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Anal fissures causing severe cramps, no bms or gases :((((((

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Posted 3/5/2013 9:53 AM (GMT 0)
For more than 8 months now, my rectum has given me real hard time. Last week, I started to have severe abdominal cramps which normal antispasmodics and NSAID injections could not put under control. When I saw my GI, he suggested that the anal fissures could be causing spasm and that's the reason and I have to see the colorectal surgeon. The surgeon asked me to fast and prepare myself for a proctoscope and warned that it might hurt coz of the fissures.
I saw the surgeon but he could not perform the scope as I had new, deep and long fissures that were really painful. These fissures never heal. He insisted I increase the compounded cream which contains GTN (glyceril trinitrtate) to 4 times/day and take Cipro.
The surgeon said that the fissures were causing spasm which made my rectum closed though I still do have my diarrhea. It's a real torture. My intestines and colon keep cramping as I need to have a bm but my rectum is closed and can neither have a bm nor pass gas out.
Has anyone experienced this before? I'll see my GI but is there a different med that can be prescribed? The surgeon told me that Crohn's could be causing these recurrent fissures. When cramps increase, it's a real torture.
BTW, I discovered that I always mistook intestines for colon and my intestines have never become better even after taking Entocort. I thought mistakenly that the ileum was low and that the colon was on the same line w the navel. The GP told me that it is the opposite.
Any advice will be highly appreciated.
Posted 3/5/2013 12:33 PM (GMT 0)
Forgot to mention that the surgeon told me that it is an impossibility that I can have a surgery since it could entail the risk of fecal incontinence.
Posted 3/6/2013 9:50 PM (GMT 0)

I have to say that unfortunately I know what you are going through.  I had anal fissures for about 2 years back in 1997-1998.  I was not actually diagnosed with Crohns until I had a major flare-up in 2002.  Anyway, life at the time that I had the fissures was terrible and very painful every day.  They just would not heal.  Every time I had to go to the bathroom, they would rip open again and there was always a lot of blood.  My doctor suggested a new procedure at that time called a sphincterotomy.  The way that he explained it to me was that because of the pain, I was not letting my butt muscles relax during a bowel movement and that is what was causing it not to heal.  So the operation would make a small up in the sphincter muscle with would allow the fissure time to heal and then the muscle would heal.  He said that the success rate was about 80% but at that time I would have tried anything to stop the daily pain.  So they did the operation which was an epidural and my butt in the air for an hour which was embarrassing.  After that, the healing started and within 2 months I had no more pain and the fissures healed all except for the scar tissue.  Since then, I have had no problems with fissures and I still have full control over my bowels.  I wish you the best.

Posted 3/6/2013 10:47 PM (GMT 0)

minnietoty said...
Forgot to mention that the surgeon told me that it is an impossibility that I can have a surgery since it could entail the risk of fecal incontinence.

But what type of surgery? I definitely would not take that opinion at face value. I know I've mentioned her before, but Christine1946 had a panproctocolectomy two years ago to treat intractable ulcerative proctitis. Her GI was utterly against surgery, despite none of the meds working. Eventually she changed her GI, got surgery, and hasn't looked back since. But there's other forms of surgery too, such as the sphincterotomy that Duane mentioned.

It's rarer for a surgeon to be against surgery than a GI, that's for sure, but some doctors can be extremely resistant to surgery. Almost like they take it personally when the meds fail. Anyway, I would want at least three colorectal surgeons to say the same thing before I'd be satisfied that surgery is an impossibility in your case.

