Looking for advice after recently being diagnosed

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Looking for advice after recently being diagnosed

Postby yuckyuckyuck » 04 Aug 2017, 11:38

Hello everyone! I have a bit of a long backstory that I'll try to abbreviate. I've been having pain/discomfort in my rear area since last December (so 9 months now). I thought it was a skin problem, and since I have psoriasis on other parts of my body, I went to my dermatologist. He thought it was psoriasis (though without a biopsy, which I didn't want to do, you can't be 100%). I tried numerous topicals and antibiotics (in case it was bacterial instead), but with no solution found. I'd have good days and bad days, good weeks and horrible weeks. I also saw 3 other dermatologists, none of whom gave me ideas that worked out to eliminate the pain.

About 15 years ago I dealt with an external hemorrhoid, and every now and then I have a hard stool that would irritate me for about a day (maybe once a year or every other year). My derm said he saw an external hemorrhoid in the spring, so I was doing my normal routine for that (diet, fiber, water intake, soaking), and over this 9 month stretch of discomfort, I've had a few episodes where I thought to myself, why am I getting more hemorrhoids now? I finally got a referral to a GI doctor, who I met with last week. He said he didn't see any external hemorrhoids, and he didn't feel any masses inside based on the rectal exam. He said this sounds like a fissure, and it could be a fissure that's been bothering me this whole time. He recommended Citrucel as a supplement and Rectiv.

I waited a couple of days to get the Rectiv so I could investigate it. I was worried about the headache side effect. But I've been having a bad week down there, so I ended up getting it. Now, as a straight guy, the idea of putting something up the bum wasn't pleasant, but I've been getting through that. I can't get it up the full inch that is recommended though. I do the best I can. I haven't felt any side effects...no headaches, though I've been proactively taking Tylenol before doing the treatment.

I have a million questions about the Rectiv. How do I know if it's working? Could I be aggrevating a fissure by sticking my finger up there? (it sort of feels worse after I do it). I use a finger cot, of course, but is it possible that I'm making the fissure worse? Does applying the Rectiv externally do anything? That doesn't make me feel as bad. I'm also wondering if I'm not getting headaches because I'm not getting enough of it up there? I'm on day 3 right now. I also don't know the best way to position my body to insert it?!?!?

I've been soaking in a plain tub of warm water, but is that the same as a sitz bath? Does it do the same thing? My legs are covered in addition to my rear end. I'm not sure I understand how a sitz bath clinically helps, but I've still been soaking. Sometimes it makes me feel better and sometimes it doesn't. That's the story of this whole thing, though. I'll have a period of a few hours where I don't fell anything back there, and then that same day I'll feel stinging pain.

So...I've written a lot here...sorry about that. If you have any advice on how to get through this for someone who was recently diagnosed with a fissure, it would be much appreciated.

Thank you!
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Re: Looking for advice after recently being diagnosed

Postby hurtinend » 04 Aug 2017, 19:56

My understanding is that the ointment does not need to go very far up, apparently gently rubbing it just inside the opening is good enough, it absorbs and does it's work. Also, it is not a healing ointment per say....it works by relaxing the anal muscles, allowing the fissure to heal on its own as blood flow increases.

Also, it is not an overnight fix, it can take weeks before you notice less pain in general. It works well for some, not so well for others.

I wish you healing.
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Re: Looking for advice after recently being diagnosed

Postby yuckyuckyuck » 05 Aug 2017, 07:48

Hello hurtinend, and thank you for the reply. Have you had success with Rectiv or something similar?

When I apply the Rectiv internally, even just doing just inside the opening (which is all I can really do), I feel a sting, similar to when I'm passing a stool. I'm just worried that that is aggravating the fissure even if it is getting the medication on it (?!?)

Also, do you have any advice on what the right procedure is for a sitz bath in the tub? Do I need to sit on my knees so my anus is exposed to the water? Or would just laying in the tub do the same thing?

Thank you again for the response! I feel like I should know some of these little details (but don't).
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Re: Looking for advice after recently being diagnosed

Postby hurtinend » 05 Aug 2017, 19:39

I've had some success with Nifedipine ointment, although I am still battling chronic fissure problems. I recommend you rub it just on the outside of the opening, don't go inside if it is irritating your fissure.

Go to a medical supply store and buy a sitz bath basin. It fits on top of the toilet, just fill it with warm water and sit in it for 20 minutes or so. If you choose the bathtub, just fill enough water to cover the hips. The goal is to just have the anal area submerged in the water.
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Re: Looking for advice after recently being diagnosed

Postby yuckyuckyuck » 06 Aug 2017, 08:21

Thanks again hurtinend. I will get a sitz bath for the toilet and see if that helps.

The tricky thing today I am running into is stomach pain and cramps. I'm not sure if I ate something bad yesterday (I'm careful with diet), but I feel bloated and cramps. I've been on fiber supplements for a while now, so I don't think it's that, but at the same time, I'm now afraid that if I don't take the supplements and I take a lot of fiber today, I'll get constipated and end up back at square one. This stinks.

With the Rectiv or nifedipine, how do you know if it's working? Do you actually feel the sphincter relax? I haven't felt any physical relaxing down there since I started Rectiv...not sure if I'm suppose to?!?
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Re: Looking for advice after recently being diagnosed

Postby hurtinend » 06 Aug 2017, 19:21

for me, I noticed less pain on bm's, it took many weeks. The ointment helped but never cured the problem completely, and it tends to want to keep coming back.

I have not had surgery or Botox.

Don't obsess on everything you eat and drink, but be consistent. Drink lots of fluids and don't be afraid to use the odd laxative if necessary. I find that magnesium citrate works well to keep things soft and moving....I use 600 mg per day, 300 morning, 300 evening. I also have a herbal laxative tea if I get into trouble.
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Re: Looking for advice after recently being diagnosed

Postby yuckyuckyuck » 26 Aug 2017, 12:10

Hello. So it's been a few more weeks, and not much better. I saw my GI again, and he didn't have anything new to contribute. He said I could have a colonoscopy to make sure nothing else is going on, but that it's probably a fissure. I had used the Rectiv for 2 weeks at that point, and he said I could discontinue it. I've kept using it though...not sure if it is harmful to use for longer periods. He said it would have helped within the first 2 weeks if it was going to work. He didn't seem concerned about extended use. But during that 2 weeks, I had a bout of diarrhea, so I felt that sort of threw everything off.

I'm not having terrible pain during BMs, but after a BM my bum is sore for most of the rest of the day. If by some magic I don't have a BM until the evening, then I have a terrific day...so that seems to indicate a fissure, right? The problem is, my cycle has been to have a BM when I first wake up for the past 10 years, so that has pretty much continued. I still take fiber supplements, and my BMs are not hard.

Has anyone had success with lidocaine, Aspercreme, or Dermoplast? Or anything like that? Something for the pain...over the counter stuff? I'm not sure what to try next. I don't really want the colonoscopy since I don't think it's something else (and the GI doesn't either). He said with my level of discomfort, that it's probably healing...but it's been mostly this level of discomfort for going on 9 months now.

I'm also wondering if I was using the Rectiv correctly. I was inserting it as far as I seemed to be able to. I would put the ointment all around the little finger to the first knuckle, and it seemed I got that much up there. I think I've read in here that Rectiv doesn't work unless you use it correctly, though, so I'm wondering if I wasn't. Sometimes when I inserted it I felt a stinging (presumably, the fissure?) and sometimes not. I was worried about aggravating the fissure though.

So any additional thoughts or solutions short of surgery or invasive procedures would be appreciated.

Thanks!
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