Hello!
I'm not really new to this forum but this is my second post. I first posted here about a month ago I think in the Introduce yourself section (I would post what I had written then here but I can't find it, sorry!).
Long story short: Self diagnosed myself with anal fissure, treated myself for about a month, went away for around a week, but then came back
- I'm a female, just turned 20 years old. On April 10th 2012 I had a very hard to pass bm, and after there was some blood. I experienced discomfort for about an hour afterwards, but it went away so I forgot about it. My next 2 bm's were easy to pass but I still had blood on the tissue and discomfort afterwards for about an hour.
- After those 3 bm's I have not had any blood whatsoever when having a bowel movement.
- As the days went on, I would have a bowel movement and then right afterwords would go into spasms. It was awful, and would last anywhere from 4-16 hours, dissipating until I had a bm again. I thought that was bad. By April 29th I was experiencing constant, 24/7 spasms.
- Also I should mention that I was doing exams at university from April 15-30. I wasn't at home and didn't have any time at all to worry about it, even though I wanted to. Therefore I didn't really start treating myself until May 2nd. All I had done was used Preparation H (I thought first that I had hemorrhoids, my mom told me that's what it probably was) and increased fiber intake.
- May 2nd: I immediately start treating myself. Had researched up and figured that I had an anal fissure. I really don't think that I have hemorrhoids because why would they be spasming 24/7? And I don't bleed.
- Tried: Prep H, pecans, magnesium tablets, metamucil tablets, weetabix, increased water intake, advil, hot baths, and heating pads.
- After about 4 days I figured what was making a difference and what wasn't. The pecans were kind of a 'shot in the dark' so I stopped taking those as I didn't see a difference. Stopped taking Prep H. Continued with 1000mg of magnesium a day, as much water as I could drink a day, increased fiber, and HEAT.
- What I found worked the best: Magnesium, and heat. Magnesium makes me regular and bowel movements extremely easy to pass. I don't know what I would do without it. I have two heating bag/pad things that I've been using constantly as they're a lot more convenient than baths.
- For about a month I did this regimen daily, and noticed some improvement. I would have like 3 bad days, followed by 1 good day. It got to a point where I would have alternating good and bad days. I wasn't having to use heat as much to relieve pain (which was considered a good day). I had hope!
- May 22 was my birthday, that was a bad day. Woke up on May 23rd and that was a good day. I then had ALL GOOD DAYS until May 31st.
- I had continued taking my magnesium, but wasn't taking baths or using heat as much (maybe once every 2 days I would feel the need to). The pain wasn't completely gone (I could feel it if I bent over, or did physical activity). But it wasn't constant, thank god!
- I had basically been living the entire month of May in my bed or on the couch (great start to the summer). But once the pain started to subside I started doing things; I unpacked my school things, did laundry, cleaned the house a lot, etc. These are really not things high in physical activity I know, but after doing these things I would feel the pain come back a little bit. But it was getting better! I figured that I was healing.
- May 30th comes, and I only took 500mg of magnesium. I'm really wary when it comes to using drugs of any kind (even though they're vitamins), and figured that if I wasn't having spasms 24/7 and my bowel movements were consistently good, I could reduce the magnesium a bit.
- Wrong
- Woke up May 31st with the same pain I had been experiencing at the beginning of the month. I can't believe this happened. Now it's June 6th and I'm still experiencing pain like I was at the end of April and most of May. Besides that one day that I didn't take all of my magnesium, I've stuck to my routine of magnesium, fiber, water, heat when needed, etc. Now I need heat on me 24/7, and there have been no good days since May 30th.
- I'm basically in need of some serious advice here. Did I just relapse? I remember reading somewhere that in the healing of a fissure, sometimes you have to relapse a few times before it will completely heal?
- Could the minor physical activity, not taking my daily dose of magnesium and not using heat enough have caused this pain to come back?
- I should point out that I have no pain when going to the bathroom. It started where I would go to the bathroom, have pain afterwards for 4-16 hours, and progressed to the point where I was just in pain 24/7.
- I'm sorry for the lack of coherence to this post. It's 5:30am where I am now and I haven't been able to sleep yet because of the pain, and just worrying. I have to work on Thursday and if things are still like this I don't know how I'll be able to get through the work day.
- The pain is not 10/10. It's more a 3-5. The main issue is that it's always there, and hasn't dissipated since May 31st.
- In my previous post someone advised me to go straight to a CRS, but I can't. I'm from Ontario and here I would have to see my family doctor first, and then it'd be his choice whether to refer me or not. There is also only one CRS in my area. The ones with good reviews online are at least 3 hours away from me. The CRS that is in my area has awful reviews online, and though I know not to trust those completely, it's kind of discouraging.
- The reason I haven't been to my doctor yet: Childish embarrassment and anxiety. I know, I know. I should go. I don't think I need to get into real detail here, but the last time I was at my doctors (April 1st, 2012 -- just 10 days before this all started) it was one of the worst experiences of my life. The exam went so badly that he couldn't continue and I had to just sit there uncontrollably crying until he just walked out, giving me absolutely no answers to the issue I had at the time. Thankfully my problem later miraculously cleared up -- but with a new, equally embarrassing one taking it's place. I get really bad anxiety thinking about going back there so soon and just really don't want to do it. I was treated without any kindness or compassion at all, even though the appointment made me very uncomfortable and anxious and I let them know before hand. Anyways, I think if in a week I've seen absolutely no sign of improvement I'll have to make an appointment, but until then I would really, really like to cure myself on my own.
- If there is any advice anybody on here is willing to give me please do. Is relapsing just a sign that your fissure is healing? I know it sounds crazy but I have read that somewhere on the web. If I keep up my routine and don't slack on it, even if I get better, will that hopefully bring permanent relief? I know you guys can't tell me for sure. I'm just seeking some advice, please. And sorry for such a long, rambly post!
- Sam

