Not sure where to start as I am feeling quite depressed right now. I stumbled upon this forum while googling about my condition, so here goes. I’ll try and keep this note brief, but please bear with me as it’s 25 years of history I am trying to condense here.
I am a 59-year-old male from Singapore. In 1997 when I was 36 years old I was diagnosed with anal fissure, triggered after a really bad bout of constipation. If I recall correctly, LIS was one of the first treatment options offered to me, and because I was in so much pain at the time, I decided to take a chance on it.
The surgery solved my problem but about 5 years later I began experiencing anal fissures again. This must have been around 2002 or so. That's when my CRS prescribed Rectogesic 0.2 percent (I think it’s the same as nitroglycerine?). Over the next 15 years or so, this was my go to remedy, along with Lactulose to soften my stools. And of course plenty of fruits and veggies in my diet, and at least 3-4 liters of water every day.
As the years went by, I realised that it didn't take a hard BM to cause a fissure in my butt. All I needed was a slightly harder stool than usual for me (what in fact would be considered perfectly normal for most people!) to result in a fissure. The healing time also seemed to take longer between each incidence of fissure. I got so sick and tired of the situation that I consulted a new CRS, and in Jan 2018 underwent LIS again. The recovery took a couple of weeks but the surgery helped and I was free of pain for the first time in 16 years.
I continued to eat a fibre-rich diet, drank 3-4 liters of water every day and discovered the wonder of magnesium supplements, taking one or sometimes two capsules a day. Life was good until Aug 2020 when I underwent surgery for another (unrelated) problem. Unbeknown to me, I was given an opioid-based painkiller called Tramadol to take and within 3 days I was severely constipated, triggering yet again another fissure. You can imagine how depressed I became, and I blamed myself for not researching about the side effects of Tramadol.
Whatever the case, the damage had been done. I went back to the same CRS who performed the LIS but he said there was nothing much he could do, and referred me to another (lady) CRS who treats women who suffer from pregnancy-induced fissures with Botox. She examined my butt but said the tear wasn’t visible. Unlike most other fissure sufferers, my tear isn’t at the rim of the anus but a little deeper. The CRS had to insert a scope to discover the source of the fissure.
Anyway the lady CRS decided against using Botox and suggested I give Rectogesic another chance. And so I did, thrice daily for 3 weeks, then when it was slightly better, twice daily for another two weeks. Since Nov 2020 I had been fine, but two weeks ago the fissure was triggered again. The funny thing is that this time around I don’t recall being constipated. If at all, perhaps the stool was ever so slightly larger and harder than usual. Or maybe it was because I ate some really spicy food the night before? Whatever the case, my fissure is back. There was some bleeding the first few days, and although it seems to have stopped, the pain I experience during my daily BM hasn’t let up. I’ve been applying Rectogesic faithfully 3 times a day since 15 June and today is day 14. Usually, I would see a marked improvement after 2 weeks, but this time the fissure doesn’t seem to be getting any better. My stools are very soft because of my diet, water intake and probiotic and magnesium supplements plus a once daily sachet of Forlax, so I just cannot understand why the pain isn’t getting any better.
I am really down in the dumps and my wife thinks I am becoming clinically depressed. At this point, I just don’t know what else to do...