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.