Anal Fissure During UC Flare Up. What do you use for pain.

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Ed E.
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Date Joined Jun 2018
Total Posts : 3
   Posted 6/13/2018 8:51 PM (GMT -6)   
I'm currently in flare up so going constantly , hourly I would say. My BM are really small currently but for the last 2 days I'm getting that stinging feeling as you go and immediately need to try to clean and dry the area to try to help the pain. I'm on new meds to help with flare but I'm trying to figure out what's the best thing to apply to not only help with pain but hopefully heal the fissure quickly so it doesn't add the pain to the movement anymore. Was trying triple antibiotic ointment and now switched to Desetin. I've heard coconut oil is also a possibility. Just hoping for some recommendations.
45 Years old
Diagnosed with mild UC in 2013
Mesalamine 800mg 3 Tablets 2x a day
Also on meds for Cholesterol(Rosuvastalin), BP (Losartan/Amlodipine),Sugar( Metaformin)
Usually get FlareUp once or twice a year. Length about a month give or take a week.

Veteran Member

Date Joined Mar 2007
Total Posts : 4509
   Posted 6/13/2018 9:53 PM (GMT -6)   
I've used A&D diaper rash ointment and baby wipes. Hope you get better soon. This disease is hell.
34 years old; diagnosed March 2007.
Latest scope: 9-29-16: mild-to-moderate chronic and active proctosigmoiditis (infectious cause). Battled reoccuring campylobacter & c diff. Oct-Dec 2016. Healthy since Dec. 25, 2016 until I started smoking May 2018.
Current meds: Delzicol, 6, 2xday; Rowasa nightly; singular and Allegra for allergies; Xanax. Have tried Bentyl, Donnatal, and Levsin; dont help.

Uniform Charlie
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Date Joined Jul 2015
Total Posts : 712
   Posted 6/14/2018 6:02 AM (GMT -6)   
Calmoseptine is good for temporary pain relief. It also promotes healing. The pain relief does not last very long with it, unfortunately. A&D as sara mentioned or preparation H are worth a try or anything that will act as a barrier cream for your next bm like vaseline. I would also recommend taking scalding hot baths, as hot as you can tolerate, as often is possible. You can add epsom salts to the water to aid healing.
Diagnosed Proctosigmoiditis (UC) February 2015
Hiatial Hernia w/ GERD
Current Meds: Lialda 1.2gm 2x daily (discontinued for now), duloxetine, rowasa as needed, VSL3 occasionally, One a Day Multi-Vitamin
Did SCD for about 2 years but lost willpower. Want to get back to it at some point.

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Date Joined Dec 2008
Total Posts : 16578
   Posted 6/14/2018 6:19 AM (GMT -6)   
Ilex will coat the area. Calmoseptine is good for protecting too. Lidocaine can help ease pain, but it doesn't really touch the pain of a bad fissure and you need a prescription. Are you using any rectal meds? Steroid supps can help... I think the best thing is hot sitz baths a few times a day. That should promote healing. The other thing is to use the protectant before you go, I know it's easier said than done with UC because we are often in a rush, but if you use it after you go, it will usually be gone by the time you actually wipe. Ilex is interesting because it seems to stick around for quite a while. My GI used to say to use stool softners, bit with UC, the last thing you want is a softer mess than you've already got.
Moderator: UC
Currently: no meds 6/15 Step 1 J-pouch Surgery Complete 9/15 Step 2 Complete 11/15 Step 3 Complete
From Sickly to UC Free

Give a man a fish and he will eat for a day; teach a man to fish and he will eat for a lifetime; give a man religion and he will die praying for a fish

Regular Member

Date Joined May 2016
Total Posts : 262
   Posted 6/14/2018 7:56 AM (GMT -6)   
ask the doc for a prescription for nifedepine ointment and lidocaine (need to get it mixed at a compounding pharmacy) Use that 3x a day to heal the fissure. Use A and D ointment to coat the whole rectal area and frequent sitz baths. The fissure won't heal without the nifedipine ointment though. I have a fissure and this treatment heals it!

diagnosed proctitis April 2016 s/p a c diff infection age 53
Nov 2017- ?Crohns colitis to mid transverse - mild/moderate
remission March-Sept 2017 then flared again-failed prednisone/balsalzide wean
started Humira 11/17/17, -5/17- failed Humira
started Remicade 6/8/17
past meds- cortifoam, canasa, rowasa,balsalazide, prednisone

Elite Member

Date Joined May 2003
Total Posts : 30857
   Posted 6/14/2018 12:02 PM (GMT -6)   
In addition to the above should request mesalamine retention enemas to deal with the rectal inflammation...asap.

