At a glance
A stomach bug is miserable for anyone. With a fissure, or a few days after surgery, many people are frightened of what it will do to their healing.
Experiences vary. Some describe days of burning and a setback that took weeks to calm. Others are surprised that their fissure came through fine. A common thread is that the risk does not end when the bug does. The first firmer stool afterwards, when you are a little dehydrated, is the moment many people find hardest.
This guide covers what people describe, how they care for the skin, what to think about with surgery coming up, and when to get help.
What people describe
The same themes come up in many anonymised accounts:
- Burning rather than tearing. Frequent, acidic, loose stools leave the skin raw. Many describe a burning that lingers all day.
- Irritation from constant wiping. Repeated wiping often does more damage than the stool itself.
- Soiling and urgency, which add to the soreness and the stress.
- A setback after the bug. Being dehydrated and eating little can be followed by a harder stool a few days later. This is when some people re-tear.
- Fear of losing progress. People who had just begun to heal often say the anxiety was as hard as the bug.
- Some surprise good news. A few people found loose stools gave their fissure a rest, with no lasting harm.
Looking after the skin
These are things people commonly describe doing. They are not a treatment plan. A pharmacist or your GP can advise you.
- Rinse rather than wipe. Shower heads, bidets, a squeeze bottle or a sitz bath are the most repeated tips. If you do wipe, people describe patting gently with soft, unscented paper.
- Pat dry. Some use a hairdryer on a cool setting.
- A barrier layer. Many apply a barrier ointment or zinc oxide cream before bowel movements and after cleaning. Some use petroleum jelly.
- Warm baths or sitz baths to ease burning and spasm.
- Carrying on with prescribed fissure creams unless told otherwise. If the skin is very raw and a cream stings, ask the prescriber.
- Avoiding scented wipes and soaps, which can sting broken skin.
Fluids, food and your stool routine
Fluids come first. Diarrhoea and vomiting lose water and salts. Many people sip fluids little and often, and use oral rehydration solutions from a pharmacy. Follow the pack instructions.
Your usual softeners and fibre. A common approach is to pause bulk-forming or softening products while stools are loose, then restart as they settle. Others keep a small part of their routine going because, for them, hard stools are a bigger threat than loose ones. There is no single right answer. Ask a pharmacist or your GP.
Anti-diarrhoea medicine. Some people use it to get through a bad night. It is not suitable for everyone, for example with blood in the stool or a high fever. It can also tip things towards firmer stools afterwards. Ask a pharmacist first.
Coming back to food. People often start with bland foods, then slowly return to their usual diet and fibre over a few days. Paying attention to fluids and stool softness in the days after the bug is the most common advice people give each other.
Probiotics. Some people take probiotics to try to prevent or shorten a bug. Evidence is mixed, and they are not a substitute for fluids.
Stomach bugs, flu and upcoming surgery
Getting ill a week before LIS, fissurectomy or Botox is a common worry. Points people raise:
- Tell your surgical team as soon as you are unwell. They decide whether to go ahead. Do not try to hide symptoms.
- Fever, a chest infection, vomiting or diarrhoea often lead to a procedure being moved, particularly with a general anaesthetic.
- Changing the type of anaesthetic is the team’s call. Some people asked about local anaesthetic or sedation instead. Surgeons often prefer to reschedule.
- A mild cold that is clearing may not stop things. The team may check on the day.
- Pain relief before surgery. You may be asked to avoid some medicines. Check what you are allowed to take.
After surgery
A stomach bug in the weeks after anal surgery is worth a call to your surgical team. Diarrhoea can soil the wound, and you may need advice on cleaning and dressings. Watch for signs of wound infection: increasing redness, heat, swelling, pus or fever.
If you develop diarrhoea after a course of antibiotics, particularly if it is severe, watery and frequent, contact your doctor. This sometimes needs testing.
When to seek care
Get urgent help (go to A&E or an emergency department, or call 999 in the UK or 911 in the US) if you have:
- Signs of dehydration: very little or no urine, dizziness on standing, confusion, or a racing heart
- Vomiting that means you cannot keep fluids down
- Blood in diarrhoea, or black stools
- Severe tummy pain, or heavy bleeding from the bottom that does not stop
- High fever, or fever with a hot, swollen, painful area near the bottom
See your GP or clinician if:
- Diarrhoea lasts more than a week, or vomiting more than two days
- You have diarrhoea after antibiotics
- Your fissure pain is worse a week after the bug has passed
- You have had recent anal surgery and become unwell
- You are due surgery and have any infection or bug