After almost a year of pain from a chronic fissure, I seem to have rounded the bend. The fissure has been replaced by a line of scar tissue, which I will now go about trying to heal as much as possible before it sets.

I wanted to pass along some of the tips that I believe helped me along on this long, frustrating, and sometimes excruciating journey.

I am basing some of this on personal experience and experimentation, and the rest is information I've culled from reading up on chronic wound healing and how to maintain good digestive health (with the intention of normalizing elimination via diet and lifestyle).

Healing a bad fissure seems to be less about what kind of cream/medication you're smearing on it than it is about correcting systemic issues that may be preventing your body from repairing itself. Some of those same issues likely contribute to the onset of some people's fissures. In my case, I think my pelvic floor muscles were so dysfunctional, and my digestive system was so sluggish--on top of my high levels of daily stress--that I ended up with a perfect storm for developing and keeping a fissure for WAY too long.


On we go--


1. Hydrate. Keep the tissue hydrated so that it is supple enough to withstand difficult bowel movements/exercise/etc. The ideal seems to be warm liquids and herbal teas, to encourage good digestive health.


2. Eat a minimum of foods that are challenging for the digestive system: Red meat, dry/crispy foods (crackers, chips, bread...), oily/greasy foods, spicy foods, roasted foods and foods made with processed/refined ingredients. I've come to believe that a diet focused on steamed vegetables, soups, and other gently cooked foods is the best way to go. Ideally foods shouldn't have too much moisture cooked out of them, hence the steaming recommendation. Simmering is another good way of retaining nutrients and water. Think stews, congees, soups. Get protein from properly prepared (aka traditionally prepared) whole grains and legumes, plus some high quality meat.

-HIGHLY recommend bone broths, which provide amino acids and collagen which are readily available to your body.
If you don't have time to prepare bone broth, consider supplementing with collagen hydrolysate and gelatin from Great Lakes Gelatin company: http://greatlakesgelatin.com/storefront ... ysate.html

-Avoid overeating, as this will a) tax your body's digestive system and b) increase the likelihood of improperly digested foods, contributing to problematic elimination (aka constipation or diarrhea).

-Chew your food thoroughly


3. Avoid sugar, alcohol, caffeine, tobacco. Really tough, I know, but these things seem to delay healing in their own ways. Caffeine seems to increase involuntary tension in the sphincter muscles, which limits blood flow to the area. If you're a smoker and are struggling to heal a fissure, it's worth noting that tobacco use is associated with inhibited wound healing.

See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4241583/ for one study -- there are some others out there.


4. Nutritional support/vitamins.


- Vitamin C is necessary for collagen formation.

- Zinc is crucial. See https://www.ncbi.nlm.nih.gov/pubmed/2275309

- Vitamin D, too: http://grantome.com/grant/NIH/I01-BX001066-04

- as mentioned above, bone broth/collagen/amino acids are your allies

- Magnesium (preferably magnesium glycinate or malate) can help to ease muscle tension that can hinder proper blood flow to areas that need healing.

- Arginine and glutamine. See http://www.woundsresearch.com/article/n ... e-overview



5. Get enough sleep. This is your body's dedicated healing time. Take full advantage.



6. Minimize stress and worry. Love you adrenals. Stress hormones send your body into survival mode, which can draw resources away from important functions like digestion and wound healing. The more you're stressed, the less your body will be able to take care of long term projects like repairing a chronic fissure. Take time to purposefully de-stress through meditation, prayer, walks in nature, light exercise (for example: tai chi), stretching, etc. Be mindful of how much tension you're storing in your body, particularly in your sphincter muscles.



7. My preferred natural topical treatment options that may aid in healing wounds (not including medical options that your doctor may prescribe):


Tamanu oil

Calendula ointment

Zinc oxide-containing products (Sudocrem, Butt Paste, etc)

Coconut oil

Patanjali Crack Heal cream
(patanjali crack heal)

Himalaya Antisecptic Cream
http://www.himalayaherbals.com/products ... -cream.htm



8. Sits baths, and anything else you can do to stimulate blood flow to the area (self-massage, acupressure, stuff like that)


9. Squat for BM's. Takes pressure off the fissure.


10. Stay positive and don't give up! I had days where I hated my life and felt basically cursed, but coming to this forum and feeling the support of this community gave me hope. All I can hope is that this post will pass that feeling along to you, along with a few tips.


