Anal dilatation, fissurectomy, creams, etc

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Anal dilatation, fissurectomy, creams, etc

Postby HouseMD » 06 Jan 2014, 16:49

Hi Everyone- I am posting here after being healed for 6 months in the expectation that my story helps those who are suffering unnecessarily. This board was Key for me during my suffering and it is my duty to give back. My opinion is that the official medical response to this injury borders on the criminal, IMO. So without further ado, here is my story:

My first fissure was in 2006 (I was only 26 at the time). I look back now and realize that my first fissure was due to the supplements I was taking which gave me a persistent watery stool. Furthermore (and this is KEY) I am the type of person who stores any stress in my rectum. High stress periods in my life lead to increased anal tightness which is a direct contributor to this condition. At the time of my first fissure was 3 months before I was due to get married.
I healed within 4 weeks, using nitro 2% using a qtip and would stick the Qtip gently all the way up. I would do it immediately after a BM and if the Qtip didnt go all the way up (meaning almost dissaper) then I would not feel the loosening effect. Although I healed within 4 weeks, the area was "sensitive" for months and any large BM I would feel "sensations" and I noticed a less elastic colon if that makes any sense. Anyways, I got married and life went on.

Fast forward to 2009- I went in for some hemorrhoid banding and the doctor did a anoscopy and when he rammed the instrument up there I felt a searing pain and who hoo fissure was back. Luckily healed within a couple of weeks on its own (why? because i was not under STRESS at the time)

Fast forward to 2010, the MOST stressful time in my life (move+new baby) and guess what? I got a fissure again. So what I thought, I know how to deal with this. First off, i ignored it for 2 weeks to see if it would heal by itself (it didnt). Then I went to get some nitro and the Doctor convinced me to use nitro 1% (HUGE mistake, in retrospect because the 1% made my body adapt to the nitro and it was less effective). Well, the Nitro 1% didnt do JACK SQUAT and by the time I realized I needed the 2% it had been 5 weeks, the spasms had started, and I was taking Advil for the pain. I went and got Nitro 2% which did very little because i believe my body had adapted to the medicine. The pain and spasms got to the point where I was incapacitated and would spend 3-4 hours in bed. At this point I panicked, started doing research, and started going a little nuts. Tried Aloe, vitmain e oil, and desitin all stung like effin hell. Try dilazapem, nifedipine, stung like hell. By this point, I had been 3 months in pain and doctor wanted to do LIS. I didnt.

Through this board I looked into anal dilatation Dr. Sohm and got the procedure done + fissurectormy in Long Island. The drive was hell, the enema I had to do was hell, the recovery sucked but at least the day after the procedure the Hellish spasms pain was gone but I still had pain. After 4 weeks, I still had pain during defecation and sitting was somewhat uncomfortable but the hellish spasm pains were all gone. I was like WTF is going on with this bullshit? I finally realized that all the sitz baths the previous 3 months had left my skin above the sphincter red, irritated, dry, and it had actually SPLIT EXTERIORLY above the sphincter! Hooray I thought the pain im feeling isnt fissure related its exterior. So I srated religiously drying with a hairdryer and putting desitin exteriorly , the redness and crack healed within a few weeks. But guess what? some minor pain and blood was STILL happening.

BTW this whole period i was strict on my diet, and what would happen is that I would have perfect BM for about a week and then BAM more "normal" BM and I would retear.

Went BACK to long island for 8 week follow up visit, and doctor said "still not healed but this procedure is only 80% successful looks like you are in the 20%" hooray for me. I said maybe with some Nitro it will speed up healing so he gave me a prescription for nitro and sent me on my way. After another month of no improvement I stumbled upon members dilating on their own and found an old Yahoo groups message thread - and decided to do it.

