Anal fissure: What helps it heal?

Posted by lisval @lisval, Aug 2, 2022

Hey-wondering if anyone has developed an anal fissure during chemotherapy? What helped it heal? Any advice as it is very painful!

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@mikayla68

Hi, I'm 68, I have an anal fissure. I didn't experience it as a sharp pain, so for MONTHS the drs thought my previous coccyx fracture had flared up in some way. Finally had an appointment with my GI (waited for months to get in, of course) for what I thought was my usual hemorrhoids, but lo and behold, fissure.

GI gave me Rectiv and lidocaine, told me vaguely to eat high fiber, and sent me home with a 6 week followup appointment. Well, I had a very rough 4 weeks. My poops tend to be too wide, so at about week 3 my GI prescribed Linzess. I could only tolerate that for 6 days. The worse diarrhea of my life! Just horrible. That's when I decided to experiment with some alternate approaches.

I have a followup appointment scheduled for mid-January, but I really hope I won't need it. And I'm really trying to avoid surgery - I had surgery for fissure, hemorrhoids and they enlarged my anus in 1983 (fun fun fun) so I really think surgery again is a bad idea.

I carefully eat high fiber, and be sure to not eat too much fiber. Metamucil of course. I did a lot of research and found some alternate treatments. I insert homemade coconut oil suppositories before pooping to help it come out more easily. I do sitz baths and sometimes sit on a heating pad. I use "got u cream" frequently. And a big key is that I try to avoid sitting at all, I just sit in recliners or lie down, all day long. Cannot believe the GI didn't suggest at least that - every time you sit on it and it hurts, then that means it's stressed and sitting will prevent healing.

Gotta say, it's going well! It's been 2 weeks on my homemade regimen, and it has improved a ton. But I'm still a long way from complete relief. Would love any other ideas or feedback! I just want to be well again!

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Hi Mikayla, I have had 2 surgeries for fissures and I can sympathize with you. Only 50% of people can heal them on their own. I sat on a "donut" for 14 years. During one of the surgeries, the doc hit my pudendal nerve, hence the sitting problem. I took an anti-seizure medicine off label for an unrelated problem and in 2 weeks the pain was gone. It was Topamax. My PT said she had heard it works. You might want to ask your doctor.
Mikayla (same name we have)

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@trishplace

I did the same as jeanadair. At first I was given a compounded prescription of Nitroglycerin, but it made me so dizzy that I had to give up on it. I called my colo/rectal surgeon back and he prescribed the Nifedepine. Again, it was through a specialized, compounding pharmacy. It really helped heal and helped with the pain. That pharmacy gave me the finger cots with the prescription. Good luck! Give it a try!

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It amazes me that we have to go on Mayo connect to find out what works the best? We see incredibly trained doctors in their fields yet we have to go on this site to find out what to use that no one to,d us about the nifedipine. I was in agony for at least a year or more I hated having a BM it took me years to get my pain tolerance back. Wish I had known about this site years ago. The prescription was $700 the compound pharmacy charged $60.

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@mikaylar

Hi Mikayla, I have had 2 surgeries for fissures and I can sympathize with you. Only 50% of people can heal them on their own. I sat on a "donut" for 14 years. During one of the surgeries, the doc hit my pudendal nerve, hence the sitting problem. I took an anti-seizure medicine off label for an unrelated problem and in 2 weeks the pain was gone. It was Topamax. My PT said she had heard it works. You might want to ask your doctor.
Mikayla (same name we have)

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Hi! Your name is Mikayla? Weird huh?!! Mikayla is my cat, love that name!
I'm going to heal this thing!!! I'm so determined, but of course I know it might not work. But thanks for the advice, and about the Topamax, I will definitely keep it in mind.
Did your 2 surgeries work in the end?

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@mikayla68

Hi, so okay, wow! So you're saying the nifedipine ointment is better than nitroglycerin (Rectiv)??? I'll ask my GI for a prescription. This is so helpful thanks so much. Finger cots are a great idea - I've been cutting off the fingers of plastic gloves!

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My dr gave me the nitroglycerin also I didn’t take it because the nifedipine worked. I also have migraines which is a side effect of the nitroglycerin another reason I didn’t take it. Unrelated regarding the migraines a friend told me to see an acupuncturist for them I did and have only had a very mild one since July. Amazing what one finds out.

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@mikayla68

Hi! Your name is Mikayla? Weird huh?!! Mikayla is my cat, love that name!
I'm going to heal this thing!!! I'm so determined, but of course I know it might not work. But thanks for the advice, and about the Topamax, I will definitely keep it in mind.
Did your 2 surgeries work in the end?

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The second surgery was a nightmare. The doctor hit my pudendal nerve and I had pain for 14-1/2 years. After the 2 surgeries, I had another procedure to stretch the scar tissue. Surgeries worked, except for the nerve damage. I sat on a donut for 14-1/2 years before I took the anti-seizure medicine that gave me relief in 2 weeks.

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@mikaylar

The second surgery was a nightmare. The doctor hit my pudendal nerve and I had pain for 14-1/2 years. After the 2 surgeries, I had another procedure to stretch the scar tissue. Surgeries worked, except for the nerve damage. I sat on a donut for 14-1/2 years before I took the anti-seizure medicine that gave me relief in 2 weeks.

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Thanks so much for so much info! It's amazing, isn't it, the twists and turns that can happen with a medical problem?

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Only 50% of people can heal fissures on their own; the rest need surgery. Use a sitz bath with hot water as much as you can.

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@jeanadair123

It amazes me that we have to go on Mayo connect to find out what works the best? We see incredibly trained doctors in their fields yet we have to go on this site to find out what to use that no one to,d us about the nifedipine. I was in agony for at least a year or more I hated having a BM it took me years to get my pain tolerance back. Wish I had known about this site years ago. The prescription was $700 the compound pharmacy charged $60.

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I agree, it's ridiculous!
It sounds like you had your fissure for over a year, am I understanding that correctly? Did you have success using the nefedipine? Or are you still treating it?

Yea bm's are always traumatizing!

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Have you seen a colorectal doctor? They may have more expertise for fissures than a GI doctor. I had horrible pain with every bowl movement as well, I got a botox shot and that helped. Also the sitz baths and if you are on chemo, get off Avastain. That is what ultimately solved it for me.

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@mikayla68

I agree, it's ridiculous!
It sounds like you had your fissure for over a year, am I understanding that correctly? Did you have success using the nefedipine? Or are you still treating it?

Yea bm's are always traumatizing!

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Yes! I would say almost 2 years before the nifedipine. I hated going to the toilet. It did get better though as the months progressed especially after I got the nifedipine. If I had been given it a lot earlier by Stanford I would not have had to endure this pain. I hardly use the nifedipine now but I had my radiation in. 2017 and I take the stool softeners every day.
I always keep an up to date prescription just in case. I sometimes wish these doctors could have this pain just once and maybe they could understand how we feel? There is light at the end of the tunnel though just make sure you don’t get constipated.

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