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My Diary

Postby thedude » 22 Feb 2016, 16:07

Been reading posts on here for the past month or so, and thought I would go ahead and start a diary with my experiences with anal fissures and what my path has looked like.



30 year old male
Had a super hard bowel movement roughly 1.5-2 months ago. Initially didn't have much pain after it, but did have some bleeding though. The bleeding was not extensive, but enough to streak the toilet paper for a few wipes. I'm not really sure when all this got really bad, because after that bowel movement, I was ok for a little bit, and then one day, I used the bathroom again and this time it was terrible. I don't remember if there was any blood or not, but man did it hurt. By far the worst pain I've felt in my life..way worse than 2'nd degree burns on my hand from bacon grease, or breaking a finger, or getting wisdom teeth pulled.

I suffered with this for about 1-2 weeks. I had some Tramadol left over from my broken finger and started taking that. Started with 1 tramadol, but eventually started taking 2 at a time. It seemed to help the pain go away a little quicker, but I would still hurt fairly intensely for 2 hours, then a little less intense pain for 2 or so hours after that. Basically, if I had a bowel movement around 6:00 PM, I wouldn't be able to sleep till about 11:00PM when the pain would subside enough. But when the pain was intense, the only way I could seem to get it to stop hurting some was to walk around. Needless to say I ended up walking my neighborhood a lot.

I'm an IT guy by trade so my job involves a lot of sitting, which was miserable if I had a bowel movement at work. I would basically, use the bathroom, then the next 3 hours would be me sitting down for a few minutes, then getting up and walking to get some water, or walk and check on the servers. Repeat that about 20-30 times.

The turning point where I decided I needed help with this was when I had a dentist appointment scheduled one morning, but I also had a bowel movement earlier that morning. I was able to drive the 10 minutes to the Dentist, but on the way their, the pain really kicked up. I ended up cancelling the appointment while I was there because I couldn't sit still in their chairs so there was no way i was going to sit still for teeth cleaning. Also, I was cold sweating from the pain I was in and this was about 45 minutes after taking tramadol.

I made an appointment that afternoon with a GI Doctor for a couple days away. I tried to get one for that afternoon, but they told me if the pain was bad enough, make an appointment with my primary care doctor in the interim. I did do just that and made an appointment for the next day with my primary care doctor. He did a little examination with his finger and tested for blood in my stool, but there was no blood in the stool. He told me he wasn't sure what it was, but he did tell me I needed to see a CRS and not a GI doctor. He even called one that he said was the best in Houston and made an appointment for me the next day which was nice, but also a little alarming as part of me was wondering what did he see in there to cause him to personally call this CRS doctors clinic and make and appointment for me. Till then, he gave me a prescription for some Hydrocodone, and cortisone suppositories. The Hyrdocodone barely touched the pain and the cortisone suppositories definitely didn't help.

The next day, I had my appointment with the CRS and I'll admit I was super nervous. I knew I had some issue with my butt, and the CRS had all these informational colon cancer posters all over the office. To say my blood pressure was elevated when they checked it, would be an understatement. Anyway, finally got called back to see the doctor, and after a brief conversation about what was happening, he had me drop my pants and he did his examination. Within just a few seconds of me bending over, I heard him say "Ohh..you have a fissure." I'm not sure all how he examined it, but it felt like first he used his finger, then next we used some instrument that he ended up not going all the way in with due to my pain. He prescribed me Diltiazem 5% and Lidocaine oinment and told me to stop taking hyrdocodone. Then he gave me the standard info most all of you have heard. 30 days of Diltiazem, then botox if that doesn't work, then LIS if botox doesn't work, but he said that most of his patients don't have to have the LIS. He told me to make a follow up appointment for 1 month out and if the pain goes away by then just cancel it.

