Hi everyone,
Well, as you can see from my subject header I have been a lurker on this board for a little while and I thought I would take the plunge so to speak. It has been an up-and-down journey for me so far (as I have gathered that it has been for many, many people) and I just wanted to say that this board has already been life-saver both in terms of practical advice and general emotional support. Anyways, my story, hopefully not too long:
I am 35, male, have been dealing with this fissure on and off(I think?) for nearly a year plus two months now. It started in early June of 2017 (I remember it well) though in retrospect it had probably been brewing for a little while from some stress/constipation issues. It's anterior (starting right at 12:00 and branching off to the side a little bit) and I can see it (or at least part of it) when it is acting up.
Also like many people, I had some difficulty getting a good diagnosis off the bat and didn't even see a CRS until 2 months into it. I received a Rx for a diltiazem/lidocaine and eventually through trial-and-error settled into what I thought was a good routine regarding diet/butt care. My situation plateaued/did not fully resolve after a few months and my CRS seemed surprised by this (in retrospect I am surprised he was surprised) and I decided to try a new CRS, Dr. Marsha Harris, whose name I actually got from this board after seeing she had been helpful on some challenging cases. She has been helpful for me as well.
Still though, I am not healed. I have gone through periods where it has appeared to have healed, only for bleeding and pain to return (as is the case now). I have also intermittently experienced external hemorrhoids, though fortunately that is not the case at the moment. The fissure itself causes extreme irritation while defecating and noticeable-though-not-at-all-incapacitating irritation during the day - which I think is one reason I have let it go on so long, I have not yet had the truly excruciating pain that I know some of you have had. Still no fun though.
I think Botox may be the next step for me. Dr. Harris mentioned it during my last visit with her when things seemed to be more on the mend but I decided to pass at that time and hope the then-ongoing improvement would continue. It did for a little while until it didn't.
I already use squatty potty, apply vaseline before a bowel movement, use wet wipes (or if at home, a shower) rather than dry toilet paper. 3/4 a cap of Miralax with plenty of water each night before bed. I had been applying aloe vera gel (Lily of the Desert, carefully chosen as it does not contain alcohol) after bms and that had been soothing. Two lengthy courses of diltiazem/lidocaine already tried. I had been using konsyl as my fiber supplement because I found this to be the best for actual regularity, but this may now be too bulking for me with the bleeding returning. Considering a switch to Benefiber since it seems like others on this board have had success with that.
Going to try and schedule another appointment soon and discuss the Botox, or any other options. For those of you who have used this as a treatment option, have any of you found it to be successful after having already had a fissure for as long (1 year plus, with a few retears in there) as I have? Also have any of you had success with it on an anterior-located fissure? I feel like I read somewhere that Botox is much more effective on posterior rather than anterior location, unfortunately for me. I am trying to acclimate to the idea of an LIS eventually being in my future, and I know there are some good success stories on here regarding it, but considering the risks I know it is not something to be undertaken lightly.
Anyways, this is a great place, and this board has already been tremendously helpful for me even before I decided to dip my toe in here. Thank you everyone.