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Treatment for anal fissures - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: Men Sexual Problems
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
Doctor :   hi
Doctor :   HI how can i help you
User :   hi sorry
User :  
I did not see that you responded
Doctor :   how can i help you
User :  
yes, I have been diagnosed today with a condition that I feel is severe and was worried about getting
Doctor :  
what is that
User :  
about 9 months ago I developed an anal fissure
User :  
which healed and then retore open
User :  
then healed and retore open
User :  
for a while
Doctor :   k
User :  
so then after having abdominal pain I had a simoidoscopy done
User :  
after that the fissure tore back open again but more severe pain
User :  
so I began nitroglycerin treatment
User :  
which is a more aggresive treatment for fissures than what I tried before
Doctor :  
k
User :  
and it seems to be healing better this time
User :  
both based on symptoms and doctor exams
Doctor :  
k
User :  
but for the past month or so I've been noticing a lump after bowel movements
User :  
but it was going away after those movements
Doctor :  
k
User :  
I mentioned this each time I had a fissure exam
Doctor :   k

User :  
and the doctors say they see nothing to worry about and no abnormal lumps
User :   then on this Saturday I noticed the lump was bigger, not dissappearing and painfull

Doctor :  
k
User :   so I did some research online and thought it looked like a thrombosed external hemmorhoid / pile with a blood clot

User :   I went to the Doctor today and she confirmed my self diagnosis is correct

Doctor :  
k
User :  
she said the fissure still seems to be healing
Doctor :  
k
User :  
but I did not like the prognosis for the external thrombosis
User :  
she said she could surgically drain it in the office, but it would cause spincter spasm from the pain
Doctor :  
k
User :   this in turn could redamage the fissure

User :   so she said I could wait and let the clot self resolve in 4-6 days

Doctor :  
k
User :  
but I asked if this would lead to total relief or if I would still get a lump after bowel moves
User :  
she said I would likely still get a lump after bowel moves
User :  
which I don't like
Doctor :  
k
User :  
I also asked if the thrombosis could come back
User :  
and she said very possible
User :  
she said the only way to prevent it from comming back is surgery to remove the entire vein
Doctor :  
k
User :   but that I would have to wait 2 months for the fissure to completely heal then have it examined again, then surgery then a long recovery period of several weeks after that

User :   so this would mean about 4 months of more suffering for me if I added it all together

Doctor :  
k
User :   and I have already been suffering for a while now

User :  
and had made lots of plans for summre
User :  
summer
User :  
are there any other options I can consider?
User :   my goal is complete recovery like this never happened, fast recovery and prevention of recurence
Doctor :  
sure we will help you with this
User :  
thank you
Doctor :  
your age and name
User :  
25y/male
Doctor :  
k
User :  
also, if recovery will take this long I will need to exit my job
Doctor :  
as it is told it can be reduced with medications but it may reappear again
Doctor :  
best option is go for surgery only
User :  
It sounds like surgery will be the only permanent solution so I expect this
User :  
my concern is that I need to wait 2 months then 4-6 weeks of painfull recovery after that
User :   maybe even longer from what I've read

Doctor :  
ya there is no other way
Doctor :  
we can't help know
User :  
are you familiar with the risks of the surgery?
User :  
can these lead to incontinence?
User :  
or permanent scaring?
User :  
numbness?
User :  
more fissures?
Doctor :  
ya sure we will tell you
User :  
ok
Doctor :  
common are it can lead to splincter functional disabilities
Doctor :  
and scarring
User :  
sphincter disabilities?
User :  
for how long?
User :  
4-6 weeks?
Doctor :  
we can't say it may recover within 2 days to months
Doctor :  
can't really say
User :   wow, this is a really terrible condition, I have no idea how this came about

User :   I have friends that had brain cancer and were cured with surgery in 3-4 weeks
User :   No I will need to leave my job for 4 months of treatment

User :  
ok, one final related question
Doctor :  
brain cancer is not cured
Doctor :  
it can only be prevented
Doctor :  
frrom progressing
User :  
they had an operation that removed all cancer tissue, it was a less severe case
Doctor :  
k
User :   but in any case my last question is that after starting the nitroglycerin treament for the fissure

User :   I noticed my stools were green and sometimes 5 times a day

User :   sometimes once every 2 days

User :  
but still green
Doctor :  
it can be due to the wall or splincter hypersensitivity
Doctor :  
it will be relieved after some time
User :   is this related to the nitroglycerin or something else?
User :   how does hypersensativity turn it green?
Doctor :   hypersensitivity cause the stools to be passed more times
Doctor :  
green colour is due to the bacterial fermentation
Doctor :  
is there anything else that i can help you with
User :  
I guess that is all, this is bad news but I appreciate your assistance.
User :  
thank you
Doctor :  
thanks
Doctor :  
wish you happy rcovery
Doctor :  
good luck take caree
Doctor :   Thanks for consulting HealthcareMagic. Bye for now. Please refer your friends to our service.
Question is related to
Diseases and Conditions
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