Multiple fissures and piles and the use of glycerol trinitrate in the treatment there

[ElizabethJane]

I have just returned from the doctors and the blood tests that I had done to eliminate various bowel diseases such as crohns and caeliac disease have come back as being normal. Unfortunately I have bleeding and pain from my back passage. My GP had a look and diagnosed the piles and fissures. I hada sphincterotomy many years ago and we discussed me using fybogel to keep my bowels loose (TMI I know) She has also prescribed some ointment called glycerol trinitrate which is also used in greater quantites to treat angina. I'm not keen on this treatment as it can cause headaches. I explained that I have been having severe headaches but she said that these would be a different type of headache! If the ointment does not work then they will refer me for surgery. I'm not impressed but because of the pain and bleeding will have to give the treatment a try. I would be grateful to hear any positive stories using this ointment for anal fissures and avoiding having to have surgery. I have also heard of botox being used for fissures but that wasn't what was offered I don't fancy that much either. Thank you EJ.

[nomorepanic]

I assume this is the one that you put up your backside? I was given some but never used it to be honest as they told me it could cause headaches but they are short lived I believe.

Mine calmed down without taking it but I do have Crohn's so am prone to bouts of piles etc.

Give the ointment a go and hopefully things will calm down in time.

[ElizabethJane]

Yes Nic I will have to put the stuff inside my rectum! Not sure that I want to. Is this stuff the same as the stuff they make bombs with? Anyway I have a friend who is a doctor and might ask his opinion about the stuff too. I am worried about the headaches and it not working and needing surgery anyway. Thanks Nic. EJ.

[nomorepanic]

They also gave me this plastic thing that apparently you put up your bum and do exercises with it.

I know this sounds bizarre but it is true :roflmao:

I have never used that either.:wacko:

[ElizabethJane]

Well the truth is out. I have been too scared to use the gycerol trinitrate because it can cause severe headaches. My bowel problems have not got any better using suppositories (for the pain) and fybogel to keep me regular. I sit on the loo and pass blood even without a bowel movement. I went to see my GP and she has agreed for me to see a colorectoral surgeon next Tuesday privately. I know this could mean surgery and I have had a spincterotomy before so I know what is in store except they have to warn you that you might become incontinent after the procedure. I have had enough of the bleeding and pain but incontinence. Any experiences of a spincterotomy would be good. I had it done before and I wasn't incontinent afterwards so we shall have to see what the consultant says next week EJ.

[ElizabethJane]

this for treatment for my anal fissure

[nomorepanic]

Hi EJ

Wouldn't a headache be better than surgery - or have they said there is no point in trying it now?

[Vixxy]

Ack that does not sound fun >< I've had fissures since I was a kid, but luckily the cream my doctor gave me was enough to help. Although they're still there ><
Are yours internal? Is that why they bleed more?

[ElizabethJane]

Hi Nicola it isn't just a headache rather severe headaches. I already suffer with headaches that leave me unable to lift my head and nausea. I'll see what the consultant has to say but my GP is not very happy with me.

[ElizabethJane]

Hi Vixxy sorry to be an old grump. I have several fissures plus piles that bleed. That is why I want the consultant to have a look. Went away last week and was afraid I might bleed in the swimming pool. The pain from the fissure is quite a different pain hard to describe but high up internal. If the consultant says that I have to try the cream then maybe maybe I will have to. I have also heard of people having botox up there so there might be another option. If the risk of incontinence is high then I wont have the spincterotomy done.

[nomorepanic]

I don't think the headache is that bad EJ. A few people have told me it is just a headache that passes quite quickly. I did take my GTN spray once in hospital and don't remember a bad headache at all.

[ElizabethJane]

You would be having the GTN in much higher strengths for your angina? I am a bit of a wuss so risk a telling off from the consultant.

[Vixxy]

:( I feel for you. It's bad enough having one fissure.

[nomorepanic]

Give the GTN a go and save the op I would say. As I said the headache is only temporary and there is no guarantee you will even get one - not everyone does.

[Vixxy]

Correct me if I'm wrong, but I'm assuming its a cream? maybe you could only use a teeny tiny amount and see if you get a headache. then if you don't you could increase the amount used by a little bit and repeat?

[ElizabethJane]

Hi there I thought that I would post an update as I went to see the surgeon last week. He gave me a thorough examination of my bowel. He could see the fissure and wants me to try a different cream to be put outside the bowel. The cream is called 'diltiazem hydrochloride' or 'anoheal' I have to apply this three times a day. This is to relax the muscle of the bowel and promote healing of the fissure. I have to see the consultant in six weeks. He has also told me not to get constipated so I'm using fybogel every day. This cream has far fewer side effects than the previous one but probably costs three times as much so not NHS. I still seem to be feeling nauseous in the morning so probably unrelated. I feel a little more relaxed about the whole thing as I have been given a whole sheet about caring for this area. Also he said that the skin within my bowel was very thin and prone to tearing as he could see lots of tiny tears hence the diagnosis of multiple fissures from my GP. The only problem I have found so far is that my skin stings quite a bit when I put on the cream. It has also felt very itchy all normal so I have been told. EJ.

[Vixxy]

Let's hope the cream does a good job :)

[ElizabethJane]

I thought that I would post an update as I have been back to the consultant today. The fissures that I had back in November have improved considerably. I now have a small tear which bleeds a little after a bm and is a little uncomfortable. This is so much better than previously where there was one large fissure and several smaller ones. The 'cream' diltiazem hydrochloride has worked. The consultant suggested I use a barrier cream but I have had less success here as it is staining. Metonium is also used for nappy rash. Vasogen was suggested but I have been unable to find this locally. We discussed a referral to see a dermatologist as the skin in that area is thin and prone to tearing. I am allergic to parfum (fragrance mix) and this must be in the moist toliet tissues that I have been using. I need to find some without 'parfum' in them. Most of the household products we use had some sort of added perfume to them. I have decided to see the consultant again in May before I go to Germany. This will be done under hubbys BUPA scheme. I was feeling so stressed before I went and it was so hard to relax. Fortunately the examination part was over very quickly. EJ.