Hi Sam and Welcome
So sorry you feel at such a loss here and are experiencing such pain :( . I hope you'll be able to navigate through this forum for advice relative to your personal concerns.
I'd like to say that I'm not comfortable with self-diagnosis, and only because of my own personal experience. I suffered for 2 months, believing I had a really bad hemmorhoid and for those 2 months tried to treat/heal it as such. I did all hemmie remedies and the pain continued on until I was in 24/7 dire agony . That's when I saw a crs and was properly diagnosed with a fissure. I had wasted 2 months trying to heal something that wasn't the cause of my pain, and not properly treating what was the cause . So I am an advocate for seeing a physician, and getting properly diagnosed/treated. Remember, there are different conditions that carry similar symptoms, and although you may very well be on point here with your own diagnosis, imo it would certainly be best to seek out a doctor and get a proper exam. I understand your reservations/anxieties about doing this, and I wish I could talk you through it or find you a physician you're comfortable with. Maybe you have a trusting family member or friend who can come along with you for support...?
I'm certainly no expert, so this is just my opinion, but I'm not understanding how relapsing is a sign of healing. I have never heard this. Again, my experience, I would get days at a time when pain was near gone, only to have it come back again, real hard, ...and that cycle continued many times over the 6 months I had a fissure . It fools you into thinking you've won, only to knock you down again. I did end up with surgery after 6 months of these ups and downs. If you look around here, you'll see that the roller-coaster is a very big part of this for many of us....so relapsing seems to just be a cruel part of the game . That being said, it doesn't mean you won't heal at some point...but for now, something keeps hindering your success.
You seem to have a good diet regime in place...fiber, water, magnesium...all helpful, as long as your diet provides you with the ability to maintain that soft (toothpasty) consistency for your bm's. Easy, strainless bm's are a major key factor towards healing .
Best Wishes to you Sam and I hope that you are able to find yourself back in a comfortable place with relief from the pain. I'll keep you in my thoughts and prayers .
Angel

Do you drink alcohol? aside from fiber what is your diet like? Were you normally regular at passing bowel movements in the past?
I agree with Alegna, self-diagnosis can easily lead you to an incorrect conclusion and cause more damage and pain in the long run.
Your fissure may at this point have grown to such a severity that it may require surgery, similar to many on this forum have had to do. However you will not know until you see a doctor.
I was lucky at least so far, I have yet to need such drastic treatment. It is good for you to be conscious of the amount of magnesium and vitamins your are taking, to much magnesium supplements can actually kill you. Not to alarm you too greatly but these are the reasons you truly need to consult with a licensed physician.
Miralax was a godsend for me worked great, softened the stool no problem, and was probably one of the safest treatments to take long-term, however once again a physician should be consulted before taking long term just as I have.
Water, a woman should be consuming at least 2L of water daily, make sure to do so. If you exercise, drink alcohol, or participate in any other activity that could dehydrate you... hey even sex... you must the consume even more water to make up for that. Water has made a major difference in my consistancy.
Baby Wipes, a miracle second only to miralax... Toilet paper can be to coarse and rough when it's used around a fissure site. To this day I still use them to prevent further damage to my own fissure, Which hopefully is mostly healed.
Keep track of your fiber... Fiber bulks up stool so if your consuming too much fiver it can actually have the opposite of your desired affect. The stool can become to large to pass. Make sure your consuming enough but not o much... As well as not to quickly... Drastically switching your diet, or wavering back and forth day to day can have devastating consequences on your fissure. I've learned these consequences first hand...
Regardless of any self treatment you intend to try or feel has been working, or even have suggested to you here see a doctor! spend the money, trust me in the long run it will save you much more then you spend along with a larger amount of pain. See a doctor asap!
Best of Luck!

