Anal fissure: What helps it heal?

In my case I have had to learn to live with it because I had a very bad doctor in the beginning. He should have done surgery on me. But I have figured out how to treat myself and stay on top of my constipation. Good luck to everyone. Prayers to all.

50% of people can heal these on their own. I was unable to on 2 different times and had to have surgery. I wish you luck. The pain is unbearable, I know. Let us know how you are making out.

Fissures are one of the most painful things in the world Many years ago I got two one inch fissures from constipation. And I have had pain from them since. My heart goes out to you. My doctor prescribed suppositories Anucort 25mg for me and they really help! In between I use over the counter neosporin with long QTIPS. That I came up with on my own. But the idea came from a prescription of an ointment compounded by a Proctologist from OK where I live really fight hard to make sure that I don’t get an infection. I also use Flexeril because tears in the rectum cause the Sphincter muscle to spasm and boy does that cause added pain. Again my heart goes out to you. Hope you can use some of the things that I use and have learned over the years. Diane.

Thx so much. Talking to specialist tomrrow

Hello Jette - I avoided taking ibuprofen and Tylenol. The few times I did take either (or both), I did not get much relief. What helped the most is two homeopathic OTC medications [Arnica Montana and Hypericum Perforatum (St. John’s wort)]. I used the Boiron brand but there are several available. That said, I cannot say I was pain free, but the combo did help. I did not pursue stronger Rx medications (although I sure thought about it). The Rx compounded ointment that I mentioned initially also helped with reducing the pain and inflammation. Do you feel the nifedipine/lidocaine ointment you are now using is reducing your symptoms?

I have read that acupuncture may be helpful, but did not investigate further. Certainly, checking out functional alternatives is worth it (my opinion). I see an integrative/functional medicine MD periodically for other concerns and it has been helpful. I hear you on the expense though!

One thing I did not mention is that I found sitting on a heated gel pack / heating pad when things were at their worst provided a lot of relief. Alternating that with casual walking seemed to help.

I mentioned that pelvic floor therapy was helpful. In my case, it was a game changer. If you’ve not already been for an evaluation, you might want to ask your colorectal surgeon for a referral. There are things a therapist can do externally to ease the pain while you are healing internally – at least, that was my experience. I discovered through this process that I had some very tight muscles in numerous adjacent areas that were contributing to my pain.

Hang in there. If it helps, I was told by both my physician and physical therapist that progress is not linear and to expect ups and downs. Praying for healing and relief for you. You will get there.

Thx so much. I'm trying to be hopeful. It seems every other day exactly is excruciating pain and the next day is OK. I don;t understand why. Have BM about 3-4/day, very raw inside 🙁 Thx again. Need all the help I can get.
Jette

Thanks for inviting me, @lisalucier. Nice to meet you @jette123. How frustrating to deal with your anal fisture for 9 years, and on top dealing with what it takes to try to treat it.

First, I want to let you know that through my long road I am finding relief and comfort. You can do this!

My progress began at a 2021 GI appointment when it was determined I did not necessarily have a fisture. Rather, it is documented as “perianal excoriation” that my doctor could see. I described my pain as a periodic “rock on my tail bone”, hits me out of nowhere and most often waking me in the middle of the night. Like you describe, that place is higher up. Pelvic floor dysfunction was suspected then subsequently confirmed by anorectal manometry testing. Bluntly, my poop muscles functioned backwards and held everything in instead of pushing out. My muscles do not relax properly during bowel movements, thus chronic constipation and difficult passing stool. It made absolutely no sense to me at the time but I pursued Mayo Clinic’s evacuation program for pelvic floor therapy…..because I was absolutely miserable by this time and they were confident it would help. (if I put in the effort - it is effort).

Because of learning first-hand that everything in my body does seem to be connected, I am wondering if you have other nagging health issues? Besides the nifedipine, what medications/supplements do you take?

Thx for replying . The ibuprofen and Tylenol is not really enough. So I am in pain a lot.

Thx so much for your lengthy reply! Very helpful. I’m kind of at my wits end trying to be hopeful. My life is like a rollercoaster. Seems every other day extreme pain next day tolerable. I take ibuprofen and Tylenol but it doesn’t take it away. Did you take anything stronger? Also wonder about the Chinese naturopath clinics for this problem. Do you know anything about those? Expensive! Thank you. Jette

Hello @jette123 - so sorry you are going through this! I can relate and, hopefully, some of what I outline below will be helpful...

I developed a fissure approximately 3 years ago – unknown to me at the time. Once I was correctly diagnosed (long story), it had become chronic. It was very painful during the day and subsided somewhat overnight. Getting to the right colorectal surgeon was the key to finally healing. It sounds like your second doctor is prescribing a similar approach with a few differences. I'll summarize what I used/did (both by Rx) as well as more holistic measures:

1. The fissure was finally diagnosed approximately 1 year after symptoms started. In that interim period, I saw my primary, a gastroenterologist, and my first colorectal surgeon – all of whom thought my pain was coming from a hemorrhoid. That sounds crazy, but I’ve since learned that fissures are misdiagnosed all the time. There are many reasons for this, which I won’t go into here.

2. It was not until I went to a second colorectal surgeon that I was diagnosed with a fissure. I was prescribed a compounded ointment with three components: hydrocortisone, nifedipine, and lidocaine. I applied it 2x per day for 8 weeks at which point I saw my physician again. By this time, my symptoms were much better and my physician indicated the fissure had healed. [You mentioned the Nifedipine in your post. My understanding is that it helps the muscle relax which should be helpful – at least, that was my experience.]

3. During the 8 weeks, I also used a therapeutic red-light panel 5 days per week for 10-15 minutes. I cannot scientifically prove it, but I believe it really helped w/healing.

4. I was left with some residual pelvic floor spasms supposedly set off by the chronic fissure. These were horrible, but pelvic floor physical therapy took care of those and today I am pain free and feel like I’m 98% back to normal.

5. You mentioned that BM’s are a problem and while you are likely already taking steps to keep things on the softer side, here is what worked best for me after much trial and error. I drink ¼ cup of aloe vera juice 2 to 3 times/day before each meal. I consume ten 8 oz. glasses of water/day. I also supplement with magnesium (a blend of magnesium oxide, malate, and glycinate) 2x per day – 1 capsule in the morning and 2 at bedtime. Magnesium citrate is also an option. I was already eating a Mediterranean, whole foods diet before this started and I did not make any changes to it. If you’ve not tried this before, look up recipes for Chia Seed Pudding. My physical therapist told me about it and suggested it could help with keeping things moving. She was right. On average, I have ¼ cup of the pudding each day. It is very easy to make and taste great too. That said, what works is unique to everyone! I may have veered off too far from the subject at hand, but I wanted to share given some of your comments.

6. If you’ve not already heard about/discovered Dr. Albert Chung’s YouTube channel, it is worth investigating. He calls himself “Your Friendly Proctologist” and really breaks things down into layman’s terms with a healthy dose of humor along the way. He has several short videos re: fissures that you might find encouraging and helpful. The link to his channel is: https://www.youtube.com/@yourfriendlyproctologist and you can also get there from his website: https://crsurgeryoc.com/ .

I apologize for the length of this post and it is likely TMI. However, if you have additional questions, feel free to private message me. I wish you the very best on your healing journey.