A quick about me: 25 year old male, 180 lbs, 6 ft tall, exercise 6 days a week, try to eat healthy, and have IBS but have not suffered from it for roughly 7 years since I cleaned my diet up. My bowel movements are a 80/20 split between type 3 and 4 stools on the Bristol stool chart. I usually go every other day, but sometimes go through periods where I go daily. Usually when I eat more I go daily and have a higher probability of type 4 stools. I am on my parents awesome insurance until the end of November. After that I will be on a high deductible plan through my work. Lucky me for getting something like this right at the transition!

Background story: Summer of 2017 I had a similar fissure to the one I have now, but it healed in about a week with no intervention on my part. About 2 months ago, I had an abnormally large bowel movement, which I knew was going to cause some damage as it came out. It stung a little bit and left some blood on the toilet paper, but it wasn't bad at all.

For the next 3 weeks, I ignored it, and assumed it would heal on its own as the previous one did. Luckily, I have never experienced the gut wrenching pain described on here. Its just a minor annoyance with some blood on the toilet paper. After 3 weeks with no healing results, I did some online research and started to implement some of the healing techniques I found online. Warm bath morning and night and coconut oil to promote healing/lubricate.

Things seemed to be getting better until I had surgery to fix my deviated septum on October 10th (again, trying to get everything done before my insurances switch). I couldn't take a bath for 2 weeks to avoid nose bleeds, so all anal care went out the window, and my situation stayed the same with no improvement.

Now that I am cleared to bathe again, I can get back to healing my fissure. I've done a few hours of research and have formulated a game plan for healing. Let me know if I have overlooked something/need to do something different :)

Daily Water Intake: At least 120 oz.

Daily Food Intake

Breakfast:
* Shredded wheat cereal with whole milk
* Plain greek yogurt with raspberries and blackberries

Morning snack:
* Sunflower seeds
* Dried fruit (apricots, papaya, mango)

Lunch:
* PB&J with Dave's Killer bread powerseed (5g fiber per slice) and 2g fiber from PB.
* Protein shake with whole millk
* Some type of fruit (or rarely a salad): apple, grapes, pineapple, banana, etc

Afternoon snack:
* Almonds and/or trail mix

Dinner is less rigid but I eat a fruit/vegetable with it always.

Changes - Try for 2 weeks to see results
* Restarted taking my multi-vitamin and 300mg of Magnesium Citrate (had to stop taking 2 weeks prior to surgery).
* Bought a fiber supplement to add 5g of soluble fiber to my diet to make sure I am hitting 35g.
* Morning and night bath
* Apply coconut oil morning and night. Also right before bowel movement if possible.
* Replace protein shake at lunch with Kind bar (6g of fiber) or Clif bar (4g of fiber)

If no improvement in 2 weeks, stop fiber supplement and magnesium supplement. Start taking milk of magnesia or Miralax. If still no improvement, take the hit and go to the doctor.

My advice start taking miralax and take magnesium supplement. The longer is lingers, the harder it is to heal.

Sounds smart to me. I picked some up today and am starting on it.

Time for a quick update.

I went to my general practitioner in early November and he prescribed Rectiv (nitro cream). I used that for 2 months thinking it was working well. During that time I was taking a stool softner which was creating a small bowel movement every morning in which I didn't see any blood on my stool. Aside from 2 or 3 larger bowel movements that did have some blood on them, I thought I was healing well.

The second day off the nitro cream, the blood was back full force. About a week later I went to a surgical specialist and he confirmed that I still had a fissure. He told me that it was still acute and that he would be very surprised if I could not get it healed since my muscles didn't seem tight at all during the exam. He told me to drink 6L of water a day, don't strain and take citracel for fiber.

So I did that for about a month with no positive results. I called him back and he prescribed Diltiazem. Immediately after starting the new cream, I realized that I had been an idiot for the past 3 months and incorrectly thought my fissure was on the left side. Facing the toilet, the blood is on the left side of my stool, and my GP had indicated the left side a few months ago. Sitting on the toilet though, the blood is actually on the right, and my fissure is actually on the right. Putting the nitro cream on the left side for 2 months didn't help much at all I'm sure.

The Diltiazem doesn't seem to be helping so farand for some reason my stool softner is no longer producing good results. I'm going every 2-3 days with large, soft stools which causes blood. The good news is that I still don't have any pain aside from a brief twinge during the BM. I'm planning to switch to Miralax this week and try drinking tea every morning to promote a bowel movement.

My final hail Mary is going to be this summer when I'll be traveling around Europe for 3 weeks. Last time I did that during summer of 2015 I didn't have a bowel movement for 2+ weeks until I got home. I'm hoping that might occur again to give myself enough time to heal...and then pray the resulting bowel movement isn't large enough to re-tear. If this doesn't work, then I guess LIS is my only option....which seems insane that there isn't better treatment options for this.

I honestly do not think that having just one BM in two weeks will spare you of having an even larger fissure. I advice you do not go that route and instead try to find a way to keep them soft every day.

What would likely happen is sure, it's heal until that 2 week BM. Then it will retear.

That's the thing - I already am trying to soften them daily. And am highly successful. I don't strain at all, they slide right out, and are incredibly soft. Yet the tear still opens back up. It honestly baffles me as I cannot fathom what else I could possibly do beyond somehow shrinking the diameter even more. Which I'm not sure is even possible.