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Suggest Treatment For Anal Fissure
My 19 year old son has an anal fissure diagnosed by a colorectal surgeon. He was given cream with diltiazem and lidocaine and the pain is better, but he is having severe constipation. He had hard stools, not really constipation (he went about every day), which caused the fissure, but now is having severe constipation (only small amounts of stool over the last 5 days despite eating a regular diet that includes a ton a fiber, probiotics and prune juice). He was taking miralax, but it didn t seem to help, so he tried dulcolax which has not helped either. He also is having difficulty urinating and it hurts his bladder to pee, but his pee is clear when he does pee....His Dr says the 2 are not related and he probably has a UTI, but he has no other symptoms of a UTI....He says he just can t push to poop or pee....Any ideas??? Also, they did a CT scan when he went to the ER initially for the fissure and it didn t show any masses or anything. He is drinking water, but not 8 glasses/day like I told him to..
Mon, 3 Jul 2017
Hello Dear. Your son needs to follow some home remedies. Most short-term anal fissures can heal with home treatment in 4 to 6 weeks. Pain during bowel movements usually goes away within a couple of days after the start of home treatment.
There are several steps your son can take to relieve symptoms and help the fissure heal:
1. Try to prevent constipation. For example: Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fiber.
2. Drink plenty of fluids.
3. Get some exercise every day- half an hour per day
4. Take a fiber supplement, such as Citrucel or Metamucil, every day if needed. Read and follow all instructions on the label.
5. Schedule time each day for a bowel movement. Take your time. Don't strain.
6. Try taking stool softeners or laxatives to make bowel movements less painful. Ask your doctor how long you should take laxatives.
7. Sit in a tub filled with a few inches of warm water for 20 minutes, 2 or 3 times a day. This is called a sitz bath. It soothes the torn tissue and helps relax the internal anal sphincter.
8. Talk with your doctor about whether to try a nonprescription cream such as zinc oxide, Preparation H, Anusol, or 1% hydrocortisone for a short time. These may help soothe anal tissues. But fiber and sitz baths help symptoms more.
9. Instead of using toilet paper, use baby wipes or medicated pads, such as Tucks pads or Preparation H wipes, to clean after a bowel movement.
10. Don't avoid having bowel movements. Knowing that it might hurt may make you anxious. But trying not to have bowel movements will only make constipation worse and keep the fissure open and painful.
11. If a fissure lasts more than 8 to 12 weeks, you may need prescription medicines. These may include nitroglycerin cream, or injections of botulinum toxin (Botox).
12. If medicines don't stop your symptoms, you may need to consider surgery. The most commonly used surgery is lateral internal sphincterotomy. In this procedure, a doctor cuts into part of the internal sphincter to relax the spasm that is causing the fissure.
Hope i have answered your question. Feel free to contact me if you have any more questions. I ll be glad to help you.
All the best
With warm regards
Dr Sanjay Kini
There are several steps your son can take to relieve symptoms and help the fissure heal:
1. Try to prevent constipation. For example: Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fiber.
2. Drink plenty of fluids.
3. Get some exercise every day- half an hour per day
4. Take a fiber supplement, such as Citrucel or Metamucil, every day if needed. Read and follow all instructions on the label.
5. Schedule time each day for a bowel movement. Take your time. Don't strain.
6. Try taking stool softeners or laxatives to make bowel movements less painful. Ask your doctor how long you should take laxatives.
7. Sit in a tub filled with a few inches of warm water for 20 minutes, 2 or 3 times a day. This is called a sitz bath. It soothes the torn tissue and helps relax the internal anal sphincter.
8. Talk with your doctor about whether to try a nonprescription cream such as zinc oxide, Preparation H, Anusol, or 1% hydrocortisone for a short time. These may help soothe anal tissues. But fiber and sitz baths help symptoms more.
9. Instead of using toilet paper, use baby wipes or medicated pads, such as Tucks pads or Preparation H wipes, to clean after a bowel movement.
10. Don't avoid having bowel movements. Knowing that it might hurt may make you anxious. But trying not to have bowel movements will only make constipation worse and keep the fissure open and painful.
11. If a fissure lasts more than 8 to 12 weeks, you may need prescription medicines. These may include nitroglycerin cream, or injections of botulinum toxin (Botox).
12. If medicines don't stop your symptoms, you may need to consider surgery. The most commonly used surgery is lateral internal sphincterotomy. In this procedure, a doctor cuts into part of the internal sphincter to relax the spasm that is causing the fissure.
Hope i have answered your question. Feel free to contact me if you have any more questions. I ll be glad to help you.
All the best
With warm regards
Dr Sanjay Kini
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