I recommend googling "chronic wound healing" if you're interested in reading more about the reasons that bodies do and don't heal.

I'll make a separate post about scar care and self-dilation after I finish dealing with this post-fissure scar tissue. Until then, I'll keep updating this post with anything that slipped my mind the first time around.

Thanks for reading - I can't say what will work for other people, but these are the things that worked for me. I didn't do a course of prescription topicals, but those seem to be really beneficial for some people.

Thank you for sharing! Do you think the scar tissue can be minimized or eliminated?

This is my third attempt to post here and after working on this for more than an hour, I have no intent to try and put everything in once again only to have my login timeout. If I remember, this is exactly why I stopped visiting this site, not because it wasn't helpful and positive, but because I was tired of losing everything I had taken the time to add.

In a nutshell, my life was a horror story that I wouldn't wish on my worst enemy and after doctor visits, countless expensive prescriptions, untold number of ointments and a surgeon urging me to go under the knife, I started using coconut oil. Not the expensive organic, extra virgin, no it's the Lou Ana that sells for 5$ at the grocery store.

I take 1,000 mg of soft gel coconut oil, use the raw coconut oil before and after bowel movements and one Colace before bed and I have been pain-free and now I don't even have any scar tissue for nearly a year.

I don't do anything else - it isn't some special anything, just use the 100% coconut oil often and throw the other crap in the garbage.

I wish you the best of luck.

Wow LeeMS, thanks for coming back and telling us what worked for you. If you don't mind, could you tell me which coconut soft gel brand you used? I make frozen​ mini suppositories from virgin coconut oil and use them whenever I feel the need. Now I think I should use them at least twice a day.

P&H,

It's right in the posting - the Lou Ana brand that you find on most supermarket shelves. Detour around the expensive oil because there isn't any difference - as long as it is 100% coconut oil, that's all that matters. Don't worry about virgin, organic, cosmic, whatever. For the oral soft gels, it's really an optional thing that I do, so use whatever brand you prefer. You could omit this part, if you like.

Bypass the suppositories and whatever else, just apply the coconut oil liberally to the interior and exterior with a clean index finger. Clean yourself after a bowel movement and reapply. Use the C.O. As often as possible. Note: avoid using other ointments, gels, etc. while using the oil.

For 2 1/2 years my daily pain level was anywhere from 6 to 9, where tears and/or screams were a way of life. Be patient and stick to this method.

Good luck and let me know how you make out.

I started making suppositories because the oil would get everywhere except where I wanted it to go. I hated the feeling of an oily bum. And I don't think I'm brave enough to stop using my nifedipine just yet.

It sounds like you really did endure a nightmarish life before you got better. How long did you use the coconut oil for before you saw a reduction in your pain levels?

P&H,

Suggest you forego the suppositories - you only need a little oil like on the tip of your finger, so it isn't messy at all. Stop the nifedipine (and anything else) and stick with the oil. Mixing anything is counterproductive. All the prescriptions I tried did absolutely nothing.

Since I tried every prescription and herbal or natural ointment or cream that I could find - and my search was relentless - that by the time I went with only coconut oil, I was pretty far gone. The process started slowly, but I saw a little improvement every day. In a month my pain was lessened greatly and after several months, I had no pain until finally no scar tissue. My bum is like new :^)

It must feel so good to have a painless bum. :) I'm hoping I will reach there someday too. Thanks for your advice!

I never thought it would happen, really and living was a struggle. I stopped using all of the other things and stayed with the coconut oil. I know everyone is different, but a fissure is certainly a fissure. Use only the coconut oil and give that a chance. Also, using the Lou Ana oil assures that it is very smooth without any pulp. I think it's better.

I believe that ongoing use of the oil helps to make sure you have proper elasticity so it may help to prevent a recurrence. If you get healed, don't discontinue it's use - make it a part of your routine. Good luck.

Thanks for the tips!