Hi all.

Im a 23 old male and I have been dealing with different digestion/bowel/stomach problems for as long as I can remember but the last 1 1/2 years has been very difficult as my anus has started to pay the price.
I have a gluten intolerance and several mental issues being ADHD, anxiety (social in particular) OCD and severe moodswings (on/off depressive periods). I think this might be relevant to mention as I see a big connection between my mind and body. At the time, they are both in hell!

So, about 1 1/2 years ago I started to get very depressed. That lead me to sit around all day, smoking weed, eating junk food and candy and of course I got constipated. Not in the way that I dident go, Im pretty regular and go at 1-3 times every day but the bowel movements had to be forced due to the size and dryness and so, I got a fissure. Which surely must be the bodys way of saying F**k you and welcome to hell.

Anyway, I tried to fix the problem my self but a few months later I went to the doc. He confirmed my fears, I had a fissure in the 6 a clock position. I got some mild steroid creme with lidocaine in it but dident use it as I was afraid of thinning the anal skin.
So I started to do what ever I could to heal. It became an obsession, but a necessary one. Hours on hours spent on research but finally the things I did started to pay off. I got to a point with no symptoms what so ever after fighting the fissure for maybe 4-5 months or so.
I was finally free again (or as free as an isolated, none working person can be) and the future started to look a little brighter. As you can imagine, it dident last. Why else would I be making this thread right?

3-4 months went on without any symptoms. Slow, but steady things started to get worse again but it wasent the sharp fissure pain I was used to. It started to itch for aparently no reason, burning after BM, swelling of the anal skin, sometimes a small amount of fresh red blood on toilet paper and stuff like that. I went to the doc and he made another visual examination. No fissure, but the anal mucosa was red and irritated and the anal veins was somewhat swollen, but he said that it was not a hemmorrhoid (which I dont understand as I thought that swollen/twisted veins was hemmorrhoids?)
He thought it was some kind of inflamation so I got a steroid creme for it, and not hydrocortisone, this was a much stronger one. Also, it had some antifungal stuff in it.

I used this 2 times a day for 8 days and quickly got symptom free but just a week after the treatment I was back to square one.

So, back to the old rutines anyways with sithbaths and what not. Ever since I have had problems in that region, that comes and goes with maybe 1/15 days being symptom free but other symptoms of intestinal distress was starting to show it self. Abdominal pain that comes and goes (like Crohns, but is somewhat relieved by antacids), constipation like stools that come out of no where, sometimes too watery stools (rare), feelings of bloating, acid reflux and stuff like that.



3 weeks ago it got really bad. It was like my entire colon was at sleep. I dident get the BM urge as normal, I had abdominal pain and for about a week I dident fart at all. In this week I had some big, somewhat dry stools that required a lot of straining to get out and that was very painfull. This went on for almost 2 weeks and then went back to normal with BM urge at the same time a day (mostly 2 times), normal amount of "air" and the feeling of a gut at work instead of sleeping/dead feeling - dont really know how to explain this.

The episode above has left me with an anus that, well, doesn´t work!
The last week I have had stools that are soft, not too big and which would normally slide out pretty easy even if there was pain with it, normally im done and feel empty in like 10-20 seconds or so but now it wants to stay shut. I have to strain a lot, to the point there I get cold sweat and anxiety attack, my heart beat goes crazy and I think that I wont make it. The pain is severe but could be worse I quess, its more the straining that takes it out of me at this point but my situation down there can change quickly.
This got worse and worse everyday so I went to the doc yesterday. I thought that I had gotten an internal hemmorrhoid from the straining and that it was blocking the exit so I had to strain. I really wish that It was a hemmorrhoid, even though Iv never had one (at least not that i know of) and therefore I dont know how bad it is) but what my doc found just about the worst he could have told me.
I got multiple fissures. 4-5 he said, and the visual exam was so painfull just from spreading the skin down there to look that I dont know how I got through it only screaming one time.

