Patient 7

Patient 7

Watch out for cranberries! More very good self help suggestions. This is a follow up to Patient 6.

Date: Sat, 07 Dec 1996 12:38:25
Subject: Anal Fissure

Dear Jack,

I too have an anal fissure. I would like to extend my heartfelt thanks to you for having set up this page. I'm sure it has been of great benefit to many, it certainly has been to me. I have incorporated many of the tips from the lady that healed herself, to much relief. I was going to postpone writing this until I had it cured. It is not yet cured but I may have some information that could be helpful to people so felt I must write.

It seems to me that this condition has several stages one of which is the acute crisis stage with intense pain and the quantum leap into inner sphincter spasm. You know this is the point when like our friend Joe we would submit to any hair brained procedure if it promised relief from this agony. I was in such a state when visiting our local clinic. The Dr. handling my case thought it was very likely an anal fissure. He suggested an anti inflammatory to get things settled down. He prescribed Naspersin (sp?). I took one but this stuff is two tough for me, even taken with lots of food I could feel it wend its way down and out. It did however help relieve the spasm. In a second consultation he recommenced another NSAID called Relafen. This was for me much easier to handle and seems very much to relieve the spasms. This is a very strong drug. Much has been written on the negative side effects of NSAIDS. Some of these side effects are gastric bleeding which cause 20,000 hospitalizations in the US each year. Also it affects the ability of the body to produce mucus that is so important to the GI track, and negatively impacts the kidney and it's function. Caution is well advised. In my view as a patient long term use of this drug is not for me, but to wind down an acute situation with a few days usage it seems to do the trick.

A second medication that he was able to recommend after a reference from a knowledgeable colleague was a suppository called Protozone which is antibacterial and anti-inflammatory. This is made or distributed where I live here in West Quebec by a company called Technilab. I have no idea if this is available in other locales by this name and manufacturer so I will list the ingredients: Each suppository contains -Hydocortisone 5.0 mg - Cinchocaine hydrochloride 5.0 mg - Neomycin sulfate 10.0 mg - Esculin 10.0 mg. The anus being tender I have been using Johnson and Johnson KY jelly as a lube to get the suppository in place painlessly. This product seems to help. I'm resonably certain something like it will be available elsewhere. In Canada it is only available by proscription.

Anything I'm saying here should only be considered food for thought. I am not a medical person or even knowledgeable about herbs. The use or disuse of any foods should be discussed with your attending physician. In my view the long term cure for this condition is keeping the stool soft. It is because of this that I felt I had to not delay in writing. I had, had a comfortable twelve days of no pain in a state of going to healing maintaining a closely monitored food intake along with four stool softeners a day and almost two litres of water a day when I had a hard stool and a major setback. I was stunned and in pain and very disappointed. In review I was trying to figure out what it could have been. The day before I had a large glass of cranberry juice. Having the herbal encyclopaedia handy I looked to see if cranberries were in there and yes they were and under uses: "Fruit used in the treatment of diarrhoea." In my view they would be excellent for this but not useful for people with anal fissure. On reflection I have often had trouble around turkey diners. I read one of the participants reflecting on problems around the holiday meals and wondered if it may have not been so much the meat intake as the binding force of cranberry. Now all the seasonings get checked out so that I am not ingesting a binder. Cumin one of my favourites is a binder. Bay leaf, tumeric, ground coriander are fine. Basil and Oregano may even be helpful not that they are loosening but Basil is slightly sedative and Oregano is "useful specifically for gastro-intestinal or respiratory disorders"

More on food. What can we eat that could help? Barley the first cereal crop cultivated by humankind, again from the herbal encyclopaedia under use: "Barley water is a soothing preparation for inflammations of the gastro-intestinal system..........cooked barley is a useful poultice for sores."Sounds good to me. Cooked oatmeal is also slippery and is now part of my diet. Oats are famous as a nervine or nerve tonic and if your nerves aren't stretched by anal fissure the higher authorities of the church should be notified Sainthood could be in the offing. I'm also drinking lemon balm tea for it's settling effect on the nerves available in many health food stores. Fresh is better but only dried is available at this time of year here. Nettles, quoting from David Hoffmanns book An Elders' Herbal "As an astringent they may be used for nosebleeds or to relieve symptoms wherever haemorrhage occurs in the body (e.g., uterine haemorrhage)." I drink some as tea. None of these herbals are useful against full blown crisis spasm, but they may be of some use over the long haul. I am also taking one cup of golden seal root tea every day with use no longer than a week or two with out a break of a few days. Quoting again from Hoffmann under actions of the root: " bitter, .........antimicrobial, anti-inflammatory.....laxative,..." and under indications " Goldenseal is one of our most useful remedies, owing much of its value to the tonic effects it has on the mucous membranes of the body. This is why it is of such use in all digestive problems, from peptic ulcers to colitis." sounds good to me.

More on intake. Bitters have almost be eliminated from our diet. They cause the production of bile and in this way aid in digestion. Probably the best way is to find a green grocers that have dandelion leaves for sale and other bitter salad herbs and some of these to your salad and eating this before your main meal. This gets the juices going and allows the digestion to work. I have found that for me this has been a great help. At least as big a help as stool softeners which I now love and cherish. If you are unable to get food bitters there are also bitter tonics available in health food stores. The pills are dubious to me because it is the taste of the bitter that sets things in motion.

My local physician has knowledge of me and my body and past history. He has no trouble with the things I have mentioned for me. If you want to try these things please talk it over with your Dr.. Herbs can be very powerful and have many effects. Any given herb may not be right for you even if it's ok for me. Consulting a herbalists in your area may be a good idea. Often the two streams of health are at odds. See if you can find a happy medium of good herbal advice supported by your Dr..

Things to do besides read in the sitz bath. Two of my best friends are studying Traditional Chinese Medicine and acupuncture. They are far away from me physically and are not yet able to stick needles in patients. They were however able to give me a few points to massage that may help. While in the tub you could press the applicable points:

Spleen 1 which is about 1/4" kitty corner to the nail of your right and left toes. That is to say look at the nail of your big toe. It sort of has four corners. Two corners are near to the tip if the toe, forget those corners, two corners are towards your heel. One of these corners is towards your next toe, forget that one. The final corner is towards the centre line of your body. This is the one. 1/4 inch from this corner on the skin on the angle of kitty corner.

Bl 57 - come up the tendon on the back of the leg and the point is where it starts to split & turn in to a muscle (1/2 way between back of knee & heel) Ok feel the tendon coming up from your heel. At a certain point about halfway between the heel and knee it wants to disappear into your calf muscle. That's the spot. I must say on me it is tender. Don't massage it too hard. If it's painful just a little massage will help loosen it up. Both legs. Again this should be discussed with your Dr. and if you have them were you are a Dr. of TCM might be consulted.

So why all this. Well my Consulting Physician has told me " anal fissures are notoriously difficult to heal." He sent me to a Surgeon to make the absolute diagnosis. This man was a wonderful warm and astute human. A teaching physician at a local hospital in practice for twenty-five years. He said " in the time I have been a surgeon the procedure for anal fissures has changed every five years, which is to say five times. The reason for this is that they don't work." He does, if he feels necessary and would help, perform the "Lateral Sphinterotomy." This is only if it won't respond to diet and sitz baths softeners and all the things on this home page.

I have given the medical references on nitroglycerin to my Dr. he is happy to check them out. I hope I may be able to try this and that it's successful, without the head aches of course.

May this bothersome problem that seems to have no benefit for anyone dissolve out of existence.

This is the visit to this page since 27 Jan 97.
Last modified: 09 December 96, back to home page.