25 year old male here with ulcerative colitis. I always had small degree of blood in my stool or pain, but about a year ago it started getting severely worse. the blood, the pain, and the straining was increasing, when I noticed that something was prolapsing out of my anus after bowel movements and obstructing them. I started feeling around, it was a huge lump I assumed was a hemmorhoid. After a long, painful time of trying different things, eventually I saw a colorectal surgeon. He was about to dismiss my problem as an anal fissure, but i insisted he look inside to see what this large grape sized blob was. Turns out it was a genital wart inside of my rectum, and he implied i must have had gay sex to get it (i haven't. overall this doctor was the worst doctor i ever met, but i was desperate to get it removed)
Up until the surgery i was using lidocaine before every bowel movement but i would be in pain for 12 hours after it wore off. It was a nightmare, but still nothing compared to the post op. The main problem was, I think, that this doctor did the operation and everything neglecting the anal fissures that occured do to the wart and that i have IBD which can make the area more inflammed and harder to heal. Moreover, to treat any recurring warts, i had to go back for acid treatments applied inside anus which kept re-opening the wound.
When all the warts were finally gone, i was traumatized and left with a terrible anal fissure i could not resolve. I noticed a large part of the problem was, the area would get very inflammed, swollen where even soft, small stools would be hard to pass. Supplements like psyillium did not seem to help as they added too much bulk to the stool. Even gently sticking my finger up there would sometimes be painful to the non-fissure areas due to all the inflammation.
Here's some things that helped me through the process:
1. Low carbohydrate, no starchy grains diet- Basically specific carbohydrate diet or even ketogenic seemed to decrease inflammation of rectum and reduced IBD symptoms.
2. DIAPER RASH CREAM was a godsend. I tried stuff like coconut oil, castor oil, petroleum, all types of various 'lubricants'. Its hard to explain, but for some reason the protective pastyness makes it SO much easier on any painful areas. I very highly recommend PALMERS BOTTOM BUTTER - its like a smooth creamy buttery paste that when gently inserted into anus is very soothing and minimally painful. The active ingrediants are zinc oxide (helps healing/protectant), cocoa butter, vitamin A, D, and other stuff. basically, very similar to CALMOL suppositories (cocoa butter and zinc oxide)
3. CALMOL SUPPOSITORIES/ CAN MAKE YOUR OWN - i have to say these were useful, although a little expensive. As mentioned in #2, Palmers bottom Butter is basically the same thing . What i did was - squeeze a bunch of the tube out in a straight line, place in freezer, break off tiny pieces as needed. There you have it- DIY calmol suppositories, ice cold which helps with any inflammation, for much much cheaper. Ive found that having these in helps tremendously with the bowel movements, as it coats the harder ends of them so they are not as rough on the skin.
finally, what really was the turning point for me was when I got my GI to give me
4. MESALAMINE ENEMAS/ ROWASA - I'm surprised these arent mentioned as much for anal fissures. It seems to be common that people with fissures have problems with rectal inflammation/ swelling of the area which makes it tight and harder to pass stool / more straining. I noticed how hydrocortisone would help reduce inflammation a little bit, but not long enough for it to help heal the fissure. I noticed how the whole area would get super sensitive sometimes which would make the fissure very likely to reopen, and I noticed that sometimes taking my Lialda (oral mesalamine) would seem to help with it. But not always it would reach the anus in efficacy. I decided hey, i have ibd, i can probably ask my GI for the enemas to see if they help.
it was like day and night. I only used half of an enema and BAM, the whole rectal area was calmed down. I skipped the next night, using only a calmol suppository, then used the other half the next night. I could tell that it was basically over. Since then I havent had to use them anymore, maybe only half of one a week or so just to make sure everything heals up. The enema is like a white gooey liquid which also seems to help soften the stool and is very easy to pass.
As far as other prescriptions- I have been using nifedipine as maintenance, but its hard to say what its actually doing. the area does seem more relaxed, however the most significant, immediate effects i noticed was from the mesalamine enemas. The nifedipine does not seem to help at all with the inflammation that may occur.
So yeah, I've been feeling great since I got this undercontrol. Its an amazing feeling of rebirth, for so long I had such a PTSD response to bowel movements. And its gone! I feel great and now can worry about my other problems :P