I knew this could be a sign of Crohns or cancer but he dident think so. He then proceeded to give me a digital rectal exam (finger) which was painfull but quickly over. No hemmi, no blood, no mucous.

The doc told me to start the steroid cream again but I dident want to as I was afraid of getting thin skin down there (maybe im already to late and the cream is the reason that the constipation like stools gave me multiple fissures, in which case I quess I might as well kill my self). I requested Diltiazem 2% cream which I havent tried before but I wont be able to get it in the next 2-3 days.

So what the can I do untill I get this cream? I know how to keep stools soft and at the moment they are. Still, they are very difficult to pass, getting harder every day. Im pretty sure that I justify for a IBS diagnose and I know its only a matter of time before I get a big/hard bm and I dont think that I will be able to pass this.

I gave pre-BM lubrication with coconut oil a shot today but It dident help at all - if it did I surely would have passed out without it!

Im thinking about trying lidocain creme before BM untill I get Diltiazem but I would like to know if this would make stools even harder to pass as the area gets numb or? I never tried this before.


Any advice will be greatly appriciated!

Hi Lost For Words,
thank you for telling us your story. You've been suffering for a long time, and it sounds quite complicated - I'm really sorry you are going through this.
The good news is, everybody here knows what you are going through - most of us have suffered quite similar pain and anxiety. There is lots of great advice here about managing pain, good diet, keeping hydrated, getting soft stools. Read around in the tips and the success stories.

The diltiazem should help you, but by the sound of it, you also need to get your diet and water-intake working for you, perhaps with the help of stool softeners and laxatives. Laxatives sound like no fun, but they can do wonders. Some people take Colace, some take miralax. I take a mineral oil laxative called Kondremul. Whatever you use, you want nice soft BMs that slip out easily.

Definitely up your water intake. Maybe cut out caffeine and alcohol, since they will dehydrate you.

It's a great idea to keep a diary of what you eat/what laxative you take, and how your BMs are. By doing that you can more easily pinpoints what works.

Another thing, if your BMs are soft, but not coming out, try a different position to poo. It's really vitally important not to strain. Some people find that squatting really helps the poo to come out without straining. There is even a frame you can buy called "squatty potty", that fits around the toilet and lets you squat safely. Some people squat in the bath or shower, which sounds not very nice, but it's a whole lot nicer than having a fissure.

Good luck and let us know how you get on!

Thanks for the reply :)

Yeah, no doubt that im in the right place to talk about these things, just wish that I dident have to!

My diet is pretty good actually but there is room for some improvement as I tend to not eat enough then im depressed but I dont eat any candy, fast food, chips and stuff like that at all.
I dont drink coffee and I dont drink alcohol (only like, one glass of wine a few times a year)
I only drink water and one glass of tea (no sugar) a day, the combination of warm and cold liquid helps stimulate defecation urge.

I have experience with both milk of magnesia (Magnesiumoxid) and Movicol/Miralax.
I like Movicol a lot but I have been using it on/off (mostly on, at low dosage) for several months so I use MOM now.

I have tried the to keep diary of my food intake/BMs before but it got too hard to keep track of as Im not good with consistent attention. I may try it again.

I do take Dexamphetamine which will dehydrate too and cause some vasoconstriction
but I do need this to keep my mood up and not having my ADHD mess too much with my life. Also, the dosage is very small and I had these problems way before dex (started 3 months ago) but of course it could help a little not to take it. I just think It would cause more harm than good overall as my mood would drop and I might end up on the couch all day which is really bad for bowel function.