Started with an 18mm dilatan dilator 8 months after my fissure and 3 months after my dilatation procedure. Could only manage 18mm and was terrified of ripping it, so dilated at 18mm for 3 weeks and all seemed good until I had a BM which retore it. I said well Im gonna have to go higher so I started dilating with the 20mm and went 6 weeks before I retore. Then I went to 23mm and it healed. In all I dilated for 5 months, it healed in the last month at 23mm. After a retear i would have some stinging, burning, and mild discomfort for about 1 week after the retear and then life would be almost back to normal except for my diet and routine. So even though dilating for 5 months seems like a long time I was really in discomfort until 3 weeks during that whole time. I believe I could have healed quicker had i been more aggressive in moving up, but i was afraid of retearing. in retrospect, it wouldnt have mattered because i retore due to regular BM's anyway.

Nowadays I site on the toilet and relax, and have regular BM's and i feel my sphincter gently stretch wide open with absolutely no pain. the only difference between now and my pre fissure teen and early twenties is that i never strain and all i do is relax and yoga breath with a slight ab push, giving plenty of time for my ass to stretch out and accomodate whatever sized Bm is on its way.

So what are the takeaways for my fellow sufferers out there who are reading this?

1) This condition is caused and exacerbated by tightness of the rectum. People who store stress in their asses are particularly susceptible. Any pain in the rectum by hemmies or fissures causes negative feedback loops which cause the muscle to tighten further and further each time make you even more susceptible to injury. Depending upon how tight the sphincter is determines whether you will heal with nothing, creams, or whether everything will fail you. If you are relatively loose, have a really hard BM and get a fissure your odds of healing with the creams is good. However if you are like me, your odds go down drastically.
2) Any advice you get along the lines of stick this magic potion up your ass and it will heal are comeplte BS and WILL SET YOU BACK. This includes aloe, honey, desitin, etc. This is a mucous membrane of the body which is ripped open and the BEST thing is to put NOTHING on it. Similar to a canker sore in the mouth, the more you mess with it the longer it takes to heal.
3) There is absolutely NO REASON to be suffering the awful pain which comes with the spasms. Start dilating immediately, you will be spasms free within a couple of weeks.
4) The FIRST thing anybody should try to heal this is to dilate, work your way up to 23mm or higher and continue dilating. You will be healed within 6 weeks, I promise you. DO NOT stay in the mental hellhole of suffering caused by this injury trying to have perfect BMs and fiddling and farting with creams.

So the HouseMD 1st line of defense against fissures:
1) Put NOTHING up your ass, just keep the area dry and clean.
2) Have a fissure friendly diet, nothing constipating.
3) Dilate until you are healed. I used the Dilatan dilators they worked great. Be advised that healing will not happen until you work your way up to a size that means you will not retear upon a normal sized BM. I was personally so far constricted in my sphincter that all i could manage at first was 18mm and took 4 months to reach 23mm. Once I hit 23mm, i was healed within 6 weeks.

Prevention: Now, when I get stressed and notice my ass tightening up I due a premptive dilation. An extra bonus is also no more hemmies.

Good luck everyone
HouseMD
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Re: Anal dilatation, fissurectomy, creams, etc

Postby pinpin » 07 Jan 2014, 04:13

That indeed incredible experience using dilatation, not many here are up to try this, and it is always so uncomfortable.
I personally tried several times, but it really hurt to insert something down there. Also I found that got relaxation during dilatation, but shortly after. However spasms would return in 20mins or so. So I stopped this.
07.02.2013 - got open hemorrhoidectomy, leaded to slow healing wound. Link to story
11.12.2013 - LIS surgery
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Re: Anal dilatation, fissurectomy, creams, etc

Postby HouseMD » 07 Jan 2014, 05:57

Hi Ingrid,

The muscle spasms in the sphincter are not different than any other muscle spasm - If your calf muscle were to have a spasm, the only remedy is to stretch it even if uncomfortable. the stretchhing from dilatation is vastly more effective than any chemical relaxation of the muscle.

you might have tried going with a smaller dilator at first or a combination of the dilator and a chemical relaxant to aid in breaking the spasm negative feedback loop.

G
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