Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Remedy For Severe Constipation While Treating Anal Fissures
Question: Hi,
I suffering from anal fissures from October 20, 2015. Initially i had applied "oxerute cream"on it (both internally and external in anal area)but it was of not any help instead the muscles of anal area had started to pain more so i had stopped using that.After that i had applied "annovate" cream even that was not useful. After that i had consulted a doctor in medanata the medicity, XXXXXXX and done the colonoscopy and there were fissures at 6'0 clock according to the report(I have pain in both of my anal sides). The doctor had prescribed me following:
1. Antibiotics and Inflamatory pain killer for 5 days twice a day.
2. Anesthesia cream to be applied before Defacation.
3. Sitz baths with potassium permagnate
4. Crema gel for the relaxation of the muscles.
5. Lactihep syrup to make stool watery
6. High Fiber diet
After 1 month of medication there is only about 20 percent improvement but the main factor for the improvement is Stool size. The stool even after having the lactihep syrup is thick in size that is why the fissure gets ruptured. This thing i can tell you because whenever i get thick stool their is unbearable pain and blood on the stool. And whenever i am about to defecate the stool hits the fissure area and my brain sense that so it contracts the anal muscle and i also try with my hands to push my both hips together so that thick stool can be braked into smaller parts so that it is easier for it to pass without much stain on anal muscles. But since stool is not coming out at one time so that's why i had to go to defecate multiple times through out the day and there is always stool in my rectum which makes me uneasy whole day.
Please suggest something as i am refraining from the option of Surgery.
I suffering from anal fissures from October 20, 2015. Initially i had applied "oxerute cream"on it (both internally and external in anal area)but it was of not any help instead the muscles of anal area had started to pain more so i had stopped using that.After that i had applied "annovate" cream even that was not useful. After that i had consulted a doctor in medanata the medicity, XXXXXXX and done the colonoscopy and there were fissures at 6'0 clock according to the report(I have pain in both of my anal sides). The doctor had prescribed me following:
1. Antibiotics and Inflamatory pain killer for 5 days twice a day.
2. Anesthesia cream to be applied before Defacation.
3. Sitz baths with potassium permagnate
4. Crema gel for the relaxation of the muscles.
5. Lactihep syrup to make stool watery
6. High Fiber diet
After 1 month of medication there is only about 20 percent improvement but the main factor for the improvement is Stool size. The stool even after having the lactihep syrup is thick in size that is why the fissure gets ruptured. This thing i can tell you because whenever i get thick stool their is unbearable pain and blood on the stool. And whenever i am about to defecate the stool hits the fissure area and my brain sense that so it contracts the anal muscle and i also try with my hands to push my both hips together so that thick stool can be braked into smaller parts so that it is easier for it to pass without much stain on anal muscles. But since stool is not coming out at one time so that's why i had to go to defecate multiple times through out the day and there is always stool in my rectum which makes me uneasy whole day.
Please suggest something as i am refraining from the option of Surgery.
Brief Answer:
Liquid Cremaffin Plus, relaxation, diet you know- gives you softer stool.
Detailed Answer:
Hi.
Thanks for your query and an elucidate history and the understanding of the fissure that you have.
You are very correct in saying that it is the hard stool that is causing the persistence of the anal fissure.
This is an indication that you need a stool softener.
You can try the following as Lactihep is not helping you.
- Liq Cremaffin Plus. Start with 2 tsf at bedtime with water. See the effect next morning. If not effective you can increase to 3 tsf. And if too much effective reduce the dose the one or one and half tsf.
This means the dosage be adjusted as per your requirement.
- Avoid all such foods and beverages that you must have observed to cause you the constipation.
- Add more of those foods that helps to soften the stool. Like Ladies fingers (Bhindi), You can eat this raw after cleaning to be more effective. Try to remember all such foods that helped you in the past.
- One of the unseen and less talked about reason is the amount of the stress and or anxiety.
- You can have Sitz bath just before passing motion, after passing motion and once you go hone in the evening.
- Try to learn and practice to relax the anal sphincter at the time of passing motion. This is an effort that you have to do consciously. Do not rush through or strain much while passing motion.
I am sure these things will help you. Start doing these from now- today and please give me the feedback.
Liquid Cremaffin Plus, relaxation, diet you know- gives you softer stool.
Detailed Answer:
Hi.
Thanks for your query and an elucidate history and the understanding of the fissure that you have.
You are very correct in saying that it is the hard stool that is causing the persistence of the anal fissure.
This is an indication that you need a stool softener.
You can try the following as Lactihep is not helping you.
- Liq Cremaffin Plus. Start with 2 tsf at bedtime with water. See the effect next morning. If not effective you can increase to 3 tsf. And if too much effective reduce the dose the one or one and half tsf.
