeners, metamucil, lots and lots of water.

wipe with flushable wipes instead of toilet paper.

eat a lot of fruits and vegetables

eat prunes and drink prune juice

if you still have the fissure after 6 weeks or so of this i would get a referreal to a colon and rectal surgeon.

i had LIS surgery back in december of 2009 and i have had no problems what so ever

I Jones
09-01-2010, 03:38 PM
As a person with a long-term problem of fissures for no known reason I am gradually getting in control of it. The thing that works best for me is to always (not just when I have a fissure) put a fingerful of petroleum jelly up myself just before trying to have a bowel motion. This is much better than putting something on after going! I think the stools were tearing me on the way out.

Also don't go for increasing the fibre till this one is healed, then maybe add fibre to keep yourself regular in the future. For now use a softener like docusate. When you increase fibre, you have to also increase water intake *much* more than you might imagine, else your stools will just be larger but still hard!

Often there is some infection gets into your fissure. You may find it helpful to have a course of antibiotics as it will heal faster, then just watch out to try not to get another one by keeping your bowel habits good.

Yes it is VERY painful and I am sorry you are going through this, but there is little that can be done - except as I said above infection makes the pain worse and talk to your doctor about antibiotics.

09-01-2010, 04:03 PM
Hi I know someone who had trouble with an anal fissure. That problem has either disappeared or lessened altogether. Eating dry refined foods make constipation worse, such as dry crackers, dry potato chips white breads etc. I believe I wrote in a past post about nice healthy ways to lubricate. I hope you feel better soon!

09-02-2010, 03:59 PM
Dear all,

Thank you to all of your advice!

At the moment, I have been going to toilet but it seems it's a bit tight still...though not nearly as painful as before.....no spasm or pain that lingers for hours. There's still blood if I push hard...so I try not to push. However, over the last couple of days, i've only managed to have a very small amount of stool and they are little, at times, pencil-like.

What is happening?? Is it normal?

I stopped using the cream too, which has anagesia in it and I heard you should not use it for too long. I guess particularly i don't have a lot of pain now...better of go natural.

Thank you for your feedback in advance...


09-02-2010, 05:51 PM

At the moment, I have been going to toilet but it seems it's a bit tight still...though not nearly as painful as before.....no spasm or pain that lingers for hours. There's still blood if I push hard...so I try not to push. However, over the last couple of days, i've only managed to have a very small amount of stool and they are little, at times, pencil-like.

Hi Alicialo: There are a couple of causes of pencil-like stools. We are not allowed to diagnose you so you can have a rectal specialist look at it to see what is in there. Because you mention an injury that sounds like scar tissue making it harder for your stool to come out. Other possible causes are lumps, polyps, partial obstructions or maybe hemmhoroids if I remember correctly. Of course because it may have healed over and reripped and who knows how many times this can happed it may be merely scarred.:eek:

10-05-2010, 03:24 PM
Hi there, I totally understand where your coming from and your pain.
I have has "on-and-off" fissures for almost four years but about four weeks ago I had this really large fissure that came with really big pain, pain I have never felt before. There was blood in the toilet and on the tissue. I was not able to sleep, I was shaking, I was sweating... everything.
So I went to my Dr. who prescribed Nitroglycerin 0.2%. This medication causes blood vessels in the area to dilate and allow for more blood circulation, which helps in healing of the fissure, it also helps to relax the sphincter so the spasms would stop. At first, I would only apply this cream on the outside, not on the inside because it would be extremely painful to stick anything in my anal canal. I have also started to do sitz baths, by sitting in a basin or really warm water. The heat helps to relax the sphincter and allow for increased blood circulation. After I got more comfortable and less pain, I applied the Nitro cream after the sitz bath using a cue tip. This really helped.
The pain stopped and no more blood or spasms. It took me over two weeks to get this over with.
Diet: I have been taking Fibre one cereal, and Metamucil twice daily, and MOST IMPORTANTLY>>>> 2 - 3 L of water a day.... THIS HELPS!!!!!

let me know if this helps.