I just don't see how you can carry on like this indefinitely - you deserve a better quality of life than this =/

Re intestines and colon. Yeah, the colon is higher than the navel. The horizontal part - called the transverse colon - lies just beneath your ribs, so really is quite high up. The terminal ileum is in the lower right corner of your stomach, hence why so many Crohnies feel pain in that area. Easiest to understand if you look at pictures of the intestines, really <_<.
Posted 3/7/2013 12:41 AM (GMT 0)
I totally understand your apprehension to any kind of procedure unless several doctors have given same prognosis. My son has Crohns, since he was 16. However, we found out only 3 years ago. He had constant bleeding, much pain and no one could tell us what the problem was. He had several fissures that opened all the time. Our doctors kept sending us to dermatologists because they thought it was a skin thing. They couldn't find out the problem until our GP finally sent us to another gastroenterologist. Finally, we were told that he has Crohns. The first thing he did was send us to UCI for the Comprehensive Digestive Disease Center where a team of doctors told us how badly my son was doing, and overwhelmed us with all kinds of disease outcomes and possible treatment plans. My son was 20 at the time. We didn't know how badly he was hurting. We didn't know anything because he was embarrassed about it. The pain you described is how he felt. We were so out of the loop because we trusted doctors that we thought knew what they were doing. Wrong. Get second, third opinions and don't stop till you find someone that will give you answers.

One thing that the doctors at UCI did for my son immediately (surgery - 3 months later) was to place sitons in his fistulas. Sitons are plastic wires that keep the fistulas opened so that they don't build up and cause pain, infection and more problems. They helped alot, but my son has constant leakage or discharge. He has it still after 3 years. It is very uncomfortable for him, not to mention embarrassing. He was also on remicaide for the last 2 years. However, his body has become allergic to it and rejected it. Now the doctor placed him on Humira. He's only had 1 shot. Today was his colonoscopy. It showed inflamation in the colon and stricture of the ic valve. I don't know what this means, but it can't be good.

For all of you that are living with this disease, I applaud your efforts in staying sane and uplifted. I don't know how you do it. I don't know how my son is dealing. He refuses to join any blog. Wish you all the best. If you have any details, explanations or feedback for the info I posted, please let me know.
Posted 3/7/2013 1:52 PM (GMT 0)
Dear all, thank you very much.
An update. My GI put me on Imuran again and upped Entocort to 9mg. Cipro caused me stomach bleeding for the first time :(
@ Duane71. Glad that the operation worked w you then though the success rate was 80% and I applaud your courage to do this. Well, more than 3 surgeons told me that I can might fecal incontinence if I undergo either fissureoctomy or sphincetrotomy. They say that Crohn's is an contraindication to this.
@ NCOT. Hope you are feeling better now. As I told Dunane, they are all against the surgery and their excuse is their fear of my getting fecal incontinence though I've read that it is one of the solution in the case of nonhealing fissures. Agree w you regarding quality of life which my GI does not consider.
@ Pupa 70. You are a brave mother. Hats off to you and every mother, including my mum, who cares that much and empathizes w their sick children. I'm really relating to your son and hope that he feels better soon. I don't have strictures in the ic (ileocecal valve). Don't worry, hopefully, it turns out to be put under control. Why don't you start a new thread w your son's problem so that others who have the same problem can give you their feedback and advice?
Posted 3/8/2013 1:50 AM (GMT 0)
Thank you very much Minnietoty.

I'm not sure how to do this because this is my first time on a blog or thread. I also have to do this when my son is not here because he is so embarrassed by the disease. He doesn't want anyone knowing what he has.
My concern is that he assumes that doctors are right about everything, doesn't do any research on his own, and just expects things to get better. My problem is that I know doctors aren't always right; I know that medicines can do more wrong than right, sometimes, and that there isn't always a quick fix. I feel that diet is important and shouldn't be considered lightly. I am trying to make foods that are Crohns friendly, but he wants to eat out all the time. So, I just don't know what to do. I will support him as long as I can and hope for the best. I want to be more positive so that he feels better about himself, but it is difficult. The more I read and do research, the more nervous I become.

I've read that poop therapy could help some people. I've also read that getting off gluten, caffeine, dairy, sugar, and alcohol on a full-time basis will definitely help as well. I read that stem cells can help with fissures but the only country that does it is Spain. I've also read that some kind of oxygen therapy may help some people. The problem with all these treatments is that they are costly and may or may not be of help.

