I have been struggling with a fissure for nearly a year. In April 2014, I decided I wanted to lose weight and began exercising at a kickboxing gym. I also started myself on a high-protein diet. I started with the best intentions, but not knowing much about nutrition, I basically ate mostly meat and cheese. I also never drank more than 24-32 ounces of fluid in a day - EVER - even after I began working out. It didn't take long for me to become severely constipated and soon I developed an anal fissure.
I dealt with it on my own at first, but around June 2014, I finally went to a doctor. He started me on Miralax twice daily and a rectal suppository twice daily for about 2 weeks and then eventually Linzess daily. He also told me to eat more fiber and drink more water, though he never quantified it or even mentioned it again. At my breaking point, I was having 4-5 BMs a day, all of which were excruciating, and all of which would trigger hours of incessant, debilitating rectal spams of indescribable pain. In September 2014, after spending 18 out of 24 hours each day in agony for weeks, I absolutely lost it in front of everyone in my doctor’s office - nurses, doctors and patients alike. It was then that I was referred to a colon and rectal surgeon.
The surgeon stopped the Linzess (thank god), put me back on Miralax, told me to eat 25-30g of fiber daily and started me on Nifedipine in Petroleum Jelly applied twice daily to the anus. Two months of suffering later I returned to her with no improvement. I had a lateral internal sphincterotomy in early December. The first week after surgery was pure bliss. BMs hurt like hell but I had no spasms afterward and no blood in the stool, in the toilet or on the toilet seat for the first time in nearly 8 months.
The second week I had a setback, then another, then another, and within 6 weeks I was back to where I started before the surgery. The surgeon told me I would be the 6th person in her 20+ year career to need a second LIS performed. I wasn’t pleased but I was willing. Before I could do the surgery, I had to have anal manometry performed to see if I could tolerate a second surgery. The test took about 30 minutes and consisted of inserting a manometer into the rectum and inflating it while I tried to bear down, etc. The pain was horrific. The removal of the manometer is the most pain I have ever felt in my life.
After a month of hearing nothing, a medical assistant called and informed me that the results indicated I cannot tolerate a second surgery (i.e. I would not be able to control my bowels). She told me to schedule a colonoscopy, which I have coming up in late April. I have not heard from them again – no alternate treatment plan, no pain management advice, nothing.
I am once again at a breaking point, and I currently have no treatment plan. I do not know what direction to even start in. Should I go back to taking Miralax? A stool softener? Has anyone found anything that works for the pain? I tried Ibuprofen, Tylenol, and even Vicoden that was left over from my wisdom teeth being taken out - nothing stops the spasms or the endless pain they bring. Has anyone tried just not eating solid foods? I’m ready to never eat a bite of solid food again if that is possible without dying.
I’m looking for any advice anyone can offer on nutrition, water intake and pain management. Thanks for listening.