Suggest Treatment For Severe Anal Pain While Suffering From Anal Fissure

Posted on Thu, 18 May 2017

Question: I had Anal fissure in April 16 due to hard stool and since then I have been facing occasional pain in my anus. But the pain didnt heal completely .Fissure didn't heal completely. My Bowl movement seems to be normal and some time the initial stool appeared hard. I use Sucral Ano cream. I still use Cremafin plus and Lactifiber for more than a year and any harm in that.Shall I continue .I heard that a fissure will take 1 to 2 months to heal What should be the reason for this delay in healing fissure . How to heal my fissure permanently. Still how long I need to wait for my fissure to heal 100%.

Answered by Dr. Dr Manjunath Metri (59 minutes later)

Brief Answer:
Do not worry, anal fissure most oftenly heals well..

Detailed Answer:
Hello, XXXXXXX
I am really sorry to hear this but do not worry..
I thank you for posting your query here..
Welcome to HCM..

I am Dr Manjunath..
I read your question completely and have understood it well enough..

Please note the following few facts XXXXXXX .

1. Anal fissure is a really disturbing problem, and most of the times it will heal well provided we give time and necessary help for it to heal..

2. Need few other details
Does it pain even now?
Because, sigmoidoscopy that you mentioned in history should not be done in a case of fissure.

3. 41 years is not that bad for you to suffer from fissure.
Because I understand if it was old patient, for them to avoid constipation would be a tough job.
But for you, it should not be a problem.

4. Basically you have to avoid constipation. That is most important for healing of a fissure.
This is achieved by
A. Drinking lot of water
B. Eating Fibre rich food, vegetables and fruits.
C. Avoid or reduce non veg if consuming.
D. And use stool softeners that you are already using.
I am sure you would have followed all these..

5. We see a lot of such cases where fissure won't heal with all these conservative methods.
One year is a long time.
I agree with you that, generally fissures should heal in 3 to maximum 6 months of time.

6. In such cases, we go for surgical procedures.
It's called lateral internal sphinterotomy.
This effectively heals the fissure..

7. And I suggest you to stop, cremaffin. One year Is a long time.
But you can continue using local applications for pain as prescribed by your doctor.

Hope I've answered all your points..
In case you need further assistance, please let me know..
Take care, happy recovery..

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Dr Manjunath Metri (1 hour later)

Thanks for the reply doctor.
Fissure pain is very minimal and 98% of the time not noticeable. Still do you recommend for LIS surgery ? or May I wait for few more months

As suggested I shall stop cremafin plus but can I continue with Lactifibre

Please suggest a best/very effective anal cream , currently im using Sucral ano

Answered by Dr. Dr Manjunath Metri (6 minutes later)

Brief Answer:
You can wait for surgery

Detailed Answer:
Hello XXXXXXX I thank you for getting back with your doubts..

Please note these following things..

1. If pain is minimal, then no need for surgery.
See, decision for surgical intervention is based on patient's response rather than the disease most of the times.

2. Yes, I suggest you to wait and see how you improve..

3. I suggest you to stop lactifibre too if you are using for more than a year.
Please use natural methods of avoiding constipation.
As I've already described.

4. Local application also, please use only if you have severe pain.
You can use that same or go for SMUTH gel. Anything will do..

Hope I've cleared all your doubts..
In case you are satisfied with the answer, kindly close and rate or you can ask any other doubts.
Take care..

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Above answer was peer-reviewed by : Dr. Vaishalee Punj