Hi Everyone,
I'm new and have been reading the forum for the past couple of months. Have learned a great deal and feel better emotionally reading about success stories. Thanks to all who have poured their souls into this forum, it is greatly appreciated!
So a little about me. I'm 52 and have had hemorrhoids for 20 years which started after the birth of my first child. I've never been a great water drinker but eat a healthy diet and exercise. I had my hemorrhoids removed about 10 years ago but they came back. I deal with them when they arise with the usual medicines and they go away.
I now have an anal fissure. It was diagnosed by a CRP about 2 months ago but pretty sure it has been there for at least 3 1/2 months. He cauterized it and gave me .2% nitro cream. Very painful for about a month and now it's starting to feel better. I do have good days and bad as well as ups and downs throughout the day. He wanted me to come back after a month and do botox and cauterize it again. I haven't been back because I don't feel the intense spasms anymore. I do feel them after a BM, but the nitro takes care of that. I really don't want him "all up in there" possibly making it worse. I have decided to give it one more month and if I'm still in pain, will go see him.
This is what I currently am doing:
Take a full dose of miralax a day at night. I desolve in one glass of warm water.
Use .2% nitro after every BM.
Use polysporin during the day.
Use Vit E at night.
I drink water but not a huge amount.
Eat a healthy diet with lots of fruits and veges, oatmeal in morning and no beef.
Take a bath, only if I'm in pain.
Sit on a heating pad! This has helped the most with pain!
What I have tried:
Thought the miralax was making me burn to bad so tried Colace. First day after 4 colace was awesome but then stool turned hard. Jumped back to miralax.
Used coconut oil. Don't think I gave this long enough but didn't think was helping all that much.
I have a BM 2 - 4 times a day. Good softness and size, sometimes can not even tell I'm going. But I can tell that they are not complete, as in there is still some in my colon but scared to push out. So it sits there and burns. Once all stool is gone for the day, I do feel better. No burning and don't feel any pressure. Spasms are light, I don't have them very bad anymore. I can tell I'm not tight down there so feel pretty much normal with slight twinges and maybe a little itching. A couple of days I only had one BM. Those days were heaven! Also, some mornings I have to basically run to bathroom and others I don't. So very inconsistant. Before the fissure and miralax I went once every morning. Would so like to get back to this!
So, how many BM's do you have? Do you feel like stool is still present afterwards? Do you have to run to toilet?
I know I would heal a lot faster if I could cut down on the BM's. I have been thinking about cutting my dosage of Miralax down or taking something else but honestly very scared to change. Any suggestions?
Thanks!! Buttinpain

Hi Buttinpain (Sorry to hear that!...)
Welcome to the site and sorry to hear you are having to go through all this too.
I know exactly what you mean by cutting down on the BM's but unfortunately, I feel that you go pretty much when you're meant to and for me that's between one to three times a day and trust me there's been times when I've dreaded it!! I've always been able to maintain fairly nice soft stools, so even with going more, it's never been any worse because everything comes out smoothly (most of the time) - I just put this down to my hige fibre diet, lactulose and olive oil before bed! and LOTS of water...I do get a lot of fluid in. I think your regime sounds great, other than personally, I'd take 2/3 baths a day because I find as well as helping your sphincter muscle relax more, it also relaxes ME a lot. I believe that trying to reduce stress levels when going through this is highly important. Deep breathing on the toilet and focus on a calm BM!!...
I also went through that incomplete stool feeling and that tended to happen when I was more stressed in myself and slightly constipated. If that happens, I up my fluids again and just try not to worry about it, knowing it's a stage that will pass. The most important change I have made with regards to this issue, is to squat! Sounds yukky I know but your poop can't come out fully and properly when you are in a conventional sitting position. Squatting means everything generally comes out completely and all when it's meant to. I feel like my bowels are properly empty after this and when you're ready to go, it comes out a lot more quickly too. Sorry TMI but personally I really feel this is important and really helped me resolve that issue.
It sounds like you're doing generally really well with it all Buttinpain and good luck with it all x May you soon be fissure free!..

Thank you so much for your great advice Ever the Optimist. I really appreciate it!
The last two days have been a lot better. I did add 1 teaspoon of Metamucil with water to my plan. Did not think I was getting enough fiber. Also, added more water. I ordered a sitz bath for the toilet so will start that when it arrives and I do agree that taking a bath is very relaxing just time consuming.
So, haven't squatted yet. Will diffenently try it to see if it helps.
Will let you know how it goes with additions to plan. So far so good but as everyone knows that could change in a minute.

