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Antibiotic Fissure
I got fissure by having augumentin 1000 twice a day for my throat infection
now my gut got bad but i have taken probiotics tata 1mg 30billion probiotics , also have taken differents strains like s bouroullis and latic probiotics also all in billions
but now my issue is if i dont have probiotics for 3-4 days my fissure return with burning poop
Answers (25)
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Keep with your probiotics and also use stool softener
All the best.
J G S R clinic
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Didn't find the answer you are looking for?
Talk to experienced stomach expert online and get your health questions answered in just 5 minutes.
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Avoid fried and spicy food
Water intake mor3
Do connect and consult
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Can help you with the next course of action and treatment plan. Kindly consult via whatsapp at nine zero two nine six zero zero four seven zero.
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If you want to discuss your problem in more detail, feel free to message me on WhatsApp at nine one one nine two five five six nine nine for a free detailed discussion
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Anovate ointment by index finger first on buthole than gently push inside the anus rotate the finger to cover anal mucosa completely before n after defication two times for two weeks. Zerodol sp3 times a day after food for five days.
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Here is a clear, practical treatment plan you can give to the patient.
This combines fissure-healing protocol + gut recovery after Augmentin.
⸻
✅ Comprehensive Treatment Plan for Recurrent Anal Fissure
1. Stool Softening (most important)
Must be followed daily for 6–8 weeks without interruption.
Primary option (best):
PEG 3350 (Restoralax / Miralax)
• 17 g once daily
• Adjust dose to keep stool soft like “toothpaste consistency”
• Safe long-term, non-addictive
Alternative/add-on:
• Psyllium (Metamucil) 1 tsp in water once daily
Only if water intake 2–2.5 L/day
Hydration
• 2–2.5 L water/day
Soft stool is the only reliable way to prevent re-tearing.
⸻
✅ 2. Fissure-Specific Medication (mandatory for healing)
Helps relax the internal sphincter → increases blood flow → promotes healing.
Choose one of the following for 6–8 weeks:
Option A (first-line):
Topical Diltiazem 2% cream, apply pea-sized amount
• Twice daily inside the anal opening
• Excellent tolerance, fewer headaches
Option B:
Topical Nifedipine 0.3% + Lidocaine
• Twice daily
• Good pain relief
Option C:
Nitroglycerin 0.2–0.4%
• Twice daily
• Watch for headaches
Do NOT stop midway even if symptoms improve.
Stopping early → fissure reopens.
⸻
✅ 3. Probiotics (supportive, not main treatment)
Use only ONE stable regimen, not many strains at random.
Recommended 4-week course:
• Lactobacillus + Bifidobacterium blend (10–30 billion CFU once daily)
• Saccharomyces boulardii 5–10 billion CFU daily
Then continue only the Lactobacillus/Bifido blend for maintenance, if needed.
But remember:
Next Steps
Pain Management (if needed)
• Lidocaine gel 2% before bowel movement
• Acetaminophen safe
• Avoid NSAIDs if causing GI upset
Health Tips
. Red Flags → Need Specialist Referral
If any of these occur:
• Symptoms persist after 8 weeks of proper treatment
• Severe pain despite topical therapy
• Fissure is lateral (possible Crohn’s, infection)
• Recurrent fissures for >6 months
• Signs of abscess or fistula (fever, swelling)
Colorectal surgery can consider Botox injection if not healing
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Is it fissure or piles? Kindly consult with me on 94 two six 86 seven eight 96.
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You can consult me directly on Practo, or reach out via WhatsApp:
Eight Seven Six Two Seven Four Nine Nine Seven Four
I’ll guide you step-by-step with easy-to-follow treatment plans.
Early consultation helps avoid complications — feel free to connect.
Only whatsapp message no calls
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Thanks for explaining everything — it’s quite common for fissure symptoms to flare when the stools become even slightly hard or irregular, which is why you feel better only while on probiotics. To settle things properly, you’ll need a combination of stool-softening, local care, and the right diet. A soothing fissure cream like AnoBliss can help with the burning, but I’ll need a quick consult to guide you on how to use it correctly and what else you should start.
Next Steps
Please book a short consult so I can check your symptoms in detail and help you break this cycle safely.
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Need few more details for proper understanding of your issue.
You can consult with me online on Practo or whatsapp on eight three one eight four six nine eight eight six for proper diagnosis, conclusion and management
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Hello,
What you’re describing is a very common pattern after a strong antibiotic like Augmentin.
It wipes out your gut flora, stools become acidic/irregular, the anal canal becomes irritated, a fissure develops and once a fissure forms, even slight acidity in stool can re-trigger pain and burning.
Right now, probiotics are only masking the symptom, not fixing the underlying problem:
Your gut microbiome is still unstable.
The fissure area has not fully healed.
The stool consistency is fluctuating, which keeps re-injuring the site.
Antibiotic-induced dysbiosis sometimes takes weeks to repair unless managed properly.
If the fissure pain returns within 3–4 days of stopping probiotics, it means we need to:
1. Rebuild the gut systematically, not randomly with different strains.
2. Identify what’s making your stool acidic (diet, timing, hydration, fiber mix, etc.).
3. Assess the fissure healing stage to know whether you need dietary correction, local care, or something more structured.
4. Break the cycle, so you don’t become dependent on probiotics.
This requires a proper clinical plan otherwise the fissure will keep coming back and the gut will never fully stabilise.
You can message me privately for a detailed step-by-step plan tailored to your symptoms on w.h.a.t.s.a.p.p nine three two six zero two zero five three six.
