Ok, so I've reached the point where I no longer know what to do and would really appreciate getting some views from the board.
So, had a fissure aged 16 (I'm now 34), had the no longer recommended 'anal stretch' op which did nothing for me but I was young and just lived with it. Continued to live with excruciating pain + blood with most bm's until age 33 when I saw a CRS for something unrelated (had a 'lump' scare, was basically just my imagination but hey) when the fissure symptoms were explained to CRS and he obviously wanted to try to correct.
Gave me Diltiazem (Anoheal) cream which, along with a small diet change (basically, I drank no water, so started drinking lots) seemed to work. No more bleeding, no more pain, no symptoms of any kind! When I saw the CRS next, he said 'healed'. Great I thought. The CRS said there was a chance of a superficial fistula due to the chronic nature of the fissure but I had no obvious symptoms and surgery to determine if there was one was optional.
Once I think there's a problem, I like to fix it, so agreed for the CRS to take a look. Being the NHS (in the UK) they have a find-and-treat policy, so I knew going in if they found something, they'd act. They did find a very small superficial fistula, treated it with the standard 'lay it open and let it heal by itself' method, and so began my journey.
CRS said recovery should be quick, but it was slow. The surgery was done in September 2011 (10 months ago). Initially, I had a text-book recovery, back to work after 6 weeks. Then had a big BM at work and I could feel the 'stretch' which many here will know and fear. Blood followed and it seemed I'd had a re-tear of the wound.
What followed was more diltiazem (Anoheal) from the CRS, the baths, the healthy diet we all know and love which brings me to two weeks ago and the latest 'event'.
Before I give details of the event, a few facts…
Since the op 10 months ago, I've lost about a stone in weight. I was a skinny guy anyway, but pretty much all fat and muscle has gone. I do not look good. I want to hit the weights, but obviously concerns over pressure down there. For the last 4 months my diet has gone from healthy to ultra healthy. I eat the following, every single day, no changes.
Breakfast: Shredded wheat + milk
Lunch: Baked Potato + Baked Beans
Dinner: Small port of fish (usually prawns or cod) + Salad + Baked Potato (dressing of olive oil and vinegrete)
Drinks: Lots and lots of water. 3/4 cups of tea.
Treats: Choc bars which are quite 'wheaty'. Lately have tried more normal chocs when I want to have a real treat, seem to be fine.
Since this seems to produce (mostly) trouble-free BM's, i've stuck with it. I miss meat quite a bit, but I tell myself it's worth it.
I have two BM's a day, like clock-work. I don't seem to have the space to store a full day's worth and frankly, I'm terrified a large BM will tear things up down there.
So, the event.
Two weeks ago, I had a large/hard BM for no obvious reason. There was a bit of blood and pain (my old friend!). Blood lasted for two days with BM's, then went. Continuing with the diet and back to the diltiazem (Anoheal) cream and baths seems to have made it go away. Then this morning, another large BM gave me the feared 'stretch'. But no blood, so seems to have held out.
And basically, that's me.
Problems down there have completely taken over my life at this point. I live in constant fear of my next BM. The diet that seemed to have caused trouble-free BM's seems to not always work, and now I'm fearful that a return to 'normal' food would cause immediate problems. I can't make any sort of plans in my life, the thought of holidays, dating or anything normal just raises fears. Ultimately I fear a complete repeat of what's gone before.
What I'm looking for is a long-term solution that works for me. I don't want to rely on meds like laxatives just to live, and a past experience tells me that would be a real disaster for me (long commutes, lack of toilets, bad experiences!) . I can't improve the diet more (I don't think) and should really be moving to a more 'normal' one.
It seems my body is just 'tight' down there (i've seen a few CRS and they all agree basically am small in that area) which causes problems. No CRS will recommend LIS for me as currently there is 'no problem', just the knowledge there will be one soon enough, and LIS scares me for a number of reasons. I'm also not sure it would even work, as my problem seems to be the whole area is tiny, not just the muscle part that would have the surgery, and I don't think there is a 'make ass bigger' op. Something to 'lube' me up down there might be an idea, but what could I use for life-time use that would work and have no side-effects?
I've effectively lost a year and a half from initial concerns to today and I want my life back!
Haven't mentioned but obviously depressed about my situation, gone from being a 'normal' guy (albeit with a fissure that brought tears to my eyes every time) to a man living in fear, genuinely a shadow of my former self.
All advise appreciated, though as i've said, i'm not looking for laxatives (or anti-depressants).
Thanks all.