My dear Minnietoty, I don't know how old you are because this disease affects young and old alike. I applaud you for all that you are doing for your well-being. I am sure that you have become very knowledgeable in this whole topic area and can teach even doctors new tricks. My son is 23. He has Aspergers as well as Crohns. His social skills are somewhat lacking, but I am awed by friends he has kept over the years. When he is not going to school or working, he sits in his room and listens to music, plays video games, watches T.V. and is on the computer. Most of the time, he doesn't socialize with us. Both my husband and I maintain a good family life and we try to eat dinner together. However, he is not always home because he works. I am happy that he can work and not be so isolated, but I wish that he can become more involved with his own healing. Please forgive me if I sound like I'm venting. I probably am. I only hope that he joins up and talks with people experiencing the same problems. Thank you for your help. God bless you.
Posted 3/8/2013 1:21 PM (GMT 0)
Pupa, thank you very much. I'm really flattered. I'm 35 1/2 years old and I started my disease 6 years ago. I have a history of GERD (Gastroesophageal Reflux Disease) for 14 years. Joining this forum helped me a lot esp when I found that it's not me alone who is suffering from these strange symptoms. No member of my family or friends can relate.
You have the right to vent and we are all here to support each other and this what has helped me in days when I was very desperate and no one did empathize even my doctor.
You can start a new post by clicking on the Post New Topic on the upper left hand of this page. Viola here you are and you can post whatever you want.
Your son is still young and like all people in his age he likes eating out and won't listen to pieces of advice. Why don't you while you are sitting w him tell him about your new Crohnie friends (we here at this forum) and tell him that you read about something OR you could ask him to help you out w posting a new topic and may be when he accesses it and sees that problems like his are discussed here, he might become interested. It's not easy to convince a person of his age to join a forum that discusses his disease, his problem, in a direct way. He wants to live, enjoy his friends and act like his friends w/o being indulged in a disease that is esp. chronic. I'm very glad that he goes to work as working helps one overcome the pain. When I stay at home, pain rises but when I go to work, I get absorbed in work and forget temporarily about pain.
I remember when I started having pain and diarrhea and I could not find any other person whom I knew that had the same problem, I was shocked. Normally, a person who gets a chronic disease goes through 3 phases, as far I know: the first one is the shock, the second be resenting and denial and the last would be coping w the disease and accepting it. I know people who suffer from severer chronic diseases who never passed the second stage. One has to try to adapt.
In my case, I owe a lot, to a friend and she used to be my boss who got breast cancer but could bravely deal w it and acted as if nothing has happened to her. She encouraged me to bear pain and accept whatever complications I go through.
Hope I have answered your queries.
Wishing your son best of luck and you are mostly welcome to vent or ask whatever questions you like and I again ask you to send your questions to the whole forum so that ou can benefit more.
{{{Hugs}}}
Posted 3/8/2013 3:51 PM (GMT 0)
@minnie - Hmm. So at least 3, maybe more, colorectal surgeons have said surgery is not suitable for you? Something is not adding up for me, but I'm not sure what :-/ Normally when three doctors agree on something, I'd go along with it. But I'm just not buying the risk of faecal incontinence as a reason not to operate. I'm not saying that there is no risk at all, but at some point you've got to weigh up remote risks against quality of life. I'm thinking your doctors aren't doing that. You're now left with basically three options: 1) seek yet another opinion, 2) persuade your current surgeon(s) to perform surgery or 3) do nothing except take yet more useless meds.

Meanwhile, I don't know how you are with Dr. Google, but doing some research on operations for perianal Crohn's disease seems like a good idea. I can help out with that if you like. It would be nice to have some idea of the success rates, incidences of post-op complications, etc.

