Hello all,

I'm a 41 year old male and this is my first fissure I've ever had. Before this began I weighed 547 lbs. Long story short, I decided to diet and be serious abut it cause I was getting older and needed to do something. I went on Atkins and ate mostly meats for a couple of weeks and lost 20 lbs but it caused me to have bad diarrhea. I think the diarrhea is what started this whole mess to be honest. It made me very sore around my rectal area and irritated.

I then switched to a low calorie diet but the diarrhea wasn't going away so I used some anti-diarrhea medicine and a couple days later I had a hard stool that was difficult to pass. It was my first solid stool in a little over 2 weeks so I think coupled with the irritation and soreness from the diarrhea it tore something. After that my bowel movements returned to a more normal state but it became very painful each time I had one. A week later I had a bowel movement one morning and it felt like I was pooping a razor blade!! It hurt so bad I screamed out loud and almost passed out from the pain. When I got off the toilet I noticed drops of blood and I just stood in the shower running warm water over myself to calm down and sooth it.

My wife is an RN and she examined me for Hemorrhoids but said she didn't see any. She said the area on the left side of my anus was a little red and irritated but that is all she could see. When I have a bowel movement the pain is coming from the left side and it feels to me that there is a cut on that side but she couldn't actually see any cut, just irritation. I think the tear or cut may be slightly on the inside of the hole from what I can feel.

I bought some anal fissure cream from the local drug store and have been applying it daily but it doesn't seem to do much. It has Lidocaine in it as well as some other stuff so it kind of takes the edge off but I can still feel an intense pain when I have a bowel movement. I am on blood thinners as well so the bleeding was a concern but it doesn't belled every time.

This has been going on for 2 weeks and I thought it would heal on its own but I see no improvement. I scheduled an appointment with my regular Dr. for this upcoming Tuesday but she most likely will send me a specialist and that may take up to 2 more weeks before I can get in to see him.

What can I do to help this heal? I read some people take fiber like Metamucil and stool softeners but can anyone recommend a decent brand? Is there a preferred type of over the counter cream I can be applying until I get something prescribed by the specialist? The current stuff I'm using is called "Dr. Butlers Hemorrhoid and Fissure ointment." It helps to take a slight edge off the pain cause it has 4% Lidocaine in it but it doesn't seem to do much else.

I'm willing to try anything at this point! I also think the fissure is causing a side effect cause it started at the same time as the painful bowel movements. My left buttock has begun aching very badly and it usually lasts about 3 hours at a time. It comes and goes but when it happens it makes it to where I can't sit comfortably and even when I lay down it hurts so bad I can't go to sleep. At least the fissure pain is mainly when I have a bowel movement but this pain in my left buttock comes throughout the day or night. It is enough to drive me mad! The pain sometimes run from the left buttock down to the back of my thigh so I tried to put some Icy Hot muscle rub on it to see if it would help. Sometimes it works and sometimes the pain just lingers for hours.

Last night was particularly bad as the pain in my buttock and back of my thigh raged on for about 4 hours and I literally just cried. It started after I had a very painful bowel movement and Tylenol didn't seem to help the pain at all.

Any advice as to what I should do? What products should I incorporate to help with all of this? Creams, fiber supplements, stool softeners? Any stronger cream for the pain on the fissure I can buy over the counter until my Dr. Appointment?

Hi PW,
Not much advice really there is coconut oil, olive oil to apply before a BM but nothing and I do mean nothing over the counter stops or even comes near to stopping fissure pain. Get in the bath as hot as you can handle straight after your BM oh and do NOT wipe with toilet paper wash with the shower head if you can or wet wipes if not.
My main reason for reply was to tell you that my worse pain comes on a couple of hours after a BM would radiate into my tailbone and all the way down both legs for hours this was a result of my sphincter going into spasms. I have never experience anything that comes close to this level of pain it's horrific I can literally be rolling on the floor and sobbing in agony.
Try and get to see a CRS asap as they can prescribe you cream specific to a fissure.
Good luck

Mypoorbutt's advice is spot on. See a CRS as soon as you can. Doctors and GI specialists seem to have no idea about anal fissures. And, there is nothing you can get OTC that will help. For their size the pain is ridiculous. Like having a calf cramp that is persistent in the arse! Far worse than childbirth!