*Heather* I give suggestions, do with them what you will.
Status: ...Asacol 3 @ 2x daily; Salofalk enema @ 3rd night (nightly/ flares, tapered/maintenance)
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol 20mg as needed; Zantac 150mg; Pulmicort/Oxeze/Airomir (asthma); Effexor XR 75mg (depression); Rosuvastatin 10mg (cholesterol); Telemesartin 80mg / Amlodipine 5mg (BP)
~vitamins/minerals/supplements; Probiotics....(RenewLife Ultimate Flora Critical Care + Genuine Health Advanced Gut Health 50 billion @ bedtime)
~Metamucil capsules 6 @ 2x daily with meals; Vitamin D 4500 IU
~URSO 500mg @ 2x daily for Primary Biliary Cholangitis
"TREAT (FROM)BOTH ENDS" worth it !!

Regular Member

Date Joined Jun 2018
Total Posts : 56
   Posted 6/14/2018 1:06 PM (GMT -6)   
In the past I have found the best thing for fissures is pure vitamin E liquid. It coats and heals. But I also had to use suppositories to lubricate the area otherwise BMs would keep tearing it open.

I just posted a topic asking how I tell the difference between an anal fissure and UC symptoms. I'm curious how you know the difference? In the past my fissures were huge and back then I did not have a UC flare so all I was dealing with was fissures. Now It's UC + fissures and I don't know which is which.

Forum Moderator

Date Joined Aug 2012
Total Posts : 13024
   Posted 6/14/2018 3:22 PM (GMT -6)   
Severe rectal inflammation from a UC flare can make it feel like you are crapping out razor blades, but that sensation only lasts while pooping. No pain sitting, or touching that area (like when wiping with tp). If you have a UC flare then you know the rest of the sensations of severe rectal inflammation: tenesmus, bleeding, frequent bms, and may/not include blood. You're not just going to poop out razor blades, it would come with the rest of the awful symptoms too.

A fissure's pain persists after you are done pooping, which can be short or long. However that pain will subside before the next bm. A fissure can have a terrible smell, and might expel puss. A fissure is going to be painful and you might feel pain when sitting or touching that area. I'd say the persisting after a bm, and pain in touching that area with TP would be good indicators that you have one.

Anal fissures are cracks or tears in the anus and anal canal. The primary symptom of anal fissures is pain during and following bowel movements. Other symptoms that may occur are bleeding, itching, and a malodorous (smelling very unpleasant from pus) discharge.

Squatting over a mirror (or having a spouse look) might help. Anal fissures are diagnosed and evaluated by visual inspection of the anus and anal canal. Gentle inspection of the anus can confirm the presence of a fissure. If gentle eversion (pulling apart) the edges of the anus by separating the buttocks does not reveal a fissure, a more vigorous examination following the application of a topical anesthetic to the anus and anal canal may be necessary (via a doctor). A cotton-tipped swab may be inserted into the anus to gently localize the source of the pain. An acute anal fissure looks like a linear tear. They look like a red paper cut, it would be very near your sphincter (at the edge or just within).


We can also get perianal abscesses, they look like red pimples very close to the sphincter. They can burst as well and cause pain, release puss and blood.

A fissure or abscess benefits from Sitz baths. Sitz baths (essentially soaking in a tub of warm water). Sitz baths are encouraged, particularly after bowel movements, to relax the spasm, to increase the flow of blood to the anus, and to clean the anus without rubbing the irritated anoderm.

Post Edited (iPoop) : 6/14/2018 2:32:30 PM (GMT-6)

Regular Member

Date Joined Jun 2018
Total Posts : 56
   Posted 6/15/2018 4:10 PM (GMT -6)   
Thanks iPoop for clarifying, I think my pain is actually UC pain. It hurts during the BM but afterwards I feel relief, until the next BM. I feel pain in my rectum when the stool arrives and pain during BMs but not after.
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