Hello AF members, I have been reading through the forum over the past week or so. There is tons of information and support here so I thank you all for that. After much reading, I decided I wanted to put my current situation (and a few ?'s) out there to see what kind of feedback I receive.

So.......

I'm 26, male, and consider myself to be in good shape. I workout regularly and I have always incorporated heavy weightlifting into my workouts. My diet is good through most of the week, BUT I do have a very bad habit of binge eating when I do my "cheat" meals. About a month ago, I developed a bad case of diarrhea from a stretch of poor eating. I did not feel nauseous and I never vomited, but the time between my BM's could be from a couple hours to maybe six hours if I was lucky. During this episode of the diarrhea, I believe I developed one or more AF's (~two weeks ago from the time I write this).

When I first started feeling pain from the fissure, I assumed hems. The pain was bad (soreness and burning), but it did not compare to what I would eventually feel. I ordered some wipes w/ witch hazel and prepH. The wipes gave some minor relief and the prep H did little to nothing. I didn't feel SEVERE pain until one day after a BM, I sneezed. Nights of Columbus. I experienced my first spasm and it felt like someone jabbed a good sized knife up my butt. I don't know if it made my existing fissure worse or created a new one, but it has pretty much gone downhill since then.

Currently, I am still getting those god awful spasms. When it's triggered, everything tenses up causing excruciating pain. The tightness/clinching only lasts a few seconds, but it follows with very bad burning and soreness. It seems that most people here get them after BM's. I do too, but only sometimes. Mine are more frequently caused by straining from standing up, sitting down, getting in/out of my vehicle, or rolling over in my bed. It has reduced my mobility to that of a 90 year old man. I have also been getting them when im about to fall asleep. My mind will be wondering and I'll be right at the point when I'm about to dose off, and then WHAM, the spasm hits me. I had some blood on the wipe after a BM yesterday, but I think the bleeding is minimal compared to others (from what I can tell).

Here is what I have done to try to help myself.

Increased fiber - psyllium
Coconut Oil - applied topically
Anorectal Cream (5% Lidocaine)
Tylenol
Diet - increased veggies and fruit, avocados, eggs, chicken, turkey, fish.
Warm water - I don't have a bath so I use my detachable shower head instead.

The fiber and diet have helped digestion. I think the coconut oil was causing irritation so I dialed it back. The Tylenol and anorectal cream helps relieve SOME of the pain between spasms. The warm water from the shower helps with pain from spasm. I use a broom stick as leverage to help prevent spasm when sitting down and standing up.

I understand I haven't dealt with this nearly as long as some of you (some of you are truly warriors), but I'm hoping I can nip this in the bud before it gets worse.

I have a few questions....

Is it possible to have a fissure heal when you are having spasms? The tightness of my spasms don't last long. This is what prevents healing, correct?

What's the best remedy for preventing spasms? The warm water helps, but that's only after the fact. I find it weird that I get spasms when I'm about to fall asleep, is there a controllable mental component to them?

Any weight lifters out there? Has this ruined any chances of me ever getting back to heavy lifting?

Any and all feedback is welcomed and appreciated.

This is all my understanding, which I believe to correct, but others can weigh in on the accuracy of my statements.

The spasms will likely require nifedipine ointment. They are the result of your body trying to protect itself. When fecal material passes by the open wound, the body tries to shut off blood supply so that you don't allow the bacteria into your bloodstream. But this prevents healing, and compromises the tissue further so that you can tear even more with firmer bowel movements. My doc also gave me Valium to calm the spasms. And yes, they feel like a knife stabbing you! So painful.

My doc told me not to use any wipes of any sort. There is a mucous lining in the anus that needs to stay intact. I would even avoid witch hazel. My doc said only water. I wet toilet paper and dab until clean.

You will be able to work out again, and do heavy weightlifting after you are completely healed which could take a while. I have gone to a plant-based diet and it has helped me immensely. Definitely avoid red meat!!! As far as the mental component, my issues always rise up when I'm stressed. I try to use meditation to calm myself, and have found it beneficial as well.

I would see a doctor, and get some Nifedipine asap. I hope this advice helps. Hang in there!

Thanks for the info T. Just curious, why's the plant based diet is beneficial? Any reason other than keeping stools soft?

Here's an update on my situation.....

The day after my last post, I discovered a pea sized lump above my anus. It was just to the right of 12 o'clock. I was still in severe pain and still getting spasms. As the days went by, the lump continued to grow. The lump did not stay round, it started growing perpendicular to my crack. The burning pains, spasms, and soreness continued to worsen and I was at a point where I could not move at all. From what I could tell, I had developed an abscess. I had a doc appointment with a GI set up for Monday, but I had to check myself into the ER Sunday night due to the pain. They confirmed it was an abscess. They "lanced" the abscess; put some packing in; and prescribed antibiotics, muscle relaxers (for spasms), and pain meds. The next day the pain was a little lighter, but still pretty damn painful. I went to the GI and he took a look. He said it was still very swollen and he could barely see an incision. He told me to stop taking the antibiotics they gave me at the ER and prescribed me 2 different ones. He set me up for a colonoscopy in about 4 weeks and said that if the pain and swelling does not start going down, I needed to call him and he would set me up with a surgeon. He did not have much faith in the ER's work. That night I was able to get to sleep with the help of the meds, but I was up at 4am with unbearable pain. The abscess was bigger than ever. I got ahold of my GI as soon as the office opened and he set me up for an apt with a surgeon at 3pm. I somehow made it to the surgeons office (this was yesterday). He looked at the abscess and said the ER did not even lance it. He said they get pantients from there all the time where the work has to be redone. Anyway, he cut the abscess and drained all of the fluid. Based on the amount of fluid that came out, he determined it was a very large abscess. After lots of poking, cleaning, and screaming it was finally over. I felt a good amount of relief, but it was still sore from the operation. He said to come back everyday for a week so I can get it cleaned out.

Today I feel 90% better. I can get out of bed, move around, and sit down with just a little bit of discomfort. I have had 2 BM's with almost zero pain. I've had 1 spasm, but it did not "clinch" nearly as hard and was not nearly as painful. I went back to the surgeon to get the wound cleaned (ouch) and there was still some pus the the abscess. I currently have gauss pads covering the wound with no packing inside. When I change the pads there's a good amount of blood and pus.


I'm keeping my fingers crossed in hope that I don't form a fistula from the abscess. The colonoscopy is to find the root cause of this whole ordeal, the diarrhea. I know there may be more complications ahead, but right now I'm extremely happy that I have found some relief. I have started to question whether the pain was from my fissure or the abscess the whole time. The fact that I have pain free BM's right now makes me think the fissure is mostly healed. Either way, I'm drinking as much water as I can and sticking with the high fiber intake.

That's all I have for now.... feedback is always welcomed and appreciated :)

For me, the plant based diet is for stool consistency, because meat is hard for me to pass apparently....I may even have some allergy to certain meats...? I had tried everything and this diet helped me turn the corner. Maybe I was about to turn the corner anyway, but I'm sticking to it for a while longer because I'm currently pain free! Yippee!

Man, you've been through the ringer (I'm surprised they didn't numb you before cleaning your abscess. Geez!)
Glad things are better!