Thank you to everyone who contributes to this forum. It has helped a lot to cope over the past several months. I appreciate the insight and positivity of people who are currently suffering or who have experienced anal fissures.

I am a 26 year old gay male living in Los Angeles and have been in and out of depression dealing with this disability. Sometimes I am positive and believe I will get better, and other times I fear this is a lifelong journey which will ensnare me in a twilight world of anal punishment for the rest of my life. I realize that I am young, and that relief and recovery are imminent, but this process is arduous and I don't always handle the pain very well. Any advice, tips, suggestions for treatment would obviously be enormously appreciated.

In the past 8 months I have been diagnosed with hemorrhoids, then intestinal parasites, and now an anal fissure. After treatment of my intestinal parasites, it seems that my condition has stabilized but I have not seen any dramatic improvements in the fissure department. I have been on a regimen for several weeks that seems to be at least keeping the pain to a low/moderate level, some days no pain at all.

My current treatment is as follows;
Every evening I take a stool softener, magnesium, and ibuprofen. This way I get a good night sleep, lower inflammation, and ensure a soft bowel movement in the morning.
In the morning I drink a glass of fruit juice, and take a daily probiotic, rutin, ibuprofen, and magnesium. After my bowel movement I use epson salts in a sitz bath sometimes with witch hazel and black tea. Then I apply coconut oil and insert a vitamin E suppository. I try to take at least one more sitz bath in the evening.
I am also taking several kinds of herbs recommended by herbalists and an Ayurvedic practitioner. I take licorice root with amalaki in hot water, avipatikar, marshmallow powder, and a tincture with echinacea and horse chestnut.

I have a very strict diet because anytime I stray from a particular set of things I have bowel issues, which is something I cannot afford to risk in this condition.Mostly i try to stick to Ayurvedic principles of eating. I eat lots of boiled or steamed vegetables, sauerkraut, bone broth soups, and lean meats, mostly chicken. My bowels seem to be fairly regular but I am prone to constipation and take stool softeners to ensure I don't re-injure myself when I shit. I am active, exercise regularly by weight lifting, am generally athletic and healthy besides the anal issues. I am thin and athletic, always have been. In fact I have such a penchant for watching my health I don't know why these things are happening to me. Although I only recently stopped smoking and drinking due to these problems.

I have no pain during my bowel movements, and no blood or mucus, so I'm not sure why I am still experiencing pain and not seeing much improvement. Doctors have been fairly useless besides confirming the diagnosis. I am NOT INTERESTED IN SURGERY. And any prescribed ointments have been no help or made the muscle spasms worse. I experience discomfort often when sitting. I don't know what else to do to be honest.

My life has been turned upside down by this experience and it has effected all dimensions of my daily life. I have not been able to date or have sex with anyone. I cannot go out drinking anymore, in fact I often avoid socializing because my confidence is often pretty low. Sometimes I ignore it to great success and have a great time, but sometimes it reminds me that my life is bound to this private injury I'm not comfortable talking about with most people.

Are there any treatments that I should ABSOLUTLEY be doing?!?!?
Is there anything I should NOT be doing?!?!
Are there any other gay men out there dealing with this issue? Other bottoms who have overcome this? When will I he able to have anal sex again?
Is there anyone out there who has experienced success with the Ayurveda or with the GAPS diet?

I will continue to read other posts and learn what I can, thanks again to all contributors. Thank you for reading this. Please reach out if you have any advice.

Hi sorry to hear you are suffering,
I think there comes a point with fissures where no matter what you do with diet creams and supplements that you have to admit defeat and use surgery as a positive step in your recovery. I tried every natural supplement and cream available for me...I have crohns and IBS so I go too much....some helped some did nothing, for me the best were coconut oil, oil of oregano, and comfrey all cream based the best supplement was homeopathic nitric acid, but none of them worked long term, the most important thing to remember is if you have a high resting pressure then nothing can stop the spasms other than Botox or LIS. And until the spasms stop long term the fissure cannot heal or will retear.
Is there a reason you don't want surgery....
As a straight female I cannot help with whether you will be able to return to a normal sex life after its healed....but I do know that while I was having active spasms I couldn't have sex.
I really hope you see some improvement as I know how much this can impact our lives
Good luck

Sorry you are going through this...it's hellish. I still have tons of pain despite my fissure healing over - I've been told by my gastroenterologist, colorectal surgeon, and pelvic floor physiotherapist that, unfortunately, LIS is the best option, since the continuing pain is likely from a very very high resting pressure. So overall, I'd agree with MPB on this one...sorry, I know you said you're not interested in surgery. I'm also young and very athletic and healthy - this seems to happen to a lot of people who take really good care of their bodies, it seems unfair.

However, I do see a pelvic floor physiotherapist who has helped reduce my pain about 10-15%. She isn't able to do much work because my pain level is too high - but it seems as if your pain is under better control. Perhaps a pelvic floor physio would be able to help you out!

I really hope things improve for you. 8 months of this feels like an eternity, I know. Hang in there

-GG

Thanks for your support! I really appreciate the feedback.

It seems like things are getting better for me. I have been experiencing far less pain, and less frequently. BMs have not been very painful and I have been keeping a tight regimen which I described earlier. But today I noticed something that made me freak out a little bit... I have some extremely sensitive tissue on the outside of my anus, about a half in from the opening near the coccyx. When I press here, either with my finger or while wiping, I can feel a little hard ball deep in the skin, and it is very inflamed. I read online that it is possible that this is a symptom of an perianal abscess or fistula, but I don't have any puss. I also noticed there is a new little external hemorrhoid as well! Which is shocking to me since I have been so committed to healing and stuck to a strict regimen. I don't know what to do about this and I'm afraid if I go to the doctor I will just get turned away again. The last time I visited the Gastroenterologist he told me to come back if I wanted to get a colonoscopy. But he thought it sounded like I was improving and I should just continue. What should I do? Ask for an examination? Do you think I have an abscess or something?!

I would have it looked at but I wouldn't worry. I've had a small lump like that and it was painful but went away...I think it may have just been a clogged vein or something. And as for the new small hemorrhoid, it could be a skin tag from having the fissure - they come in all shapes and can look just like a hemmie.

I would get them to have a look, but I would worry too much about it!!

-GG

I've been hearing people use coconut oil (vco) on their fissures, I understand that the oil can reduce the friction, but doesn't it sting? and shouldn't wounds be dry to facilitate healing? What about baby powder? Can I rub/sprinkle 'em on the pesky AF? Your thoughts are appreciated, guys~


and louchebinny, we kinda have a similar experience, how are u feeling?