I am 3 months post 1 stage jpouch surgery, and have been having some major pain problems with my anal canal. It is very sore most of the time particularly during and after a bowel motion. I am currently on hydrocortisone suppositories for a possible internal fissure as well as rectogesic cream for a few small external fissures, but the pain seems to be through the whole canal. I have a few questions which I hope others may have had some experience with.

1. What other treatments have you used for an internal fissure?
2. Is surgery a good option if they can't be cleared using medication.
3. Has anyone not been able to resolve this anal soreness, and gone back to the ileostomy.
4. If you revert to an ileostomy what happend with the unused j pouch? Could it still cause pain, leak mucous etc.

Whilst I intend to give this a good shot at healing, I just want to know what other options are out there. Thanks.

Hi Gary
I have been experiencing something similar though Im not sure that it's a fissure. I ended up going to ED because I was so worried something was wrong. They said it was inflamation of the j pouch which can happen if nothing is moving through it (I havent had takedown yet). Im on a course of flagyl and it seems to have cleared it right up. I was on the drip for a couple of days as I had started to pass blood but Im just finishing the course off at home. Dont know if this helps you but I thought it was interesting to find someone else who was having pain before takedown

Jbear. I am post takedown. I have had a 1 step procedure where it was all done at once.

Oh ok. Sorry, cant help then. Hope it gets sorted

Hi Gary, I am 4 weeks take down with Jpouch and have very similar problems as you. I had/have horrific hemmoroids which doc removed internal ones while doing jpouch procedure, but left exernal ones (which I begged him to remove since I would not be using that area for 6 months during the pouch healing but he didn't). Had ileostomy for 6 mnths and as I said just had take down. I have fissures also and have significant pain/ pressure/ burning with BMs and for about 5-10 minutes after. Went to Doc b/c it was so bad. He said he thinks I am spasming. Has me taking valium and a powerful Nsaid, and said to take my Hydrocodone if I need it. I am still having 10-15 or more bm's a day and mostly need to push to excavate. Sometimes they are loose and come out on own. He also gave me a gel that has lidocaine in it which helps numb the anus. I don't know if this will ever stop. I feel pressure down there all the time. I am hoping that time will be the prescript. and that it will eventually get back to a new normal. It is hard to go out anywhere b/c of making sure you can get to a commode if you need it. Women's restrooms always seem to have a waiting line, so for the time being I don't go out. If you find anything that helps you, let me know. I just ead a post about a diet that a women tried that helped her. At this point I am still eating what I want, but do learn very quickly what doesn't work for me. No spicy foods at all. Dairy can be a problem. No red spag. sauce or anythng like that and as much as I love salads, they affect mem too. I do eat them on occasion but just deal with the aftermath b/c I enjoy them so much. Wish I could find something to heal the fissures. Good luck to you.

Jackie. I happy to say that I am a little better than when I wrote this. There are a few things that I have done which have helped. I used hydrocortisone suppositories for a week which seemed to help the inside fissure pain, and am still using rectogesic for the outside. I also have hemmoroids on the outside which make it very tender when having a motion. Also used buscopan for the spasming. I have 3 baths a day for about 20 mins each, and use a heat pack for 20 mins when I go to bed. The number of times you are going is in part attributed to the anal canal discomfort, as it is not comfortable to hold waste, whilst it is sore. I assume you are using lomitol or similar ro slow things down. I have I have also started pelvic floor physiotherapy. They instructed me on how to sit on the toilet, and how to use your stomache muscles to apply pressure, but not force your motions. Also remember you are very early on in the recovery. I too am impatient and want to be back to normal ASAP. Everyone will tell you it takes time. I am just 3 months and expected to be back to normal by now (bull****ting surgeons). My diet at the moment is very basic. I lost 16kg as I couldn't eat much to start with, but am gradually regaining some of that. My theory is to keep it simple until I feel like my BMs are normal and not painful at all. All of this will come in time. You have to believe.