4 Weeks In, Taking Any Help I Can Get!

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4 Weeks In, Taking Any Help I Can Get!

Postby exbestfriend » 10 May 2013, 11:01

Before I start, I just wanna thank whoever started this forum, I feel like I've learned so much and it is such a great resource. Thank you Internet! So here's my story, I'll try not to be too gruesome. I'm 24 years old and I'd never heard of an anal fissure in my life before I got one. I have not seen a doctor regarding this matter. About four weeks ago I had a large and painful BM that resulted in a lot of blood. I was extremely concerned but kept it all to myself, as I felt fine otherwise and was not eager to discuss this bodily issue with anyone, even a doctor. My ass of course hurt afterwards but I have a pretty high pain tolerance, so like usual, I convinced myself to just sleep on it and not stress out. The next few days were not so bad at all. A little blood in my stool, but really just a few specks on the toilet paper, nothing that freaked me out. I just assumed I had some sort of cut and that it would heal in a couple of weeks. After a while, I got a very unique uncomfortable pain and it quickly became clear that it was not going away so soon. So I finally took a mirror, twisted my body around, used a desk lamp and got an up close look at my....hole. I saw the irritated cut and it freaked me out. It wasn't huge, but it was upsetting to see it so clearly. As a gay man, I was also very worried it could have been an STD. I'd just had sex, as a bottom, the week before this issue came up. I'd been tested recently and came out clean and disease free and HIV negative but I was still concerned. However, there had been no bleeding or problems then. I'm always safe and lubricated and I definitely remember the specific BM I had with the blood. So after thorough research online I came upon "anal fissures." I had never heard of this in my life but it sounded like, and after Google image searching it looked like, that's what I had. So I took to some of the basics. I picked up epsom salt for baths, baby powder for my ass, and a lotion with aloe vera. My diet didn't really take much effort to change, the pain and discomfort in the area really killed my appetite, as I loathe a BM at this point. That being said, I did make it a point to change my diet and eat differently when I did eat. Forums like this helped teach me a lot when it came to eating with an AF. So after four weeks of this issue, it seems to have kind of plateaued. It's not getting worse but it's not really getting much better. I'm about to pick up some fiber supplements and Milk of Magnesia because I hear that those are helpful for some people and I've never taken either for anything ever before. A new problem that's developed is a shooting pain when I cough. It is the worst. Never had it before the past couple of days. Does this mean it's getting worse? Anyway, I guess I'm just asking for any help or advice I can get! How do I get this cleared up without seeing a doctor? How quickly do minor AF usually heal completely? Also, I'm completely aware that I have to keep my diet in check and my BMs healthy, I've read so much about retears. I've also, obviously, completely avoided sex and plan to for a long while. Do AFs ever clear up permanently? Or is this something I'll have to worry about for life? Does having it once make it much easier to have them in the future? I'm dreading this being a chronic condition and praying it isn't. How bad are caffeinated drinks and alcoholic drinks? I like to have beers and energy drinks sometime and I haven't avoided them that much because I drink a lot of water to keep things balanced. Should I cut them out even if I'm going by the water cure recipe? (Water cure: Your weight divided by two equals how many ounces of water you should drink a day. I'm 6'1" and weigh 180lbs so I'm drinking 90oz of water a day) Do you all think I'm ok treating this from home or should I go get some of the prescribed creams/lotions? I also plan on trying to get some aloe vera, either a plant or something stronger than the lotion I have now that simply has some aloe vera in it. Please everyone help me out, I'll take anything I can get. This is the only place I've shared this story, no one in my life knows I am struggling with this right now. I wanna clear this AF up and beat this thing ASAP! Thank you in advance. This forum is incredible.
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Re: 4 Weeks In, Taking Any Help I Can Get!

