Manual dilation

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Manual dilation

Postby rockfellow » 19 Jan 2020, 13:15

I will try to be brief as possible. Hope this helps.
I was having problems with painful fissures for approximately three years with trips to the doctor with both my general practitioner and surgeons. The fissures would generally last for 1-1/2 months and then go away for several months or a year, and then ultimately always come back. The pain was mind-bending. Then toward the end of the three years, my GP told me "the colo-rectal surgeon made a note that you have a tight rectum, but I don't recommend surgery because then you will have a loose rectum, and with it comes a whole other subset of problems."
That set about a change in my thinking. I had to do something, though, because the spasms and pain were unbearable. There is a journal study that is readily searchable on the internet that concludes that manual dilation is 80% effective when using a finger, and 60% effective when using a dilator (butt plug). So I figured this was worth a try.
For 10 months I used butt plugs starting small at under an inch and going up to 1.33 inch diameter. I had no desire or need to go larger than that. The spasms stopped pretty soon after I started using the smaller plugs. There would be blood and new fissures on probably 8 different occasions, resulting in heartache because I didn't know how far the new fissure had set me back and if I was back to square one or not. Turns out in all cases, I wasn't back to square one, but the fissures healed much sooner and with fewer spasms at first, and then no spasms after a few months. The last 3 or 4 times there was blood due to a new fissure, it basically felt like a sunburn on the bumhole that seriously lasted only one day!
My anal region feels much stronger and now I am confident that manual dilation has worked. There has been no blood when using plugs for the last several months now. However, I think I could have avoided breaking open new fissures if I used a finger for the first several months before moving on to the plugs. I went with plugs right away because I found that they are slightly easier than reaching all the way down with a finger. I haven't told the wife yet because I don't know what she would say...I guess now that I know it works, I should tell her too!
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Re: Manual dilation

Postby Fissure UK » 01 Mar 2020, 06:48

Hi Rock fellow,
I am pleased that you have achieved a degree of success, in that you have improved your situation quite a lot.

I am surprised that you were able to dilate at 1.33 inch  so well done to you! In metric that is  just under 34mm. The  max dia  I have managed without tearing is 18mm. I tried a 20mm and it caused a tear. I still use 18mm. My anus remains very tight as you can imagine- 2 years post OP.

You say,  "I went with plugs right away because I found that they are slightly easier than reaching all the way down with a finger"

Are you meaning that you need to dilate right in to the anal  canal? I am guessing that generally there is only tightness at the anus-at least that is my experience and understanding.
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Re: Manual dilation

Postby rockfellow » 01 Mar 2020, 13:04

The sphincter is around 25mm long I think, so if using a finger you may want to go a little farther than that using a circular motion in order to evenly dilate. I found that a butt plug was slightly more comfortable for me (and with no applied circular motion). Relaxing is the key--stretching should be performed only ever so gradually to prevent tearing. I found that taking a lot of time to get the plug in while frequently backing it out worked best for me. When I backed it out, I found that the sphincter tended to relax more than going forward.
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Re: Manual dilation

Postby Fissure UK » 04 Mar 2020, 18:00

Thank you for clarifying  Rockfellow.
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Re: Manual dilation Update

Postby rockfellow » 03 Nov 2020, 18:55

Just a quick update. Everything is still good and I don't expect to ever be plagued by fissures again. Looking back, the pain was so bad it was making me think all sorts of conclusions like caffeine is bad for fissures, alcohol is bad for fissures, this food is bad, that food is bad, and so on. The way I see it now there are only two things that matter: The cause of the fissure, and management of the fissure. I was so racked with pain that I was confusing lack of perfect management for the cause of the fissure. My fissure was not caused by lack of perfect management. My fissure was caused by one thing, and one thing only, which is a sphincter that was way too tight. There are only two ways to loosen it: One is manual dilation, and the other is surgery. That's my take. Good luck.

Just to qualify/clarify or whatever, it took me a long time, maybe seven months to really loosen up. It wouldn't have been possible for me otherwise. I had to take breaks of two weeks or longer, and I was kind of in the balance for months (no pain, just in the balance in order to avoid another fissure).
Last edited by rockfellow on 10 Nov 2020, 02:13, edited 1 time in total.
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Re: Manual dilation

Postby Fissure UK » 09 Nov 2020, 15:30

I certainly improved the diameter of the area. I started with 18mm, and increased by 2mm increments 20, 22 and finally 24mm over a few weeks.

I found that dilating every alternate day for 10 mins to 20 min was fine.

It is NOT a fail safe. If you suspect a large tight bowel movement is on it's way, STOP and poke it out manually. Unpleasant maybe, but nowhere near as unpleasant and depressing as another fissue.
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Re: Manual dilation

Postby chrosy » 25 Jan 2021, 12:05

Hi rockfellow & Fissure UK,

Just want to see how you guys are doin? I had on and off anal fissure as well, which happens twice a month. I've been practicing manual dilation using my finger and so far so good. Question, how far do you put your finger in?
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Re: Manual dilation

Postby rockfellow » 26 Jan 2021, 22:49

I used a plug not a finger. However, I have read that you should use a nitrile glove and lube and insert finger past both the exterior sphincter and the interior sphincter, which is probably about one inch (2.5 cm). Then go in a circular motion (like stirring a pot with a spoon.)
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Re: Manual dilation

Postby Pzgre » 22 Apr 2021, 10:33

Which kind of dilators did you use?
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Re: Manual dilation

Postby rockfellow » 24 Apr 2021, 10:21

The smallest and most soft material I could find. The smallest was one I read about on this forum, which was Doc Johnson Naughty Mood. It was pink in color and as I recall, was about 3/4 inch diameter. It made me bleed the first time I used it. I read as much about other people's experiences before trying this, and read about people who would leave them inserted as they would do chores around the house, etc, but that didn't work at all for me because I found it would get more and more uncomfortable the longer I left it in.
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