At a glance
Bowel prep means hours of watery stool. With a fissure, that can sound frightening.
Many people say the reality was easier than the dread. Nothing hard passes, which is often the fissure’s main problem. What people complain about most is sore, burning skin from so many trips to the toilet.
The main themes in the accounts:
- People protected the skin before the prep started, not after it hurt.
- Gentle cleaning mattered more than any product.
- Telling the endoscopy unit about the fissure changed how the day went.
- How the fissure was afterwards varied, from better to briefly worse.
This guide describes what people report. It does not tell you how to take your prep. Your unit’s instructions always come first.
Why a colonoscopy comes up with a fissure
People often ask why they need a scope when the problem is “only” a fissure. The reasons they are given tend to fall into a few groups.
- Bleeding that does not fit the fissure, or that continues after healing
- A fissure that is in an unusual place, or slow to heal
- A change in bowel habit, or diarrhoea that needs explaining
- Family history of bowel cancer or inflammatory bowel disease
- Age-based screening that happens to fall at the same time
Several people describe the test finding something else that explained part of their symptoms, such as internal haemorrhoids, a polyp or inflammation. Others were simply reassured. Both are useful outcomes.
What people describe about the prep
The burning. The most common report is stinging skin after repeated watery stools. It tends to build through the evening rather than start straight away.
The fissure itself. Many say the fissure hurt less than with a normal bowel movement. Some still had spasm afterwards, especially if the fissure was in an active phase.
The timing. People describe the prep taking longer than expected to start working, then coming in waves. Some were caught out by how long it went on into the night or the morning.
The low-fibre days. Some units ask people to eat low-fibre food or stop fibre supplements for a few days before. People with a fissure often worry this will firm up their stools before the prep starts. This is worth raising with the unit, especially if you normally rely on a stool softener. They can tell you what to keep taking and what to stop.
How people looked after their skin
These are patterns from many anonymised accounts, not instructions.
- A barrier before the first trip. Petroleum jelly or a zinc-based barrier cream on the outside skin was the single most mentioned tip. People reapplied it after cleaning.
- Water, not rubbing. Many rinsed with water, used a shower head or a bath, then patted dry. Others used soft, fragrance-free wipes.
- Setting up the bathroom. People mention having everything within reach: soft paper, wipes, barrier cream, something to drink, something to read.
- Cool rather than hot. Some found a lukewarm rinse eased the stinging. Very hot water seemed to make it worse for others.
If you use a prescribed fissure cream, ask the unit whether to carry on through the prep and on the day.
What to tell the endoscopy unit
People who raised the fissure ahead of time generally had a better experience. Things they mentioned or asked about:
- That they have a fissure, where it is, and how sore it is right now
- Whether the scope could be passed especially gently, with plenty of gel
- Whether a smaller scope was an option
- What sedation was available, and whether they could have it
- Whether to keep using their fissure treatment and stool softener
- Whether anything else, such as Botox or an examination, could be done at the same time
A sigmoidoscopy is a slightly different case. It is often done without sedation, and some units use an enema rather than drinkable prep. People with a very sore fissure describe this as harder. Several asked whether the test could be done with sedation, or whether waiting was safe. The clinician who requested the test is the person to ask.
Combining procedures
Some people had Botox, an examination under anaesthetic or other fissure treatment during the same session as the scope. The appeal is one prep, one sedation and one recovery.
Whether this is possible depends on your hospital, whether the same team does both, and how urgent each procedure is. People who wanted this usually had to ask for it. It did not always happen automatically.
How the fissure was afterwards
Accounts split into a few patterns.
- No change. Many people noticed no difference to the fissure at all.
- Briefly better. Some describe a spell of easier, softer bowel movements in the days after. For a few, this did not last once normal stools returned.
- A short flare. Some had soreness, a small amount of fresh bleeding or more spasm for a few days.
- Slow to restart. The bowel is empty after prep, so the first normal stool can take a day or two. People often say this first one felt firmer than expected.
People commonly went back to their usual softener routine and fluids straight after, once the unit had confirmed it was fine to do so.
When to seek care
Call 999 or go to A&E straight away if bleeding is heavy, if you feel faint or become confused, or if you have severe tummy pain, a swollen or hard tummy, or a high temperature after the scope. Do not wait to reach the unit first.
Contact the unit, your GP or NHS 111 (or your local urgent care line) if you notice:
- Bleeding that does not stop
- Vomiting that means you cannot keep the prep or fluids down
- Dizziness or passing very little urine during the prep
- Severe anal pain that keeps getting worse rather than settling
- Swelling, discharge or fever that could mean infection
See your GP or clinician if the fissure flares after the test and does not settle within a week or two, or if the scope found something you do not yet understand.