In a rush now (gotta get to the pharmacy before it shuts :-/), but I wish you and your son the best of luck as well, pupa70.
Posted 3/9/2013 1:11 AM (GMT 0)
Thank you, both of you. I feel I can talk to you both about my son. Minnie, I'm sure it had been difficult for you, and you are probably still having some difficulties now, but know that my heart goes out to you, NiceCupofTea and anyone out there with the same problems. I see my son and his ailments and my heart hurts. I wish I could have done something different to prevent it, if I could have. I've have had 6 children and lost one due to prematurity. I couldn't prevent what happened any more than I can prevent my son from having pain. However, I will do more research until I find something valuable, to help him. Just by talking to you both I have learned a tremendous amount of useful information. The cherry on top is about me getting to know beautiful people such as yourself. My heart goes out to you both, and thank you for the information. I will try the New topic. By the way, although my son hates the sitons, they have helped alot in reducing the pain from the fistulas. He had surgery to put them in because they went through all the fissures, and unfortunately, he had many .Have you heard of this? Perhaps it could help you with these problems as well. Hope it helps. Thank you again. Hugs.
Posted 3/9/2013 9:21 PM (GMT 0)
    Hello everyone, I have been living with fissures, diarrhoea, weight loss, poor appetite, hemorrhoids, explosive bm etc. for nearly 3 years.  Every doctor that I visit is overwhelmed with my case.  Diagnosed with a terminal rare cancer since March of 2008.  Suffered with it for more than 10 years before it was discovered.  It is a long story and receiving on-going treatment. 

     However, my pain and suffering from cancer is not the problem.  My gastroenterologist said i had a fissure back in 2010 and suggested I see a surgeon.  I did and had surgery to remove hemorrhoids, repair a fissure and surprised to find out that a cyst was removed as well.  That was in August of that year and the hemorrhoids came back and I developed another fissure in 8 to 9 months.  The next year the fissure healed and the hems were gone with natural remedies like sitz baths, increased fiber and some topicals.

     But now because of my newly developed intolerance for sugars, vegetables, wheat(to name a few ), I have constant diarrhoea and or constipation which aggrevates the hemorrhoids and fissure.  As you all well know, these conditions can be overbearing.  I have not driven my vehicle in months.  I feel as if all of my freedom has been taken away from me.  Holidays have come and gone.  I don'know what it is like to enjoy life anymore.

     It's time to close now because I don't want to have an on-line pity party.

     If anyone have any thoughts about my situation please feel free to express them.  What I have written is just part of my story.  Everything that I have read on this forum is so touching and informative.           
Posted 3/10/2013 4:41 PM (GMT 0)
Dear all, thank you very much.
@ NCOT. Not all people are brave like you - lol. I don't mind undergoing a surgery if it will make my fissures heal. The problem is that whenever I read about sphintercotomy, they mention that crohn's is a contraindication. I really appreciate your desire to give me a hand.
@ Pupa. God bless you and bless your children. You should not torment yourself coz your son is sick. You remind me of my mum. She is always sad that I am suffering and I try as hard as possible to hide it. You are not the cause; it's his fate. He will bravely face it. All you can do is help him and that's what you are doing. Not all mothers are like you. You are a special mother.
@ Sympathy. My heart goes out to you. You should not apologize for venting- vent. We are all hear to support each other and welcome to HW.
I too haven't driven my car for months but try to go out w friends even if I'm just going to drink water while they are having a banquet. We got used to this. Don't imprison yourself in the disease. If you feel that your disease is overwhelming and you can't cope w it, why don't you see a psychiatrist. I did that 2 weeks ago as I was very depressed. He talked w me and prescribed me 2 meds: an antidepressant (can't remember the name) and Xanax. The former made me drowsy all day and he told me that I need to drink coffee to keep awake; the latter makes me sleep soundly at night, so I chose it. I think it elevated my mood and I can cope. I have been bedridden now as my esophagus keeps bleeding and it hurts for more than 5 days and have to continue for another week and I try to amuse myself by watching movies and browsing the net. The person speaking to you is not that optimistic and I have had episodes of severe depression but I'm trying hard to pull myself out of this. Give it a try, you won't lose anything. Hope you feel better soon. Make us posted of how you are doing. {{{Hugs}}}
Posted 3/11/2013 11:25 PM (GMT 0)
Hugs...I know how you feel. Thank you for sharing your concern and positive outlook to others even though you suffer yourself.