This means the dosage be adjusted as per your requirement.
- Avoid all such foods and beverages that you must have observed to cause you the constipation.
- Add more of those foods that helps to soften the stool. Like Ladies fingers (Bhindi), You can eat this raw after cleaning to be more effective. Try to remember all such foods that helped you in the past.
- One of the unseen and less talked about reason is the amount of the stress and or anxiety.
- You can have Sitz bath just before passing motion, after passing motion and once you go hone in the evening.
- Try to learn and practice to relax the anal sphincter at the time of passing motion. This is an effort that you have to do consciously. Do not rush through or strain much while passing motion.
I am sure these things will help you. Start doing these from now- today and please give me the feedback.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi,
Thanks for your answer. I have some queries for you.
1.) I am not able to see fissure in the colonoscopy report i have attached here. Can you tell where is the fissure in the Picture.
2.) I want to confirm that it is only fissure and not something else. Please suggest some test.
3.) Last time when i had colonoscopy it had made my fissure more verse. Pain
was more after i went through colonoscopy. Can you suggest something else
as i want to get my colon examine again.
4.) If i consider the option of "Lateral internal sphincterotomy" surgery.
4.1) How much will it take to heal fissure
4.2) How much time will it take for healing of cut made in internal anal
sphincter
4.3) How much painful will it be during defecation and till when pain last
after operation.
4.4) Side effects of the surgery.
5.) I have seen the option of BOTOX injections for fissure. I want to know how much safe they are and there effectiveness.
Thanks for your answer. I have some queries for you.
1.) I am not able to see fissure in the colonoscopy report i have attached here. Can you tell where is the fissure in the Picture.
2.) I want to confirm that it is only fissure and not something else. Please suggest some test.
3.) Last time when i had colonoscopy it had made my fissure more verse. Pain
was more after i went through colonoscopy. Can you suggest something else
as i want to get my colon examine again.
4.) If i consider the option of "Lateral internal sphincterotomy" surgery.
4.1) How much will it take to heal fissure
4.2) How much time will it take for healing of cut made in internal anal
sphincter
4.3) How much painful will it be during defecation and till when pain last
after operation.
4.4) Side effects of the surgery.
5.) I have seen the option of BOTOX injections for fissure. I want to know how much safe they are and there effectiveness.
Brief Answer:
As mentioned .
Detailed Answer:
Here are the answers for your queries:
1. The picture is a single frame of the interior of large bowel. The report specifically mentions Anal Fissure at 6 o'clock position.
2. The test done is sufficient and you do not need any other tests other than full colonoscopy which you had already in the past.
3. You can ask for CT scan of the abdomen with virtual colonoscopy done by CT scan wherein only air is insuflated in the colon, this will be painless or has minimal pain as you have a fissure present already.
4. "Lateral internal sphincterotomy''
4.1 It usually takes about 1-3 week for healing if the fissure if you follow the instructions properly.
4.2 healing of the internal cut may take about a week.
4.3 the results are usually seen immediately after surgery as the resistance is reduced immediately by having the surgery. Hence the pain during defecation the next day will be reduced to a large extent. The pain pain may last for 3 t 7 days after surgery.
Side effects: Usually not seen. Occasionally hematoma formation.
5. Botox injection is not a widely practiced thing for fissure, please discuss ths with your treating Surgeon.
All the above points depend many factors and hence the are suggestive as per my experience. It is more important that you discus further with your Surgeon.
I hope these answers your queries.
As mentioned .
Detailed Answer:
Here are the answers for your queries:
1. The picture is a single frame of the interior of large bowel. The report specifically mentions Anal Fissure at 6 o'clock position.
2. The test done is sufficient and you do not need any other tests other than full colonoscopy which you had already in the past.
3. You can ask for CT scan of the abdomen with virtual colonoscopy done by CT scan wherein only air is insuflated in the colon, this will be painless or has minimal pain as you have a fissure present already.
4. "Lateral internal sphincterotomy''
4.1 It usually takes about 1-3 week for healing if the fissure if you follow the instructions properly.
4.2 healing of the internal cut may take about a week.
4.3 the results are usually seen immediately after surgery as the resistance is reduced immediately by having the surgery. Hence the pain during defecation the next day will be reduced to a large extent. The pain pain may last for 3 t 7 days after surgery.
Side effects: Usually not seen. Occasionally hematoma formation.
5. Botox injection is not a widely practiced thing for fissure, please discuss ths with your treating Surgeon.
All the above points depend many factors and hence the are suggestive as per my experience. It is more important that you discus further with your Surgeon.
I hope these answers your queries.
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