Postby Ever the Optimist » 10 May 2013, 14:19

Hi Exbestfriend,
You've found the best place to be right now but sorry that you have to be here.....
The first thing you MUST do is see a CRS to get this properly diagnosed, even though you say you don't want to see a GP. It is highly likely from everything you've described that you do indeed have a fissure and if conservative methods are so far not helping, you need a little more help. You need to obtain a prescription for Nitro or Diltiazem, creams specially prescribed for the first stages of a fissure. These will assist in relaxing your internal sphincter, which in turn will assist in the healing process and take the pressure off the tear. Ensure you also follow the following, because these are things that have been tried & tested by many of us and have been really helpful:
1) Apply a lot of vaseline pre BM's to lubricate the area well and coat the fissure, "protecting" it as the stools pass through.
2) Start taking warm-hot "Sitz" baths or baths or alternatively use a detachable shower head to shoot water into the area after BM's to clean and encourage blood flow to the area and also for relief
3) Never ever strain (push) during a BM. Squatting might help you also. Just let it fall out naturally - If you keep your diet in check/ up your WATER intake a lot and take a stool softener, these should be sufficient in allowing you to do this.
4) Do not wipe with harsh tissue. Use baby wipes to "dab" the area to clean. Pat dry with a towel.
5) Get hold of the Nitro/ Diltiazem and use after every BM (or at least twice daily)
6) Ensure you are consuming enough fibre in your diet and cut out all fatty/ processed/ spicy/ "white" foods immediately and replace with brown (bread/ rice/ pasta)
Ensure you are eating lots of fruit & veg and fissure friendly foods - Scour this site for dietary ideas and recipes - there are lots!!
7) Cut-out the alcohol and the Energy Drinks (Sorry!) Definitely will not be helping you in any way since alcohol dehydrates...& those Energy Drinks have way too much caffeine.
Image Drink lots of water/ fruit juices & reduce your caffeine intake to a minimum. Drink water after every meal you eat and lots inbetween too
9) Purchase a stool softener (Miralax/ Lactulose - there are many - again just research the site!)
You are still in the early fissure stages, so act NOW to try and prevent the condition becoming chronic.
No - you will not have to worry about this for life if you start making those all important changes now. Even chronic fissures eventually heal....
Coughing will aggravate a fissure as will sneezing - the best tip here is to hold your buttocks together when you feel the need to do this. It really helps relieve the pressure. It is just a sign it is there but not necessarily worsening.
There is an awful lot you can do to help from home but you also really need to seek professional medical advice.
Some people here have acted immediately and very successfully been able to manage and heal their fissures very quickly, so don't despair, try not to stress - just take a positive & practical approach to dealing with it all by following the above. I'm certain others will drop in to offer you additional support & advice.
All the VERY best to you in the meantime.
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups
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Re: 4 Weeks In, Taking Any Help I Can Get!

Postby exbestfriend » 10 May 2013, 14:33

ETO, Thank you so much! I really appreciate all the advice and support. I guess I'll have to start researching doctors, but since I'm in a major city, Philly, I should have good options. I don't have anyone I see regularly and my family lives far away and I'm not close with them. Scary having to deal with this alone, I'm discouraged to read that some people have to go through surgery to fix this issue. I truly hope I can clear this up early on.
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Re: 4 Weeks In, Taking Any Help I Can Get!

Postby exbestfriend » 10 May 2013, 14:54

Just out of curiosity, what is in Nitro or Diltiazem creams that requires a prescription? Is there truly nothing available over the counter that's as effective or containing similar ingredients? Why can't they sell the items over the counter? Sorry, this question is super specific, but I just like being informed and if anyone anywhere knows the answer (besides a doctor), I bet it's someone from this forum. I'm sure I'm not the first person that was at least curious about this.
Also, thoughts on using PrepH? I bought some today for the first time and just started using it. I wanted to try something new, and needed something, before I schedule a Dr's appointment next week.
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Re: 4 Weeks In, Taking Any Help I Can Get!

Postby jr2 » 10 May 2013, 15:38

Hi exbestfriend!
Welcome! (though I'm sorry you have a fissure). But you've already discovered it is an invaluable resource for tips and support.
Ever the Optimist has you pretty well covered on the things you can do at home.
To answer your question, there really is nothing comparable sold over the counter that works like either nitroglycerin or a calcium channel blocker like nifedipine or diltiazem.
When you get a fissure the internal anal sphincter (the one you can't control) goes into a spasm in response to the injury. The tightness of the muscle does two things to impede healing. It reduces blood circulation to the area and it pulls on the edges of the wound, making it difficult to heal. What nitroglycerin or a calcium channel blocker does is to both increase circulation to the area, promoting blood flow, and helps relax the sphincter muscle. These medications are most effective when started early. Once a fissure becomes chronic, it becomes more difficult to heal (though not impossible) without surgery.
People who get fissures are more prone to developing them in the future, but it doesn't necessarily mean you will. Good dietary and toilet habits are essential.
Your best bet is to get your fissure evaluated by a good colorectal surgeon so you can maximize your chances of healing without further intervention.
Good luck, and keep us posted!
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Re: 4 Weeks In, Taking Any Help I Can Get!