So here we are about 1 month later. My appointment is tomorrow, but I have to say I feel like I'm about 95% healed. After all this started, I never had any blood on the toilet paper, but like I said above, it sure did hurt. Even though the pain is almost gone, I'm still keeping my appointment as I do have a little bit of pain still, and would like an answer to that, and also I'd like to make sure the fissure does in fact look healed and there is no sign of infections.

Some things that seemed to help me the most during all of this was using coconut oil on my butt. for the first few days I could only apply it to the outside, but after a week or so, I was able to make a little suppository of coconut oil and insert it. That seemed to help some. Also I took stool softener 3 times a day, and became an avid consumer of various fiber cereals, specifically grape nuts.

Lidocaine never really touched the pain at all. I noticed no difference.
I have had no adverse reactions to diltiazem, but I can't say I ever noticed that it helped with the pain or anything either. I tried taking baths after bowel movements or taking showers and spraying water on my anus from the shower head. The thing that helped the most though was just taking a 45 minute or so walk.

Yesterday for the first time, I had a bowel movement with 0 pain during and 0 pain after. Normally the last 2 weeks, I would have my bowel movement with minimal pain, then about 30 minutes after the movement, the pain would kick in. So it was nice to not have any pain after this time.

Had another bowel movement this morning at work, and while there was some pain this time, it was very minimal, and very minimal pain after. I was actually able to stay seated and not have to walk around. Therefore, I think I'm super close to being done with this guy. I'm anxious to see what the CRS says tomorrow.
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Re: My Diary

Postby brokenbottom » 23 Feb 2016, 08:31

Sounds like you're on the mend to me! Fingers crossed for you.
Suffered acute AFs since about 2010
2015 Chronic AF diagnosed
18/2/16 Botox (unsuccessful)
12/4/16 Lateral anal sphincterotomy and removal of polyp and two tags
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Re: My Diary

Postby thedude » 23 Feb 2016, 20:43

So just an update here.

Went to see the CRS this afternoon, and he did a quick visual examination. He said that the fissure is still there, and not healed yet, but he said if my pain is getting less (which it is), then just keep using the diltiazem and make a follow up appointment if it gets worse or doesn't go away after another month.

Not exactly what I wanted to hear. Was hoping he would say it was 90% healed and I should be good to go. But he did say it's looking pretty positive that the ointment will heal this one and surgery will not be necessary unless it just re-tears.

I'm planning on finishing out the diltiazem like he recommended and will keep eating fiber rich foods. My bowel movement today was about a 1 on the pain scale, so still doing good there. Just hoping this thing heals up fully in another 1-2 weeks. It's got to be healing since the pain as subsided drastically.
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Re: My Diary

Postby brokenbottom » 24 Feb 2016, 07:10

Sounds like you're out of the woods. Well done. Keep an eye on your diet and hopefully you'll never have to think about all this again!
Suffered acute AFs since about 2010
2015 Chronic AF diagnosed
18/2/16 Botox (unsuccessful)
12/4/16 Lateral anal sphincterotomy and removal of polyp and two tags
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Re: My Diary

Postby thedude » 24 Feb 2016, 09:39

For sure.

Never thought I'd be 30 years old mixing fiber into my morning coffee and eating all bran as a pre-bed snack lol.
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Re: My Diary

Postby thedude » 01 Mar 2016, 12:00

Still doing ok here with everything. I think I may have had a minor set back a few days ago, as I felt a sharp twinge while having a bowel movement and a little more pain than what I was having prior to this, but nothing to bad. It just felt like something maybe pulling or slightly tearing. Definitely scared me, and the pain went from a 1 to a 2, but it's now been about 2-3 days since then and still doing ok with bowel movements. Still sitting at a 2 on a scale of 1-10 scale with 10 being unbearable. For whatever reason the past several days my bowel movements have been thicker for lack of a better term and a little harder to pass. Requires a little work on my part where as before I could essentially just sit on the toilet and let it go.

