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Suggest Treatment For Painful Fissure Near Anus
Question: Dear,
My name is XXXX and i am in pain with a fissure. This happened to me in XXXXXXX this year. i was almost cured but i guess it returned and now there is a very small blister kind of thing right next to my anal and little by little pus is coming out. i have to clean regularly. i do not have any fever and or any other XXXXXXX problems other than this fissure. i have been taking Lactulose and fibre suppliment since XXXXXXX now i dont have much problem passing stool, since i am using stool softner. but after passing the stool i am having pain and pain is like, i've had an injection in my buttocks and it seems my buttocks get swollen a bit after passing stool. i had been consulting a doctor and he diagonsed me with sentinal piles and he said that blister kind of formation is quite common for fissure and i dont need to bother about it and it will go on its on.
I havent applied GTN cream till now, since he havent prescribed. i have been using ointment based on lidocane.
Am i infected as pus is coming out and do i need to do something else now.
My name is XXXX and i am in pain with a fissure. This happened to me in XXXXXXX this year. i was almost cured but i guess it returned and now there is a very small blister kind of thing right next to my anal and little by little pus is coming out. i have to clean regularly. i do not have any fever and or any other XXXXXXX problems other than this fissure. i have been taking Lactulose and fibre suppliment since XXXXXXX now i dont have much problem passing stool, since i am using stool softner. but after passing the stool i am having pain and pain is like, i've had an injection in my buttocks and it seems my buttocks get swollen a bit after passing stool. i had been consulting a doctor and he diagonsed me with sentinal piles and he said that blister kind of formation is quite common for fissure and i dont need to bother about it and it will go on its on.
I havent applied GTN cream till now, since he havent prescribed. i have been using ointment based on lidocane.
Am i infected as pus is coming out and do i need to do something else now.
Brief Answer:
Laxative , antibiotics fr the infection if needed.
Detailed Answer:
Hi XXXXXXX
The sentinel pile is a small tag of skin that develops in response to the anal fissure. Since it is at the outside of the fissure, impacted small amount of fecal matter can give a mild infection and pain on defecation.
This may go away on its own or may persist, but then will never cause a problem on its own unless fissure-in-ano reappears.
I would advise to continue as rightly prescribed by You Gastroenterolgist, including the Proctosed ointment.
I would advise you the following:::
If your fissure is just for 3 months and if there are less than 3 attacks till now and there are no associated problems , you can try the following method of treatment and you may NOT need surgery.
High fiber diet.
Avoid all the foods and beverages and stress-like conditions which gives constipation.
Laxative for softening the stool- never allow the dose too much to cause liquid stools. Normocol granules give better result as your Gastro has advised.
Sitz bath- very important- just before passing a stool and after passing a stool.
Clean the area very clear of the fecal soiling that remains after cleaning; use cotton soaked in the same water to clean.
You can apply liquid povidone iodine locally. Apply nothing else.
5 day course of an antibiotic on prescription of a local Doctor.
Add probiotics and multivitamins.
Avoid stress and mental tensions at any cost; this is a very important factor.
Continue this for 3 weeks and most probably you may not need surgery.
If the results are positive you have to continue doing all this and take proper care.
This helps all my patients and should help you too.
Feel free to ask more if you need to, and you may rate this answer.
Laxative , antibiotics fr the infection if needed.
Detailed Answer:
Hi XXXXXXX
The sentinel pile is a small tag of skin that develops in response to the anal fissure. Since it is at the outside of the fissure, impacted small amount of fecal matter can give a mild infection and pain on defecation.
This may go away on its own or may persist, but then will never cause a problem on its own unless fissure-in-ano reappears.
I would advise to continue as rightly prescribed by You Gastroenterolgist, including the Proctosed ointment.
I would advise you the following:::
If your fissure is just for 3 months and if there are less than 3 attacks till now and there are no associated problems , you can try the following method of treatment and you may NOT need surgery.
High fiber diet.
Avoid all the foods and beverages and stress-like conditions which gives constipation.
Laxative for softening the stool- never allow the dose too much to cause liquid stools. Normocol granules give better result as your Gastro has advised.
Sitz bath- very important- just before passing a stool and after passing a stool.
Clean the area very clear of the fecal soiling that remains after cleaning; use cotton soaked in the same water to clean.
You can apply liquid povidone iodine locally. Apply nothing else.
5 day course of an antibiotic on prescription of a local Doctor.
Add probiotics and multivitamins.
Avoid stress and mental tensions at any cost; this is a very important factor.
Continue this for 3 weeks and most probably you may not need surgery.
If the results are positive you have to continue doing all this and take proper care.
This helps all my patients and should help you too.