Postby Ever the Optimist » 10 May 2013, 15:47

Exbestfriend,
You are so not alone with this although it is great if you have close support to help you through the issues but you can come here anytime and seek help, reassurance & just rant as many of us have done!
I don't know why you can't get these over the counter here in the UK. I guess it's such a specialised issue and I believe the creams are also quite expensive - I'm not sure - maybe you can in the US? I really like PrepH - but it's more to soothe and provide you with relief. It helps to relieve the raw stinging & discomfort of the fissure but does not work in the same way as the Nitro/ Diltiazem creams. See the link below to see how Nitro works - Diltiazem works in the same way and this helped heal my fissure. It does not have the side effects of light-headedness that Nitro commonly has.
http://www.webmd.com/digestive-disorders/tc/anal-fissures-nitroglycerin-ointment-topic-overview
Try the Prep H in the meantime to help you with any discomfort but don't delay in booking a CRS appointment because they will diagnose everything properly, more than likely, prescribe you a cream to help you heal and advise you on the best way forward.......
Don't start worrying about surgery just yet!! You hopefully won't even get that far!.....
Ah I see Jr2 has just responded to you too! .....Jr will also provide you with some excellent advice!
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups
Ever the Optimist
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Re: 4 Weeks In, Taking Any Help I Can Get!

Postby exbestfriend » 10 May 2013, 18:56

So, as far as baths go, just taking a regular, warm bath in my bathtub at home with epsom salt is effective, right? I keep hearing the term "sitz bath" and the couple of stores I've been to haven't had anything for sale like that, at least that i could find. Is it really any different than taking a bath like I previously stated? By the way, I'm trying to do this epsom salt bath 1-2 times a day. It feels effective, the AF is always much less painful after this bath. I'm just not clear on what makes something "sitz"
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Re: 4 Weeks In, Taking Any Help I Can Get!

Postby Ever the Optimist » 11 May 2013, 00:44

Hi,
From what I've read and based on my own experience, both work as well as each other. I do not have a Sitz bath but use a shower head to clean up and then I hop into a hot bath. I believe you can purchase them on sites like Amazon though and over the net. I'm not 100% sure whether the Epsom salts do have a huge effect but I do use them now & again myself as I believe Salt water has it's own healing properties. It's the heat from the water flowing into the anal area that encourages the all-important blood flow that is key. If it "feels" effective to you, don't stop!!!
I've always interpreted "Sitz", as per the German translation, as literally sitting or immersing your bottom in hot water whether using a Sitz bath or a plain old bath tub!....
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups
Ever the Optimist
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Posts: 1625
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Joined: 12 Apr 2012, 16:00
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Re: 4 Weeks In, Taking Any Help I Can Get!

Postby Guest » 11 May 2013, 09:33

exbestfriend welcome to our little conclave:
Just to let you know, somewhwere down the line when you are certain you have this thing in check is when those nasty re-tears can rear their ugly heads.
With a proper diet, you can indeed strengthen the skin down there to avoid the re-tears or new ones for that matter. But just like hard bm's, anal sex can certainly be an issue for you in the future.
Too often, we get laxed, and just a few months or so of no pain or discomfort will have us thinking our past posterior problems was like yesteryear. Then its back to our old eating habits and lifestyle habits and Bamm another re-tear.
Please consider these things; as fissures hate the acronym ASAP. There was one person here who went 13 years without a recurrence and then the fissure came back.
With about 2 years from my last fissure, although I do not worry, I sure's the hell will not practice the same eating patterns as before and life practices of being a couch potato etc.
Please be advised.....good luck
Guest
 


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