Hi,
Really glad to hear things are getting better for you. It takes a long time to get that balance in your diet and the stools you need, so just keep trying...I think also to remember that there will be "off" days, when it might be more difficult to "go" or pass a harder stool, but I think that's just normal too. Can't achieve 100% perfection all the time!..I just keep telling myself now that it's just another BM, if it's not such a great one, up my fluids and fibre and sure enough, the next one's generally OK. It is so easy to get so stressed and hooked up on it all! but easier said than done too.!...
Good luck if you try out the squat. I got immediate empty bowel feelings and it just comes out easier for me. It may not have an immediate effect on the AF for you, but after a while, I found it really helped a lot....
Just keep up the good work and stay as relaxed about the whole thing as possible. Really have to try and stay positive!

Am feeling a little disheartened today. Last 2 -3 days have been painful. Feels like I'm having a few spasms again. I've taken a bath everyday, kept up with the nitro after every BM and am taking advil to get some relief from the worse pain. My pain would usually subside around noon after my 2 -3 BM's in the morning but not in the last few days.
I feel bruised down there. Slight pressure and swollen. Guess this could be hemorrhoids. WHen I push on the side of my anus, it feels hard, like something in side. I expect this is hemorrhoids. After a BM they come out but eventually go back in by afternoon. This can't be helping the fissure at all!
Anyway, went back to my post and want to say thank you to Ever the Optimist for his last post. Just got to take day by day.
I'm pretty sure I'm healing, it just takes a long time. Was thinking of going back to doc but I'll wait a few more days. Just don't want to get cauterized and have botox. Would really like to heal myself.
So, big question - how long did you take to heal?? Was diagnosed on May 1, has been two months. SHould I wait a little longer before going back to doc??

Hi Buttinpain,
Sorry to hear you've been suffering a bit more and that you've been disheartened....hopefully things will have improved a bit again by the time you read this?...
Those hemmroids will definately NOT be helping, just increasing pressure and pain. Sounds like those internal ones that pop in and out?? It's a nightmare - you want to treat the fissure but have to deal with those too!
I had the joys of a painful external hemmroids with it all and everything was so sore...At least they shrink after a couple of days....
Two months is still relatively "acute" for a fissure, so I really feel continue all the good stuff you're already doing, try to stay as relaxed and destressed as possible and see what happens. You'll know when and if you need to go back to see a doc. I feel you have a good and positive attitude about it all too, so stick with that! :)
Also are you applying the Recto internally? Really important and if that doesn't seem to be helping ask to try Dilitizem (my life saver!!)
There are no set healing times, everyone seems to heal at different rates and times...Between a range of a few days to a couple of months, 6 months...and sadly, some longer. It also depends on whether someone might have surgery to help heal it...
I've now had a few anal issues! but it started with a fissure in December 2011 and at my last examination on the 20th June, I was advised there was 100% no evidence of it....so provided the Docs got the diagnosis and everything correct, mine healed in 6 months.
Do what you feel you need to. If you're getting overly stressed about it all or overwhelmed or if the pain gets too much, go back for another chat. You are in control of it!
Keep us updated and keep healing :D

Thanks again ETO! Sure appreciate your advice and comments!
I do apply my nitro internally. I use a q-tip. Last few weeks I can tell that I'm not so tight, muscle has calmed down so thats good. I only use it after a BM. I did take your advice and while I don't squat, I prop my feet up on a stool to have my BM. I agree that it feels like I'm emptying my bowels better. Thanks for that tip.
So, lot better the last few days. Two things I changed. Quit taking the teaspoon of metimucil. My BM's were larger and harder to pass, made me want to strain. Now with just the Miralax, very smooth going and don't feel the need to push. Second thing is that I use Anusol supositories at night. Doc gave to me when I first went to help with swelling of hemorrhoids. Used for a little while and quit because I thought it was irritating the fissure. Swelling is down a lot due to above two things.
So, will stay this steady course for a while and see how it goes. I'm optimistict that things will heal in time. Again thanks for your words of wisdom!!

2 - 4 bm's a day? I don't care how "soft" it is, thats too often - 1 good 1 a day should do it....try to adjust the diet a bit. I found reducing the dose of miralax in half was much better for me.

Yes, 3-4 BM's a day is way to much. I can handle two, one would be perfect! Do you think if I cut the miralax in half that would help? Did that help you? I thought miralax just made stool soft. Maybe so soft that it comes out in stages. What do you think?