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Your fissure and burning during bowel movements did not directly come from Augmentin itself —
it came because the antibiotic changed your gut flora, causing:
• loose stools
• acidic stools
• mild inflammation
• harder stools after stopping
• increased anal sensitivity
This irritation triggered or reopened a fissure you already had (even if you didn’t notice it before).
Probiotics helped you because they temporarily normalize the stool consistency.
That’s why when you stop probiotics, the stool becomes slightly harder or more acidic → fissure starts burning again.
But depending on probiotics daily is not the long-term solution.
Your anal canal is still inflamed and not fully healed, which is why even minor changes cause pain.
Next Steps
What is ACTUALLY happening
You now have Post-antibiotic Irritable Bowel + Chronic Anal Fissure, which needs:
• stool softening
• anti-inflammatory therapy
• sphincter relaxation
• mucosal healing
Probiotics alone cannot maintain this permanently.
What You Should Start (This Stops the Probiotic Dependency)
1. Stool Softener (essential for fissure healing)
Use ONE daily for 6–8 weeks:
• Lactulose 15–20 ml at night
OR
• Cremaffin Plus 1–2 teaspoons at night
OR
• Isabgol 2 teaspoons in warm water daily
This keeps stool soft even without probiotics.
2. Fissure Ointment (must for healing)
Apply Diltiazem 2% or Nifedipine 0.3% + Lidocaine gel:
• Apply twice daily
• Apply inside the anal opening (1–1.5 cm)
• Continue for 6–8 weeks
This relaxes the anal sphincter → blood flow increases → fissure heals completely.
Without this step, fissures ALWAYS reopen.
3. Sitz Bath
Sit in warm water for 10 minutes, twice daily.
This reduces spasm and pain instantly.
4. Probiotic Course (Short, Not Forever)
You can continue 1 capsule/day of your probiotic for 2–3 weeks, not long-term.
After that, your gut will stabilize when stool softener + ointment are continued.
5. Diet Changes
For 6 weeks:
Eat:
• 2–3 liters water/day
• Fruits: papaya, banana, apple
• Dal, oats, curd rice, vegetables
• Ghee 1 teaspoon daily
Avoid:
• Spicy food
• Tea/coffee excess
• Alcohol
• Junk
• Skipping meals
Health Tips
Why Your Fissure Keeps Coming Back Every 3–4 Days
Because the fissure did not fully heal, it is still fresh and sensitive.
Once the fissure is healed completely (with ointment + soft stool),
you will not depend on probiotics and the burning will stop.
When to See a Doctor
• Pain lasts > 8 weeks
• Bleeding continues
• Severe spasm
• Lump forms near anus (sentinel pile)
• Pain even when stool is soft
You might then need a proctology evaluation or LIS (lateral sphincterotomy) in rare cases.
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Fissure is not related to probiotics or antibiotics.
You have make sure your stool get soft every time.
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Fissure is not related to antibiotics
Still use Anometrogyl ointment for local application and sitz bath
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It sounds like your gut flora has been disrupted after a course of broad-spectrum antibiotics, which is causing recurrent fissures and burning stools when probiotics are stopped. Continuing probiotics can help restore gut balance, but persistent symptoms suggest underlying gut dysbiosis or slow healing. Consider consulting a gastroenterologist for further evaluation, including stool tests or other investigations, and maintain a high-fiber diet, adequate hydration, and good anal hygiene to support healing. Avoid self-medicating with long-term high-dose probiotics without guidance.
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Take lots of water and high fibre diet.
Avoid fried ,non vegetarian,oily and spicy foods .
Local application of Anovate ointment before and after defecation.
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Augmentin disturbed your gut, causing hard stools → fissure pain. Probiotics give temporary relief, but the main treatment is soft stools.
Next Steps
• Drink 2.5–3 L water/day
• High-fibre diet + Isabgol/PEG at night
• Sitz bath
• Lignocaine + nitroglycerin ointment locally
Health Tips
If pain/bleeding continues, visit to doctor.
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Fissure is not due to antibiotic than
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Dr. Simranpreet Kaur
General Physician
10 yrs exp
Ludhiana
Fissures are usually being formed when there is cracks in anal area, it’s because of constipation or even your first stool is very hard
That’s the reason for having burning sensation while passing stool
Next Steps
Syrup looz 10 ml in night with luke warm water if required
Apply Ano metrogyl cream very gently on affected area and massage it until it get absorbed
Also if bleeding occur, take tab tranexa 500 mg as required
Health Tips
No oily or fried foods, no carbonated drinks, have more water intake, atleast 2-3 litre per day
More fibre diet should be there including salads like cucumber
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Dr. Chethran T S
General Physician
3 yrs exp
Puducherry
Antibiotics like Augmentin can disturb gut bacteria and cause hard stools + burning, which can trigger a fissure. The fissure returning when you stop probiotics means your stool is still not soft enough.
Next Steps
• Lactulose syrup 15 ml at bedtime daily for 7–10 days
• Sitz bath twice daily
• Diltiazem 2% or Nitroglycerin ointment locally twice daily
• Continue probiotics for now, but gradually taper later
Health Tips
Drink 2–3 L water daily and add fibre (fruits, oats). Once stools stay soft, the fissure will heal and won’t depend on probiotics.
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Dr. Ravi Kumar Nadella
General Physician
18 yrs exp
Hyderabad
Take tjem
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Dr. Digvijay Vashistha
General Physician
1 yrs exp
Faridabad
If you need guidance, I’m here—feel free to book your consultation.
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Dr. Anuj Mothsra
General Physician
6 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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Dr. Chaithra H
General Physician
5 yrs exp
Bangalore
Don’t take probiotics now
Consult doctor for physical examination and take laxatives
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Dr. Shaikh Huzaif
General Physician
20 yrs exp
Mumbai
Please consult
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