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Forum Name: Surgery Topics

Question: Anal Fissure and Thombosed Hammeroid .Surgery yes or no?


 jazzartist - Sun Jan 08, 2006 1:49 pm

Dear All,

I am lucky to have found this website. I am suffering from Anal Fissure from 8 years . It started in 1997 and its on again and off agian thing . It started with Diahorrea and there was bleeding and burning and pain. I was given stool softner and sitz bath and steriod suppositor . There was no big relief and I was suggested to go for surgery. But I wanted to give it a try . I tried Homeopathic medicine and was sucessfull . But there over the years it recuured and I took both Homeopathic and suppositors , stool softners and drinking plenty of water . and managed to pull along. This falraed up one or two time in year . I was also totally cure dfor one year. . But when I am relaxed about food habit and my stool becomes hard all this start again . Recently I was abroad for 10 days and my food intake was differnt from my home country and I lifted some weights. Which resulted in a painfull thrombossed hammeroid . I had my proctoscopy and sigmodoscopy done and was told that I have the anal fissure and Thrombossed hammeroid and need surgery. I am now taking the homeopathicmedicine and also following the stool softner , taking food with fibre fruits with fibre and lot of water and my pain and other symtoms are almost gone. This time I think I should get this over with and have surgery . One problem started this time its there is soiling of my underwear. I have found that yelllowish substance in my underwear this is not incontinece of stool and I don't have fistula the doctor confirmed . But I feel terrible about it I was told this can happen for the hemeroid or for fissure. I have three option of surgery i can have it done in my cointry in Bangladesh or I can have it done in Singapore where the doctors are of high standard or I can have it done in Canada. If i opt to do iot in canada I have to wait for another 10 months . I need suggestion form the valuable members of the board about thier opinion . Is ther any problem with the dealay ?Is it possible to get cured with Nitroglycerine ointment treatment ?Any suggestions will be highly appriciated.Thanks.
 Theresa Jones, RN - Sun Jan 08, 2006 4:04 pm

User avatar Hi jazzartist,
According to research, there has been some encouraging results with applying Nitroglycerin ointment topically to thrombosed external hemorrhoids and anal fissures, alleviating pain, promoting healing which includes anal fissures. You should certainly discuss with your physician about the use of this medication.
Sincerely,
Theresa Jones, RN
 jazzartist - Mon Jan 09, 2006 1:03 am

Hi Theresa,


Thank you for your reply. I am glad that you have encouraging view about Nitro Glycerin. I would like to give it a try. My situarion is I am immigrating to Canada and make landing in April this year and shall have to wait three months for Health card to be eligible for free treatment .After that if I require surgery I will have to wait in que. Do you think its risky to wait or to get the thing done as soon as possible. The Doctor told me I could wait while the Thrombossed hammerroid will shink . As a matter of fact the aggressive nature is already tamed and the pain and teh burn is gone. I take care to keep my stool softened.Do you think I should give the Nitro Glycerine a try ? Since I have endured over years with this Fissure . But I think sentinal piles or thromosed remain forever even if shrinked. What is the rate of recurrence of Anal fissure after surgery ? About siling the unnderware I am quite concerned and shocked its in small amount but never occured to me basically I am very hygenic and clean man so you can understand . Is it due to fissure or thrombossed hammeroid or inciontinennce?Shall look forward to your reply. Wish you all the best.
 Theresa Jones, RN - Mon Jan 09, 2006 8:12 am

User avatar Hi jazzartist,
If your physician advised that it would not be harmful waiting the expected period of time for the procedure since he/she was the one that did the actual evaluation on you then that would be acceptable. In my opinion, since you have to wait for the procedure, inquiring about the use of the Nitroglycerin ointment certainly would be worth trying at least to attempt to alleviate the remaining symptoms. According to an article written by Lisa S Poritz, MD, Assistant Professor, Department of Surgery, Section of Colon and Rectal Surgery, Milton S Hershey Medical Center, Pennsylvania State University, "Approximately 1-6% of patients have a recurrence of their anal fissure after sphincterotomy. The recurrence rate is higher after a sphincter stretch." So according to documentation the success rate is quite high. There is hope that through continued efforts that there will be a successful medical management identified that's as effective as surgical management. As for the embarrassing episodes of incontinence, (most likely related to the anal fissure)you may want to use a liner ( or pad) in your underwear (like a woman would wear while on her menses). Even though this sounds a little embarrassing this would protect your underwear from soiling, provides a descrete barrier, and they are easily changed so that you may remain feeling hygenic. I hope this information has been somewhat helpful.
Sincerely,
Theresa Jones, RN

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