Feel free to ask more if you need to, and you may rate this answer.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I am working in Kuwait. Me and my wife is planning to travel to europe for 14 days. does long walking cause problems. now i am having pain when i sit for some time.
i really do not have the confidence to travel as i dont want to end up in some health issues abroad.
is it really good to take sitz bath when i am having a punctured blister next to my anal opening. wouldnt it make the things worse ?
after going to the toilet, i am in pain as if i have taken an injection and not rubbed it off. sometimes i feel the pain till my toes. Moreover my buttocks seems to swell a bit, but it goes off after sometime espcially after when i wake up in the morning. is it something to be concerned of ?
i am really afraid of fistulla, as one of my friend recently underwent surgery and after talking to him, i am really worried, especially since pus is coming out.
i really do not have the confidence to travel as i dont want to end up in some health issues abroad.
is it really good to take sitz bath when i am having a punctured blister next to my anal opening. wouldnt it make the things worse ?
after going to the toilet, i am in pain as if i have taken an injection and not rubbed it off. sometimes i feel the pain till my toes. Moreover my buttocks seems to swell a bit, but it goes off after sometime espcially after when i wake up in the morning. is it something to be concerned of ?
i am really afraid of fistulla, as one of my friend recently underwent surgery and after talking to him, i am really worried, especially since pus is coming out.
Brief Answer:
Not to worry so much, I know pain is more.
Detailed Answer:
HI XXXXXXX Sorry for late as it was early morning here when I answered the first one.
When are you planning to have an Europe tour ?
The classical thing about fissure is once healed and when not in a chronic stage, if there is no colitis or constipation, this will not recur. So if you are getting a complete relief by the ways as already explained, you will be fit to travel, walk and have fun of every means.
Actually the discomfort and pain in acute stage makes one to loose his confidence and one feels that he may have it again. So do not be worried, take proper care and treatment.
Continue the laxatives in suitable dose, Avoid all foods and beverages that are known to you that they cause you the gastrointestinal problems when you are on a tour. Avoid stress.
Yes Sitz bath is most beneficial. It should be a plain warm water, nothing added. It soothes the muscles. No problem for punctured blister.
You have to get a prescription for an antibiotic and metronidazole if you have not taken the course. Your prescription does not mention it. You need it because you have a mild infection. Added antiinflammatory like Ibuprofen will help you for the edema ( swelling ) and pain.
Fissure is very small yet very painful as it is in one of the most sensitive areas.It heals throughout the time till the area is dilated during passing bowel motion/ stool. So the pain in the morning after going to the toilet is not to worry about, but yes, the pain is too much. The best solution is to apply and pass lidocaine jelly before and and after passing stool. It benefits so much by not straining purposefully. try to relax the muscles while passing stool. The more you can relax the anal muscles the least will be the pain and stretching of the fissure and early healing.
Fissure are not known to get converted into fistula as they are very superficial; it is altogether another problem. Please do not listen to friends and family, they do not anything about these conditions and in fact make you more frightened, increase your stress level, which in turn makes delayed healing. Pus comes from under-surface of the sentinel pile.
I would advise you to have once consultation of a Surgical Gastroenterologist so that you get better care.
Not to worry so much, I know pain is more.
Detailed Answer:
HI XXXXXXX Sorry for late as it was early morning here when I answered the first one.
When are you planning to have an Europe tour ?
The classical thing about fissure is once healed and when not in a chronic stage, if there is no colitis or constipation, this will not recur. So if you are getting a complete relief by the ways as already explained, you will be fit to travel, walk and have fun of every means.
Actually the discomfort and pain in acute stage makes one to loose his confidence and one feels that he may have it again. So do not be worried, take proper care and treatment.
Continue the laxatives in suitable dose, Avoid all foods and beverages that are known to you that they cause you the gastrointestinal problems when you are on a tour. Avoid stress.
Yes Sitz bath is most beneficial. It should be a plain warm water, nothing added. It soothes the muscles. No problem for punctured blister.
You have to get a prescription for an antibiotic and metronidazole if you have not taken the course. Your prescription does not mention it. You need it because you have a mild infection. Added antiinflammatory like Ibuprofen will help you for the edema ( swelling ) and pain.
Fissure is very small yet very painful as it is in one of the most sensitive areas.It heals throughout the time till the area is dilated during passing bowel motion/ stool. So the pain in the morning after going to the toilet is not to worry about, but yes, the pain is too much. The best solution is to apply and pass lidocaine jelly before and and after passing stool. It benefits so much by not straining purposefully. try to relax the muscles while passing stool. The more you can relax the anal muscles the least will be the pain and stretching of the fissure and early healing.
Fissure are not known to get converted into fistula as they are very superficial; it is altogether another problem. Please do not listen to friends and family, they do not anything about these conditions and in fact make you more frightened, increase your stress level, which in turn makes delayed healing. Pus comes from under-surface of the sentinel pile.
I would advise you to have once consultation of a Surgical Gastroenterologist so that you get better care.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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