First, I appreciate any responses that may be forthcoming, thanks in advance.

I first started having anal pain with bleeding -- red blood on the paper and in the toilet -- the first week of April. After a couple of weeks, went to my primary physician, and as I suspected, it was an AF and he confirmed it; told me to drink plenty of fluids, increase fiber, and take daily dose of colace, which I did, and have been, and it seemed like things were getting better then in early May, I had a difficult BM, again initial exit was difficult (too bulky) and then once the stool was out it flowed quickly, but the initial exit was difficult and it was painful and bled and started it all over again. It is a frontal tear near in the perineal area. I continued with diet, and again things went well for a couple of weeks or so and then difficult BM started it over last weekend. Can't understand why BMs are not flowing all the time. My diet consists of breakfast: shredded wheat with low fat yogurt, boiled egg, and either an orange or apple with tea, then no lunch, and for supper usually greens (swiss chard or dandelion greens or salad) with either chicken or fish and plenty of fluids all day. In fact, problem is that I have too many BMs -- three or four in am and then one at night, sometimes another small one in afternoon. If only I could go once or twice a day that would be half the battle.

Sorry to go on and on, just trying to give clear description for my questions. I'm so dejected, it's as if this will not heal and one day I'll just keep bleeding. I'm 60 years, have a son's wedding this weekend, and just want to be pain free with no bleeding. To my point, here it is July, went to Colorectal surgeon this week and he prescribed Rectiv, which I started taking on Tuesday, today is the second full day of taking Rectiv. So far, no side effects, just a little light-headed for the first hour or so and then fine. After he did the rectal exam it was sore on Tuesday, just very mild blood on tissue, very little, then Wednesday had pain but no bleeding. On Wednesday had my usual breakfast and dinner but added an apple, two stalks of celery with hummus, and pear -- also had a chocolate covered sorbet bar. This morning, it was loose, but again, difficult initial exit and then it bled quite a bit -- within a couple hours had two more smaller BMs, one did not bleed, but the other bled -- drops into toilet and bright red blood on several rounds of tissue and then it stopped. Waited about 45 minutes, and no more bleeding and applied the Rectiv.

I've put a call into the Colorectal dr's office, no response yet, it was a while ago and they seem to give standard answers, so was hoping to hear from experiences here that can help.

My questions:
Will Rectiv make me bleed more?
What happens if I have a BM in the afternoon and I applied the Rectiv just four or five hours before that time? Do I wait the 12 hours or add some more?

I don't know what to do, am nervous before each BM, really anxious, and don't want to make it worse with Rectiv, but nothing seems to be helping. My big fear is bleeding and not stopping. Will Rectiv make me bleed more? I'm hoping it will work, but afraid it will make me bleed more and more. Appreciate any advice offered, thanks. Oh, last thing, I've tried eating as little as possible, have lost 16 lbs since this all began, but still have too many BMs.

Just a quick update, things have settled down the past day and a half, no bleeding but still have multiple BMs. Would be great if I only went in the morning but such is life. Question: Rectiv is prescribed for twice a day, one application every 12 hours, but I usually have an additional BM within that, so I have to wait until the 12 hours to reapply the medicine. Was thinking to add a little more before the 12 hours but that does not seem advisable from what I've read. Usually, maybe 5 or 6 hours after the initial application I have to go again which means I have to wait another five or six hours to apply the Rectiv. I'm assuming this lessens the effectiveness of this medicine. Does anyone have any experience with this issue that they would like to share? Thank you.

Unless you have issues with blood pressure, then I think it should be fine to apply in the middle of the day as well. It may help with relaxing the muscles before having a BM.

Thanks for your response. Today is the 9th day using Rectiv and it has been going well except I over wiped today and saw a spot of blood, so disappointing and fearful I may have reopened the fissure. Will have to see how the rest of the day goes.

It's hard work to heal an area that is constantly disturbed. Don't lose hope! Keep doing what you think is helping you. A diary can also be helpful to keep track of diet, BMs and pain levels.

Thanks!

I've read that setbacks occur, but so anxious. Today after 11 days on Rectiv had a morning BM that produced blood on stool and on paper; it was just a little difficult and then woosh it came but did the damage Several more bm's after but no blood no real pain with those. Have others had these setbacks and still healed in time? Very frustrating and fearful and anxious all over again about next bm.

I can't speak with regards to rectiv nor a fissure (at least not that I know of) but like you I am dreaded in having a bm.

I have type 2 diabetes which I believe contributes to my constipation. I eat several small mixed meals a day but I have been having 1 bm every two days. I used to eat high fiber fruits veggies and grains added with Metamucil and found my bm were large and bulky causing me to strain and have pain and spasms for hours afterwards. Been recently adding additional meats and fatty low fiber foods on occasion,,coupled with a stool softener (Restorolax ) I've been having smoother softer bm but this comes cats price of being a little more runny.

Still looking for that in-between consistency.

5 - 7 bowel movements a day seems excessive, especially for the little amount you seem to be consuming.

Have you discussed this frequency with your doctor?

Thanks, I have discussed the frequency with both my primary physician and colorectal surgeon, but they don't have much to offer on that front. I should push it more to see if there's something else going on. I did have a colonoscopy two years ago and all was well.

Do you think that you could have IBS? It can be aggravated by eating foods high in FODMAPs . A short list of common foods is wheat, apples, pears, mushrooms, high fructose corn syrup, and high fat foods in general as well.