Not sure what's changed in my diet, other than maybe eating more fiber, and maybe that's the problem that i'm eating a little to much insoluble fiber and it's bulking things up to much. Think I'm going to cut my fiber in half roughly and see how the next few days go.

The after pain is still bearable and I'm still able to stay seated without much issue after a BM. Just a little more pain than what I had before during the BM. Hopefully can get the BM's to be a bit softer and be back on my way again.

Still 10 times better though than when all this first started.
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Re: My Diary

Postby thedude » 07 Mar 2016, 11:11

If what happened a week or so was a setback, I think it's better now as the pain is backing down from a 2 back to a 1 again after BM's. I even had a rather bad eating day yesterday as I had a few beers, then we went out to eat a local TexMex place here and I had some cheese dip and enchiladas.I was worried that this might make my stool rather hard and not easy to pass which would result in a re-tear, but I had taken my stool softener earlier, made sure I drank plenty of water during and after eating, then had a bowel of fiber cereal 1-2 hours after the mexican food.

Had my BM this morning and it was definitely more well formed and harder, but I was able to pass it without straining or any re-tearing. So I'm taking that as a good sign that I am still making progress. Now I'm not taking this as a sign that I can go willy nilly and stop worrying about my fiber intake and go eat a 10lb(4.5kg for you non americans) block of cheese. Definitely still have to make sure I keep taking stool softeners, fiber, but it's just reassuring that I'm on the road hopefully to a full recovery.
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Re: My Diary

Postby brokenbottom » 07 Mar 2016, 13:52

Thanks for coming on here and sharing positive vibes! I'm finding it hard to be positive right now so it really helps to read something that give me hope!
Suffered acute AFs since about 2010
2015 Chronic AF diagnosed
18/2/16 Botox (unsuccessful)
12/4/16 Lateral anal sphincterotomy and removal of polyp and two tags
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Re: My Diary

Postby thedude » 25 Apr 2016, 10:37

So just a little update here on everything.

The past month or so as been pretty awesome. Very minimal pain while going, no after pain. Almost feel normal really. I would say I was feeling about 90-95%. However middle of last week, had a bit of a stomach bug, and I never actually got sick with diarrhea or vomiting, but I noticed that after that little 1-2 day bout, things seem to have regressed some. Definitely having a bit more pain while having a BM, though it's still not the pain I experienced when I first had this issue. I'm also back to having some pain for a couple of hours after a movement.

Bit disheartened really as I'm not sure what happened, but it seems something has happened. Hoping this is just minor and I can be back to where I was here in another few days. Still got a few weeks left with the Diltiazem ointment so will finish using all that up and see where I stand.If still in some pain, then I'll probably make another appointment with my CRS, but I'm thinking he'll probably recommend the botox this time.

Time will tell.
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Re: My Diary

Postby thedude » 12 May 2016, 13:27

Another little update here:

It seems to slowly be getting better again, just trying to be careful with everything still. seem to be back to minimal pain after a bowel movement, as long I do my best to let gravity do it's work. Still taking colace once a day usually a night, and applying my diltiazem ointment.

At first I never had any reaction to the diltiazem, but now it seems I get rather itchy for 15-30 minutes after applying it. I've also noticed that suddenly overnight, I've seem to of developed somewhat of a hard lump at the 6 o'clock position of my anus right by or behind the skin tag from the fissure. Seems like whatever it is, is just underneath the skin. Doesn't hurt, a little sensitive, but not bad. Seems like one day it wasn't there then the next day it was. I haven't noticed any discharge from it, so I'm not quite sure what it is. If I google it, google says I'm going to die, so I made an appointment on the 24'th with my CRS mainly as a follow up on the fissure to see how it's looking, but also to figure what that bump is. Wondering if it's an abscess, fistula, or just scar tissue. Might try to see if they can squeeze me in earlier, as if it's some sort of infection, I think it would be best to get it treated now, however, I feel fine, and have no fever or anything.
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