I stumbled upon this forum months ago after realizing that hemorrhoids couldn’t hurt this much. I guess I should give some background...

M/37
In October of 2016 I attended a beer festival and didn’t hydrate properly. I woke up the next morning and drove 6+hrs to the beach. Upon arrival I had a bm unlike anything I’ve ever experienced in all my years. Huge, hard, and painful. I wasn’t sure if I could even pass it. It was quite the marathon. I was in discomfort for the rest of the trip, but nothing I couldn’’t bear. Then came the journey home. It was awful. I stopped to buy hemorrhoid cream. The cream seemed to soothe the pain. Weeks later I ordered some Mayinglong Musk ointment off of amazon because of all the great reviews. This also offered relief, but I’d began noticing substantial amounts of blood with most every bm. This went on for a year. I didn’t think much of it because the pain was minimal. Fast forward to August of 2017, a three hour flight followed by hours of driving each day while on vacation at high altitude, and the subsequent flight home. This is when I realized something was wrong and it couldn’t be “just” a hemorrhoid.

I starting googling and quickly found out about fissures. I tried most home remedies and tips from this board and other sites including changing my diet, fruits and fiber, no meat, 3-5 sitz a day, stool softeners, magnesium citrate, nitro ointment, enimas, gallon of water a day, no alcohol, no caffeine, psym husk, coconut oil in sitz and applied directly to anus, etc... I even started keeping a food journal and bm log hoping I could spot something. I kept thinking I could get it to heal on my own.

My pain was debilitating. 10 out of 10. Hours on the floor after each bm, spasms, glass shards, etc. much like everyone else has described. For the first few months I could get relief by laying on my back, when that quit working laying on my left side was my best option but didn’t offer much relief. I was taking the maximum amount of Aleve per day. Loud noises would even trigger it sometimes. I found that biting down on a towel and standing were my best options when it came time for a dreaded bm. Still to this day I haven’t had a bm anywhere other than the one bathroom in my house with a tub. This thing had taken over my life. I became much more irritable and had far less patience. Finally went to see a local gastrointestinal MD. He diagnosed with a fissure and internal hemorrhoids without ever examining me and prescribed Nitro cream and some type of cream for the hemorrhoids. I couldn’t insert the tip of the hemorrhoid cream because of the pain. Was adviced to just use the nitro for the fissure. Then I got an appointment to see a colorectal MD. See took a quick look and told me to continue the nitro cream and scheduled a follow up. By this time I’m several months into treating this thing, taking 200-300mg of colace and 400mg magnesium citrate a day and have seen small amounts of progress. The spasms had calmed down greatly, but I was still in pain. At the follow up colorectal doc recommended surgery. I said no thanks and would get back to her when it was healed enough for me to undergo a colonoscopy.

Today I’m around 6.5 months into this journey. I’ve made some great progress and had many setbacks. I’ve had bms and days that were pain free only to have the pain return the next day. I’ve tried to maintain patience as I know this is a long process. I’ve been able to manage by keeping my bms the consistency of soft serve ice cream with the help of stool softeners and the magnesium citrate and abstaining from caffeine and alcohol. The pain I experience now is more like a deep and dull ache. It’s definitely different from what it was. Today I had a painful bm that triggered me to join this forum and make my first post. I’m to the point where I’m seriously considering surgery. I’m really just ready to get my life back. My job has suffered, my wife is a saint for putting up with me, but she has surely suffered from this, and I have a two year old that I feel like I’ve missed a quarter of his life.
I was hoping that someone could offer some insight into picking a good surgeon. Or if anyone that has healed a fissure after battling it for six months could talk me out of having the surgery. I really don’t want to be cut on, but I’m afraid it’s my only option. I mean, should I try a juice fast? Is there other non surgical procedures that I don’t know about (not interested in stretching or Botox)?

If you’ve made it this far I can’t express how grateful I am. When I was at my lowest of lows reading this forum really helped me carry on and persevere. I look forward to hearing from anyone kind enough to take the time to comment.

Hey there

Nice of you to join us. It must be tough going through AF and having a toddler to take care of. Its great that you have the support of your wife. I saw that you've used coconut oil externally but i think for maximum benefit you shoud try usig a teaspoon with every meal. That really made a difference in terms of minimizing the pain and burning. Mind you im still not cured. But im on my way there. I found that deep breathing helps alot. Also using lots of dark green veges really helps keep bms soft. Another think thqt minimize the pain for me is bioflavonoid supplements.

Hi fiz,
I think sometimes for some of us really blessed people the only way to heal our chronic fissures is through surgery. If your IS is naturally tight so that you have a high resting pressure no amount of change in diet stool softeners or creams will be able to heal your fissure. Your body gets into a pain spasm cycle that can be impossible to stop without outside help.
You could try dilation if you really don’t want surgery or Botox, but I would advise having a resting pressure test and if your resting tone is over 100 then I’m sure you would be advised to have LIS.
I would have had LIS the first day after the spasms started...mine too were level 10 and I was rolling on the floor screaming....but I have underlying issues that meant 3 CRS’s were refusing to operate. Again like you my pain became less, I would say about a 6/7 out of 10, but who wants to live like that, I couldn’t have a BM outside my house as I needed to apply my GTN cream or the spasms would return.
It all depends on what your life is like....if you are not having to change your life to deal with this then maybe meditation (which will help lower cortisol) and dilation are the best for you. On the other hand if your resting pressure is over 120 then to be honest you would need more than that to heal your fissure.
Good luck

So, to follow up... I’m doing much better! When I first stsrtrd healing I was too afraid to believe it. Once I realized I was healed it was overwhelming! I was on top of the world. Tears of joy! I was pain free for 3 months, back to normal life. Then, it happened. I didn’t take care of myself. I got lax about my diet. Too much processed food, a few beers, too much caffeine, got overheated two days in a row, didn’t drink enough water, too much dairy, went for a long drive... all this within the span of a weekend. I was dehydrated. I had a hard and dry stool and ripped my fissure. My mind filled with dread of what’s to come, but this time I knew how to handle it. Immediately started taking stool softener, tons of water, 6 sitz baths a day, nitroglycerin cream applied as deep as possible 3-4 times a day. I ate only vegetables for a week, lots of leafy greens. Zero alcohol, cancelled mountain vacation. 4 weeks later I am back to near 100%.

Fizyour wrote:So, to follow up... I’m doing much better! When I first stsrtrd healing I was too afraid to believe it. Once I realized I was healed it was overwhelming! I was on top of the world. Tears of joy! I was pain free for 3 months, back to normal life. Then, it happened. I didn’t take care of myself. I got lax about my diet. Too much processed food, a few beers, too much caffeine, got overheated two days in a row, didn’t drink enough water, too much dairy, went for a long drive... all this within the span of a weekend. I was dehydrated. I had a hard and dry stool and ripped my fissure. My mind filled with dread of what’s to come, but this time I knew how to handle it. Immediately started taking stool softener, tons of water, 6 sitz baths a day, nitroglycerin cream applied as deep as possible 3-4 times a day. I ate only vegetables for a week, lots of leafy greens. Zero alcohol, cancelled mountain vacation. 4 weeks later I am back to near 100%.

How are you doing now?

Just created a fb group for those who are interested! https://www.facebook.com/groups/266969863992662/

Love that we can all share our tips and advice here!