Hello everyone, nice to meet you all! I am new to the forum. I got here after some long google/reddit searches on what else to do in this journey of trying to heal myself.

My info: 33 year old, gym goer, 5'4", 153lbs, fairly fit. All of my anal problems started because I was going too hard on the sex front. I am also a cancer survivor, and have done 7 months of chemo when I was 27. I also smoke weed daily, no tobacco.

In retrospect I may have been cultivating my AF/hemorrhoids for years if not decades without knowing it, but the actual pain started in July 2021. I had recently moved to America, so getting good quality care was difficult back then and from the onset of pain to getting some treatment 4-5 months passed during which I kept using baby wipes, straining, working out wrong, biking, and more stuff I shouldn't have been doing but didn't know any better. In January 2022 I met with a colorectal, he suggested doing transanal hemorrhoidal dearterialization (THD), which I got in February 2022. In April 2022 my pain was still there, so the doctor suggested a hemorrhoidectomy, and I decided to get a second opinion. That month I went to a new doctor who said hemorrhoids wasn't my problem, it was a fissure and he prescribed me a nifedipine, diltiazem, lidocaine ointment, which I've been using ever since to good results. From being on 8-9/10 pain all the time I've gone down to 1-2 intermittently after 7 months of treatment.

On my last visit, this doctor noticed some hemorrhoids, and suggested some infrared treatment that I don't really remember right now, and if that doesn't work, a hemorrhoidectomy. That last procedure scares me as I've heard the recovery is terrible, and because of the chemo my healing is terribly slow.

Nowadays my life is mostly centered around the pain, the depression isn't life-altering but it's been definitely a constant for more than a year and a half now, not to mention the anxiety and mood swings from feeling good one day and being back in pain the next.

I have started a diary of everything that goes in and how it feels coming out to see if there's a relationship between diet and pain. It should be noted that because of the chemo, I can't really digest anything greasy or too processed, so I mostly eat at home, and even that is heavy on my stomach and makes pooping weird.

I take 30g of fiber every day, probiotics, milk thistle, and vitamins. I use a bidet to clean myself, never strain, never linger on the toilet. I workout breathing properly to not put extra pressure in my butt, I work sitting on a cushion. I have recently stopped drinking alcohol all together, and trying to cut down on the weed.

So far the pain comes and goes and I'm not seeing a big pattern as of to why that is. I've hit a plateau in my healing, which is what brought me here. If anyone has any tips or suggestions on what to do, who to look for, of anything, I'd appreciate it greatly.

Thanks for reading,
Another pain in the butt

Hi,
Sorry to hear you are suffering, I have had hemorrhoids and fissures, the first is painful but can be dealt with the second controls your life.

Are you constipated if so try to drink more and like you are doing keep a diary. I found sodium butyrate to help both constipation and diarrhoea. Also put a barrier cream up there before you have a BM stops some of the burning. Try some pelvic floor exercises, I thought it would make things worse but it did help a bit. If I’m not in too much pain just discomfort I used collodial silver on a cotton ball to place on the area after a BM really helps the dull ache.
However, if your resting sphincter pressure is too high it is harder to heal and easier to get another fissure so look into a sphincterotomy.

Good look

I recently read a book that I believe is a game changer. Mostly because pelvic floor physical therapy already has resulted in the biggest stride I made with my fissure and hypertonic pelvic floor. It’s more of an assurance that it can get better, but that I have to seriously maintain a regimen to keep myself relaxed down there along with all the fluids and fiber that help make my stool soft enough to pass, not too loose, because that hurts like hell too. The main help that I received from this reading (i recommended the audiobook) is the deep understanding that my mental state, or anything that’s bothering me, tends to tighten everything up more! Staying in a mindset of acceptance and positivity is my goal now, above all else! I’ve seen the improvements happen almost magically before my eyes- don’t get me wrong, it’s no quick fix and it won’t stay unless you keep going with it, but I had been dealing with the pain daily and for long hours…. It feels like a small miracle. Now when I start to feel tense, I immediately do something to help myself relax and have found that i’m able to slow (if not halt) the progression of pain. Please read A Headache in the Pelvis by Wise & Anderson. It’s long but it really drives home these ideas and so much more that I can’t even describe!