I am 26 year old male from India and wish to jot down my
experience with anal fissure of late.
If you don't want to go through the story, go to the bullets at
the end.
The diagnostic procedure
I was diagnosed with anal fissure about a month ago after
going through that horrible procedure called flexible sigmoidoscopy wherein my
posterior orifice was ravaged with a camera fixed on one end of an optical
cable. Before that while I was discussing my problem with him, he said that he
will have to do a digital examination. Being in the profession that I am in (I
write softwares, just like any other Indian), I casually remarked, "yeah! Sure",
thinking of it being just another examination using a digital machine of some
sorts. Not in my wildest dreams could I have imagined what I was about to go
through. I was cursing medical terminology when I later found out that digital-
those beautiful 0s and 1s of binary language meant fingering for doctors.
During sigmoidoscopy, the doctor, I believe a
Gastroenterologist but definitely a sadist, made me look at the images in real
time as he gleefully jammed the chord inside me. I closed my eyes. At the same
time, he blew what I consider a tremendous amount of air, inside my large
intestine through the same chord and passively mentioned that I can break wind
whenever I like and not be ashamed about it. Well, thankfully it lasted for
about 5 minutes (the longest 5 minutes of my life) as he spotted the fissure
soon enough. I had my eyes closed by then but he asked me to open them and look
at the screen. I reluctantly opened my eyes and glanced at it for about a
couple of seconds. It looked like a notch in one of the many circular rings of
bulky tissue protruding from the wall of my otherwise flat intestine, with
blood rushing from it. I felt a teardrop rolling from one of my eye which
usually happens to me when I lie on my side for long but that day it wasn't
because of it.
1st Prescription and its effect
I was prescribed the usual (I know that now) - Phyllium husk
to add bulk to my stool and soften it, and Nitroglycerin ointment and was asked
to come back in a week. That week was the most horrific experience of my life
till date. The husk didn't work and the pain after defecation worsened with
time. Every morning I would wake up thinking about the pain that I will have to
go through. I can't forget my clinched teeth and suppressed wails during bowel
movements. The intense burning after the movement and throbbing pain was
something that I would not wish on my worst enemy. It used to get worse during
through the day rendering me incapable to focus on anything. A sudden cough or
sneeze would hurt like needles piercing my bottom. I wasn't able to sit
properly, or lie down on my back. I used to roam around just like a maniac
doing nothing. I had to take a leave from office citing some health issues but
didn't tell anyone about the actual problem. Nobody knew about it- my family or
my long distance girlfriend or my roommate. I continued to suffer in silence.
The healing
After a week, I called up my doctor and told him about that
the treatment is not working and I am still shitting shards of glass. He then
prescribed me another stool softener, a syrup this time-Lactulose, and told me
to drink 30ml of it daily. Two days went by and my stool was still stiff which
made me to call him again. This time he asked me to increase Lactulose intake
at will until stool was soft and decrease it if was too soft. I, in a fit of
emotions, drank almost 200ml of it in a day. That was the first day when I had a
painless movement after about a month. But it wasn't limited to a single
movement. I defecated almost 10 times that day. 8 of them just being water
gushing out of my guts. But I was happy. I was happy because the pain had
receded. And I was happy because I was okay with shitting water 10 times a day
rather than pieces of glass once a day. The doctor also changed my ointment to
Diltiazem which wouldn't cause headaches. I has been a week since then and I
have regulated my Lactulose intake to reach a point where I can finally give it
up. I had a regular movement today and it didn't hurt. I do not want to get too
optimistic because I have read about recurrences of fissures but I feel glad
that I can finally get back to normal life after a long time. I now know what
to do it appears again.
To those who are still struggling, I pray for you and would
ask you not to lose hope because this is treatable. My strategy was to take a
week's leave and shit watery stool continuously for a week, averaging 5 times a
day. I feel much better now.
To Summarize what I recommend:
1) Diltiazem- it doesn't cause headache and relieves pain.
If you can push your little finger, with ointment on it, inside your anus, do that. Otherwise if it
hurts, please don't overdo it. Push your anus outwards and apply it topically.
3-4 times a day.
2) Psyllium husk- it do adds bulk by absorbing water. I took
20 grams of it a day. I would not recommend less than that. For Indians, Naturolax is
available with a tangy flavor. Take 2 of those spoons which are supplied with
it- 3 times a day. Each spoon has 3.5 grams of husk (21 grams daily).
3) Lactulose Syrup -Most important. Different bodies needs
different amount. I took 90-120ml a day and it worked for me. Doctor initially prescribed 30ml a
day so you can try starting with that. For Indians, Lactulose is the only choice since docusate is
not available in India in any form. I roamed around my city for 3 days looking for
it once. I ordered it from UK through Biovea's website for a hefty sum and now that it has arrived after 10
days, I think I will not use it. But Lactulose worked for me and I believe it would work for you
too. It would soften your stool no matter what you eat, even red meat, though I would not recommend red meat.
4) What to eat --- Liquid diet doesn't help; you will still need to
defecate once in 2 days. Raw fruits and vegetables add fibre just like the psyllium husk and they
are more healthy. But I tried surviving on fruits for a day and it was unbearable. I, as an Indian, am so
used to salts and spices that I had to eat curries and chapatis, although I reduced the amount of spices
because they just burn you after defecation. Avoid meat and go vegetarian.
I can understand the irritation, frustration and pain that one has to go through in
such a condition. Not to mention the loneliness because of the nature of such a condition
but if you someone is really close to you, I am sure it would help to share it with them.
I wish you all the very best in getting cured and I can assure you that you will come of victorious.
Any other possibility is not a possibility at all because, and believe me when I say this, wound
healing is inevitable. You just need to give it time and space.
I know the shit I had to go through or rather the shit that had to go through me, literally.
But if it happens again, I am loaded with ammunition.
Best.
to the Forum, too!!