I have experienced the same closed off feeling in the past. I'm presently trying to heal a fissure. This time it is a little different, it isn't closed off. First came acute diarrhea (the pouring kind several times a day and in the night as well) Then it felt like I was pouring out glass during bowel movements. Then followed with a constant urgency, itch and constant spasms of expelling of gas, which wouldn't stop, it was embarrassing and kept me away from others, I couldn't go anywhere.. I could no longer wipe with toilet paper, I had to blot and use a wet cloth as it was too painful and swollen, moving my bowels was extremely painful. What I didn't try for my sore butt, antibiotic, fungal cream, vit E, witch hazel, penaten cream, emu oil and more, with little to no relief, but the one thing that did help was a simple on line suggestion and that was to pack the area with Vaseline, and even insert a little inside the rectum as well before a a bowel movement. (careful not to scrape or tear any healing that started) I did before and after. Finally it's starting to heal. The diarrhea is still the pouring kind but that is minimized by about 20% which is better than before. The fissure pain is getting much better. This fissure is more to the side of the rectum this time. Is yours an internal fissure or both?
I think most doctors would subsribe what you are already taking. Don't think there is another med, but I could be wrong. If a fissure continues after everything has been tried, surgery is recommended. Since I've never had fissure surgery I can't advise, but read that it is a relief over the previous symptoms one can experience. However, they don't mention the effect it would have on someone with crohn's. Hope you feel better and it heals up for you soon, so you won't need to take this step.
Posted 3/12/2013 11:58 PM (GMT 0)
Dorri, thank you very much. Well, today I saw the surgeon and he informed me that my fissures got healed w a 50 %, which made my day. I'm now suffering from the bleeding of the esophagus and will undergo an upper endoscopy in the morning.
The surgeon told me to continue his compounded cream. As far as I remember it consists of GTN and xylocaine. Thanks God it's working.
He mentioned that the length of the fissure is 8mm immediately after the anal sphincter then I have a stricture w a length of 3.5 or 4 cm. Does this mean an internal fissure? I don't know. Today, when the surgeon was examining me digitally, I felt that he could not insert his finger further. Still I'm glad that there is hope that the fissures might heal esp. after I developed this esophageal bleeding after taking only 4 caps of Cipro. He also mentioned that this means I won't be able to take any Cipro derivatives or quinlones anymore in addition that flagyl and all metronidazole derivatives irritate my stomach severely.
Hope you feel better, too:)
{{{Hugs}}}
Posted 3/13/2013 6:39 PM (GMT 0)
A stricture is scar tissue (An abnormal narrowing of a duct or passage) and does not go away on its own. That in itself could be causing your pain if waste cannot move through that area.

Good luck in the morning!
Posted 3/13/2013 10:17 PM (GMT 0)
Equestrian Mom, thank you very much. My GI told me too that the fissures got healed coz I'm not using enemas these days. He seconded the surgeon that I have to postpone taking them till next week to give the fissures the chance to heal more.
The scope went on fine and it revealed gastroduodenitis.
Posted 3/14/2013 2:31 AM (GMT 0)
It could be that he was referring to the inflammation causing the narrowing. You could have existing strictures and any further inflammation may make things worse. TG that you got a positive report on your fissures. Hope everything heals up completely for you.
Posted 3/14/2013 4:37 PM (GMT 0)
Dorri, thank you very much. I really appreciate it :)
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