Hello!

I'm a 23 year old male, 115lbs, 5,8'

When I was 15 years old I began to get external hemorrhoids and experiencing itching, swelling and general discomfort. My diet back then consisted of mainly meat and carbs, meatballs and rice or chicken and rice were pretty normal meals for me. I kept no track of BM's also so I can imagine that it was not abnormal for me to be getting constipated. The hemorrhoids began to get worse and I started to experience pain from them, which would at times get pretty large. I saw a few doctors including two gastroentologists who both told me that my hemorrhoids were not that bad and gave me some Prep H or Anusol which did nothing to help. I had some bands put on the hemorrhoids twice which were not successful and eventually I had a full colonoscopy done and the doctor told me that he saw nothing out of the ordinary.

When I was about 19 years old I began experiencing pain and blood during BM's which would at times get intense. My hemorrhoids seemed do have disappeared but now I had a new problem that seemed to be even worse. It didn't take long for me to realize that this was indeed an anal fissure. I went to an endoscopy clinic where I was first diagnosed with a fissure and prescribed Diltiazem 2% ointment. I used it religiously in hopes that it would make the pain go away but I saw no improvement. Eventually I returned to my doctor and gave him the news that the Diltiazem did not help, he decided to perform an LIS under Local Anaesthetic on me (at the time I had no idea that the success rate of that procedure under local anaesthetic is actually quite low). Again I saw no improvement in my condition, still experiencing pain during my BM's. A few months later a went to live abroad for 5 months and during that time it seemed like my fissure had vanished. I was still experienced some itching, swelling and the occasional hemorrhoid but it was 1000 times better than the incapacitating pain I felt prior.

However once I returned from my trip the fissure returned with a vengeance, again I was experiencing horrible pain during BM's that would last the entire day. The only thing I found that helped was a dramatic change to my diet. The only thing I ate was Lentil soup because it was still nutritious but left my stool very soft and watery. I began to experiment more with my diet and I found that things like Quinoa, Tofu, Fish and other veggies seemed to not upset my fissure too much. For the next year my problem was very chronic, I would follow my diet strictly when I was in pain and when I was feeling better I would begin to eat other things but eventually the fissure would "come back". I would feel fine with minimal symptoms for months at a time and then be in pain for another few months. Eventually the pain got so bad that I would be in bed for days, even when I was eating nothing but mushy lentil soup. I would wake up, be in extreme pain which would incapacitate me for the day, feel a little better in the evening and then repeat. I felt like I had no life anymore. It was taking a huge impact on my social and family life and my goals and my career. I went to another doctor that gave me some Nitro cream to try out. It helped numb the pain a little bit but it really wasn't doing much beyond giving me headaches.

Next I met with a doctor who was much better at listening to my symptoms and history, as he could not spot a fissure during the examination he proposed to do a Sigmoidoscopy on me with a possible Anal Dilation and Anal Cauterization. While I was knocked out he located the fissure and Cauterized it (burned it off). In the few weeks after the operation I was still experiencing pain after BM's but it was a different kind of pain and would go away faster until I was no longer experiencing any pain at all. I felt like I was cured, I was sick of eating lentil soup for every meal and I began to once again enjoy meats and other foods I'd missed so much. I also started taking psyllium fibre every night to keep my BM's regular. I felt like I had my life back.

After just over a month of bliss I had a BM where I felt like something nicked part of my rectum and cut it right open again, I was in pain and there was blood in my stool. I was crushed, I thought I was done with this forever but it had once again come back to haunt me. I went back to my doctor and he told me that it’s very possible that my fissure will reopen from time to time and that its something that I will just have to live with. He said he did not see anything from doing an examination. The "new fissure" seemed to go away after a few weeks and I was back at what seemed to be 80% normal.

And that's where I am today, I'm not improving at all and I have pain during my BM's whenever I stray away from my strict diet of Fish, Tofu, Veggies, Lentils and other beans. I use a bidet at home and I only use toilet paper to dry not wipe, when I'm out I bring along a portable squirt bottle that serves as a bidet. My issue is manageable at best now but I'm not satisfied with just that. I want to get to a point where I can forget about my anus for a day but I've never had a single one of those in the last 8 years. At the very least I will experience some swelling, itchiness or discomfort every day. What I'm really wondering now is why am I so prone to anal pain/discomfort? Is this a fissure that has failed to heal? Is the Crohns? IBS? Is there a different kind of specialist that might be able to help me in a way that other doctors have not? I feel like the sooner I pinpoint exactly what is causing all of this the sooner I will be able to move forward with my life. I'm sick of going to see doctors that will stick large objects up my rear end only to tell me that nothing is wrong with me. I'm sick of having to worry about following my diet everytime I want to go on a trip. I'm looking for some answers and I'm not afraid of thinking outside the box and trying new things.

Welcome and thank you sharing your experience.

I think you did everything right, though cauterization is not that popular procedure nowadays. I would think you still have fissure, but suggest you to reconfirm with possibly another doctor. Please also try to avoid dilation, it has quite high risks of following inconsistency. Try to find someone using botox or LIS as healing methods.


Let us know on how it goes currently for you