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Hi!

Postby Dylan » 17 Sep 2019, 11:09

Hi all!


Was directed here from the Reddit community as I'm still looking for answers to an ongoing problem. I'll be as thorough as I can with my details so forgive me if this post runs a little long!

I’m a 39 year old healthy male (not overweight, bloods done showing excess B12 and slightly low Vitamin D) And I have a chronic fissure problem. Although I'm starting to think it may be something else like internal haemorrhoids (or worse?!)

I’ve had a small (not painful, just a little ‘nipping’ sensation whenever it returns) but persistent anal fissure since October 2016.

During the entire time I’ve been vegetarian then vegan as mid 2017. I don’t always eat entirely plant-based (vegan junk food occasionally) but there’s plenty of fibre in my diet and I’m regular enough that my movements are upon waking and then again after my morning coffee. I drink the required 2.5 litres of water needed most days and my movements aren’t particularly hard although they are sometimes large.

So...there’s no dairy in my diet, don’t drink alcohol (can’t handle the hangovers!) and I do yoga for twenty minutes every day as well as (not very frequent) gym visits and I’m not massively unhealthy. I’m currently at 180lbs at 6” so at the bottom end of overweight but otherwise healthy.

Still…every now and then (longest I’ve gone was a couple of months, shortest would be every other week) my fissure returns. Sometimes it’s due to a particularly large movement, other times there doesn’t seem to be any reason at all. When it does there’s blood on the toilet tissue and it’s accompanied by a small nipping or tearing sensation but nothing too bad.

I’ve read some horror stories about how bad the pain can be so I’m grateful I’m not suffering in that way, but blood coming out of your rear-end can’t be normal.

Additionally, after the bright red blood on the first wipe, there is no more blood on follow up wipes or any more movements that day, normally.

I’ve tried sitz baths, coconut oil, aloe vera cream, Hermosan which all seem to heal the fissure quite quickly. But, even if I continue using them once healed, like a bad penny it will always return at some point.

Two days ago was a particularly bad day. Lots of blood on the first wipe. Still bleeding a couple of hours later, then stopped by the evening. Yesterday there was no blood at all and today back to normal. So I seem to heal quite quickly, there's very little pain when there's blood present in the bowl but it always returns. Whether it's a week, two weeks or two months.

Looking into things the blood is always bright red but the fact there's no pain leads me to think it may be internal haemorrhoids. Any other ideas?


I’ve seen the doctor several times. First time I was given Glyceryl trinitrate and stool softeners but the cream gave me such an overpowering migraine the moment it touched my skin I had to wash it off instantly.

Upon repeat visits and being referred to the specialist at the hospital (who confirmed it is a fissure but there was only a quick examination with a finger inserted into my rectum) I was given Diltiazem 2% cream which I have used religiously every day after showering since December. Still…the fissure has returned more than a few times.

I’ve got my follow up in a couple of weeks and the next step would be botox injections. I really don’t want to go down this route as I’ve heard of anal leakage, incontinence etc as a side effect. The fact that I ‘go’ quite quickly after the message hits my brain to use the bathroom worries me as anything which lowers that sensitivity would definitely be unwelcome. It also seems a terrible trade-off for occasionally have a small spot of blood once in a while which, whilst inconvenient, I can put up with. I'm also not sure how it will help the problem returning.

My question is this (after the wall of text, apologies again for being thorough, congratulations if you've made it this far) is this something which will just keep returning and I have to live with for the rest of my life now? Has anyone had a permanent fix using any method?
If anyone has ANY suggestions, however crazy, I’m all ears. I’m not ruling out magic or ancient rituals at this point.

Thanks!
Dylan
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Re: Hi!

Postby patience_and_healing » 17 Sep 2019, 19:42

Botox injections are a relatively safe method to try and heal a fissure. Infections are rare, and any possible incontinence is only temporary. Aside from this option I suggest consulting with a pelvic floor physical therapist in case there is some underlying muscle tension that's preventing healing.
8/16-12/16: Fissure due to antibiotics
5/17: Botox to sphincter, fissure healed
9/19: Trigger point injections and pudendal nerve block
11/19: Botox to pelvic floor
8/20: Botox to pelvic floor in new location.
Currently in pelvic physical therapy
patience_and_healing
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Re: Hi!

Postby Dylan » 18 Sep 2019, 19:14

I've never heard of pelvic floor therapy but that does seem to make sense. Thanks for the suggestion! :)
Dylan
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