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Postby G17 » 07 Apr 2014, 14:12

Hi everyone,
I am a 39-year-old male in Oakland, California.
In the middle of January, I developed what may well be an anal fissure. (I'm not sure because, 2 days later, an ER doctor found a fissure, but the next time I went in, I saw a different doctor who didn't find anything.) I have a long history of constipation often, for my years, sometimes extreme, so my history and symptoms really could be an anal fissure. But I'd be happier with a clearer diagnosis.

So I've had this problem for almost 3 months now. I've been seen by a bunch of ER doctors (I have MediCal), my primary doctor a few times, and another doctor who was filling in for my primary doctor. So far it hasn't gotten better. There are a lot of complicated questions and conundrums and dilemmas about all this for me. But maybe I should ask the people on this forum about them on the "General Anal Fissure Discussion" section.

Since this started, my life has been totally disrupted--hard for me to get much done--it has totally taken over my life. And on top of the other chronic health problems I already had, it makes it very hard to deal with things.
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Re: Hi

Postby matt1 » 07 Apr 2014, 19:40

g16-- a very basic q is what are you eating. i want to compare myself to you so that maybe one of us can learn something. but i would need to know what you are eating.
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Re: Hi

Postby G17 » 07 Apr 2014, 19:48

What am I eating? I'm on a very limited diet (multiple food intolerances). I eat lots of oatmeal and oat bran every day with brown sugar, chicken soup with vegetables, French bread, some cookies and rolls and stuff from a local healthy bakery. Chicken and turkey patties. Carrots and celery (cooked and raw), spinach, sweet potatoes, things like that. The main difference in my diet since the fissure started is that I avoid corn (doctor's orders). (The doctor also told me to avoid nuts, but I mostly was anyway.)
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Re: Hi

Postby Jbl22424 » 07 Apr 2014, 23:05

What are your symptoms? I believe fissures are pretty easy to diagnose because they cause intense pain for hours after a BM. If you have that, I think you probably have a fissure. I would go to a CRS instead of a GP or ER doctor. I don't think those doctors know much about fissures.
Developed fissure from constipation due to breastfeeding 7 weeks after delivery (Jan 2014)
Nifedepine
Colace
Magnesium
Miralax - godsend
Nitro - some improvement
LIS (May 2014) - cured for 3 months then setback
Diltiazem
Feeling better for now
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Re: Hi

Postby G17 » 08 Apr 2014, 12:04

My medical history, even in the last few months, is long and complicated. Here's some of it:
In the middle of January, I got pain--especially intense itching--one Friday in the late afternoon. Eventually wound up scratching and rubbing a lot, though knew it was a bad idea. It was after a lot of that (2 days later) that the 1st ER doctor diagnosed a fissure with his anuscope. A couple of weeks later, another ER doctor couldn't find anything.
Was unable to defecate at all (except for teensy amounts sometimes) till I drank 2 bottles of magnesium citrate. Later, a doctor put me on Miralax, and now I can defecate sometimes, but very irregularly. And have to take a sitz bath with Epson Salts afterwards to clean it.
After I started using a rubber ring, there's usually much less pain. Though that depends on what rubber ring I use (a lot of them broke).

Anyway, the two constant symptoms are:
1) Unable to defecate at all without Miralax; defecate very irregularly with it.
2) Any pressure on the anus, or the inside of the butt-cheeks, provokes pain and itching. So applying any prescribed creams causes pain and itching, and I can't keep using it.
So far, every pain reliever cream I applied didn't work. (I don't know if a really strong analgesic cream would work or not.) And with other applied creams (e.g. Preparation H), they didn't relieve the pain/itching, though I didn't apply them very long.
(Once I started sitting on the rubber ring, defecating with Miralax usually doesn't hurt.)

Hope I didn't load you down with too much information all at once.
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Re: Hi

Postby Jbl22424 » 08 Apr 2014, 12:32

I would go see a well reviewed or recommended CRS. I think that's a step in the right direction!
Developed fissure from constipation due to breastfeeding 7 weeks after delivery (Jan 2014)
Nifedepine
Colace
Magnesium
Miralax - godsend
Nitro - some improvement
LIS (May 2014) - cured for 3 months then setback
Diltiazem
Feeling better for now
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Re: Hi

Postby G17 » 08 Apr 2014, 12:43

Thanks. I'm already planning to ask my primary dr. to send me to a proctologist (I think that's the same thing) when I see her on the 17th.
But I don't know for sure if my health care (MediCal) has one I can see, especially any time soon. Or if a proctologist can really do anything they haven't already done. Oh well, I hope for the best.
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Re: Hi

Postby G17 » 08 Apr 2014, 16:19

Possible bad news--I checked my health system's directory of practitioners, and they don't list any proctologists--I'm not sure they have one.

EDIT: I called Member Services--there is one proctologist to whom my system can refer patients, though he doesn't work for them.
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Re: Hi

Postby G17 » 27 Apr 2014, 20:53

A few weeks ago, when I saw my primary doctor, I asked her to refer me to a proctologist (I think that's the same as a CRS). She didn't--she said I could refer myself to a proctologist, but she didn't think a proctologist could do anything that hadn't already been done for me by other doctors (advice, prescriptions, using anuscope).
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Re: Hi G17

Postby Roidsfizzman » 01 May 2014, 15:07

This is my first post but I am a long time suffer 3 plus years with a fissure. You need to see a proctologist/CRS for a fissure or for some other issue that could be causing your pain. If you have a fissure, they are most offten located just inside the anus nearest the tail bone. I used a flash light and mirror and bent over and spread the anus and I could see my fissure. I also have issues with Hems, so I wanted to identify the pain for the correct treatment. I am three days post LIS surgery and banding for the internal hems. The best toical I found for pain was lidocaine for the fissure. You need to drink at least eight 8oz glasses of water each day. Something that helped me was getting up in the middle of the night from sleep and drinking water this helped keep the stools soft. If you have a fissue, keeping the stools soft is a must. You are going to have to find a way to keep regular BMs. Miralax is a great stool softner when you are not regular have you tried to drink a glass of prun juice if you mix with apple juice its not too bad? You may want to consider a 90% vegetables and fruit fiber diet.
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