First of all, let me welcome you, its sort of comforting in a weird way that I'm not the youngest around and you're around my age. I can imagine how you feel not wanting to tell your family, etc and embarrassed about it. Believe me, its hard. After reading your post I almost shed tears as it reminded me of myself.. especially about the mum and prep H part. I first had a fissure in 06, my mum figured out because she saw blood on my pants once and being a guy, that's not normal! Lol. I really didn't take it on back then.
Then in 2009 blood came back and I never told anyone beside my gf and still I thought it was a hemorrhoid. Only until 2010 to 11 I missed two exams and got sick then I realized, 'this stuff is serious!' I took years to muster the courage.
All in all, (sorry for my life story) GO NOW! Go see a doctor immediately. I wished it was sorted out back in 06. Hell even 2010. I was so embarrassed and scared someone will laugh at me and all sorts of foolish thoughts but unless u figure out exactly what it is, you can't assume its a AF.
So how I mustered the courage to see a doctor? Its all inside you. I lied to myself that it won't be awkward, that it won't hurt, and no one will laugh. Guess what, it was exactly that. The observations took only a minute.. if not less!
Spreaded my cheeks and boom! 'U have an AF, posterior position, that's it!'
Just tell yourself it will be good, and it will be. It has to be done and in a matter of minutes you're clothed and done.
You should see me when I went to give blood for tests... I freaked out so much! Your experience reminded me of that! They had to call another technician to do it!
Why I also said to check it is that you could cause another tear as in my case so the earlier you get diagnosed the better. I really wished I'd seen a doctor early on.
And a good one, or else I wouldn't have been where I am. I guess its where God wants me to be too.
Try to not worry about what anyone might think. You are a human, the odds are 1 in 3 will have an AF at some point or something. You'll be surprised how supportive your family will be, in my case, they're just confused mostly but that's where we come in.
Do let us know how it goes ok?

Hi all: I just typed out a really long message but then my Internet cut out so I lost it all! But I'll try to sum up what I was saying:
First of all, thank you all so much for your advice! I know I need to call a doctor, it's just mustering up the courage to do so. I will update this with how things go!
One thing that worries me: I have orthostatic hypotension. Low blood pressure when standing. And after researching the prescription creams that generally get prescribed like Rectogesic, the label says "don't use if you have low blood pressure, even orthostatic hypotension". So I wonder if my doctor will go straight to botox? Haven't really been hearing good things about that. And the risk of incontinence with surgery is scary. I've heard a lot of good things about it but the few bad stories I've heard are terrifying. If there wasn't a risk of incontinence I'd have gotten the surgery already... Also I'm wondering if maybe my low blood pressure is one of the reasons why my Af hasn't healed yet. Poor circulation/blood flow to the area? Just a guess.
Angel, thank you! It must've been really frustrating to find you have something completely different from what you thought.
John, thanks for all the advice! I don't drink. I've changed my diet a lot since this happened. Just coming home from school changed it a lot; my diet was awful when I was away from home. Tons of processed foods, empty calories, ramen noodles. I ate a lot of sugar/fatty foods. Coming home I switched it up completely, drinking tons more water, eating way more fruits and veg, and fiber. However I still occasionally eat sugary/salty snacks. I've had pizza twice since this began. The dinners I have are generally meat, potatoes and vegetables - what my mom makes. So chicken/pork/steak and broccoli/green beans. I'm pretty sure the ideal diet isn't what I'm doing so if there's anything I should really be avoiding let me know. Should I be taking Miralax if I'm not having a problem with hard bm? The magnesium seems to be working great for me. BM's in the past were regular, but usually 2-3 days apart, and definitely not near as soft as they are now. I never had a problem with constipation. I'll try to drink more water as I'm not drinking 2L a day, and keep my fiber supplements more regular. I used to take 3 doses of metamucil a day, but I've gotten lazy and now only take 1 or 2. I'll try to get back to the 3 doses regularly a day.
Emm, it's really nice to hear from someone my age too! I've noticed a lot of 20somethings experiencing these actually online. Never thought that I'd have to deal with something like this so young but I guess it happens pretty frequently! It is hard to talk to people about this but not so much with my mom, which I'm lucky for. If I didn't have her, or this forum, I'd go crazy! I can't imagine dealing with something like this since 2006; I hope you're better now, or at least on the road to recovery.
Will be sure to let you all know what happens, and thanks again! :)

Remember part of seeing the doctor is to actually determine if you have a fissure (which is likely) and what you need to do.
My surgeon was telling me sitz baths with persons who didn't do surgery would heal only 2 out of 10 but after surgery its vital. But your goal I'd say is finding out how bad it is. Who knows, lifestyle changes can heal it.
I didn't realize that there are more 20 year olds :o I figure its the exact food you described is causing it because that was my diet too!
Also, if you can, when you feel the urge and not force a BM that will be great too. Letting it stay there for long can cause it to dry and become harder and thus causing more problems, because if you force and its hard, thats a retear waiting. Something you will realize is that everyone is different.
There is a post on soluble vs insoluble fiber, that should guide you to where u want your BM. Remember you have to find some balance and thats a bit tricky. Because too watery (diarrhea like) is bad too!
http://anal-fissure.org/t4357-a-key-to-af-healing-soluble-vs-insoluble-fiber?highlight=soluble+fiber
Good luck and nice hearing from you!