I already do a semi squat thing with my feet raised a little while on the toilet but Im thinking about trying the squatty potty as this is a little higher that my foot stool (not that kind ;) )

Hi lost for words,
Welcome to this amazing forum, this is the place to come for support and rants when you like. :) this place has kept me going in the darkest times. Do you have any diagnosis of IBS? Your story is similar to mine... Lots of hard BMs, straining, constipation. Of course, like everyone else at the time it is natural to push and not realise the damage we are doing. I had 3 Fissures at the worst point and the pain was unreal. I ended up on Antidepressants, which helped, and have since overhauled my whole diet, use Movicol and have had Botox. I was given the Lidocaine, but it is not recommended for long term use as it can thin the skin. Have you seen a CRS, or a GP. Xx

Hi Rachael

I dont have an IBS diagnose as I havent had any other examinations than digital rectal exam and several visual ones by spreading the anal skin so to speak. My doc recomended futher examination a year or so ago at one point there I had severe bleeding a few days but I dident agree to it as I cant imagine having a colonoscopy. I know that in the US it is standard procedure to be under total anesthesia when having this exam, but where I live they only give you something to relax (like a benzodiazepine) and some local anesthetic like Lidocaine - which of course is absolutly insane and if you have a fissure then it will most likely be the most traumatising event one would ever have to go through. Im pretty scared that I have some kind of IBD or even cancer so I think that I might agree to it after all but first I will have to convince them to give me a high dose of ketamine or the likes so that I wont feel or remember a god damn thing.

About the constipation:

The wierd thing about this, in my case, is that I am and always has been pretty regular. I go 1-3 times a day at more or less the same time every day and I have done so for as long as I can remember but somehow I can get big,hard and dry stools out of no there. It can easily go from soft stools, maybe even too soft to constipation like stools in a matter of 24 hours. Thats partially why I believe that I justify for an IBS diagnose.

How did the antidepressant help you? I can imagine that it would take the top off of the mental disstress that comes with this condition but constipation is a well know side effect from these SSRI drugs. I have considered taking these drugs several times before but the fact that it can be constipating has always kept me from trying it.

What about the botox? Would you like to share your experience with this or maybe hand me a link if you already did so on an earlier point of time? Im pretty skeptical about this treatment as what I have read about it mostly has turned out to bring people some temporary relief. I hope that it worked better for you, but after all, I quess that you would not be here if it was a complete succes.

I have seen my GP at several occasions but never anyone else. I want to meet with a specialist though so I have made an appointment at my GP in the beginning of january to discuss a referal to a CRS at the local hospital. I might try and call him tommorow to meet with me right away if possible as its even worse today and I really fear that I wont be able to defecate soon. If this happens, want do I do then? Rush to hospital? (dont know what they can do for me in that situation?)
or do I take a huge dose of laxatives to make the stools so watery that it can pass? (I know this is very bad for fissures but surely its better than getting severe constipation)

About the Lidocain. Were you able to have BM with the anus being numb? I never tried it and dont know what to expect, but I have a 5% creme on hand in case things get really out of hand.

have u tried magnesium citrate? very healing to the bowel, keeps stools soft, easier to pass - nothing ever worked for me but the magnesium citrate has - try it. Also, I would stay away from the creams, the may very temporarily relieve symptoms, but they do thin the skin, and do nothing to get rid of the problem. Eat a bland diet, lots of celery, apple sauce (unsweetened), broccoli, kale, brown rice (long grain). Take a tbsp of virgin coconut oil, good for the gut.

All the best.

Hi hurtinend and thanks for your reply, its greatly appriciated.

I haven´t had a chance to try the citrate form yet but I do have some on its way. Ordered almost 3 weeks ago from the US but it has yet to arrive here in scandinavia. I do take some Mg though, 200/400 mg chelated Magnesium glycinate every night an hour or so before bedtime, makes me relaxed and sleepy :)

Could you maybe elevate further about your experience with this type of Mg? Dosage? What else did you try before Mg citrate?

I will not use the Lidocain cream unless absolutely necessary and so far I have not used it. The topical steorid cream that my GP whats me to use is also not something that I will try again. I used it for 8 days a while ago then there was no fissure but other problems in that area and it only provided temporary relief (but it was very good while it lasted) so given the possible side effects, this will not be something I will try ever again.

I did get some Diltiazem 2 % cream yersterday though and so far it seems great and so far, no side effects at all. I will be using this twice a day for a maximum period of 8 weeks.

How might coconut oil help me if administered oral? I just started to use coconut oil yesterday but only as a pre-BM lubrication.