Hi everyone!

I've been lurking on here for a few months but thought I would join and share my anal fissure healing journey in the hopes that it will help someone.

Background

I experienced some bleeding during bowel movements in March 2020, these were 'minor' compared to the one I have now and within a few weeks would heal. However, a new fissure opened in March 2022 after I had 2 really large portions of cognac noodles (as someone who was going for a gluten-free diet, I wanted to try something new but oh what a mistake that was). The next day after eating the cognac noodles, I had the worst constipation ever and really strained to get the undigested noodles out into the toilet bowl. That was when I noticed a whole bowl of blood and lots more upon wiping.

What I did

With my previous experience of anal fissures, I thought this one would heal quickly too. But after a week, I decided to see the GP who examined my anus and confirmed there was an anal fissure. I was prescribed Rectogesic ointment and was also asked to increase my fiber. I was already taking psyllium husk capsules (6 per day) before I knew of anal fissures so continued to do so.

1 month after

The Rectogesic ointment would give me headaches as I applied it within the anal canal with a q tip but I persevered and did it twice daily. However, I was still constipated and bleeding. Was it because I had decided to go vegetarian this year? Was it because I had cut out all meat aside from the odd seafood? My stools were bulky and hard to pass. As a person who only ever drunk water and no coffee or tea, I was stupefied by why I wasn't healing.

Mini week of no pain?

After a month, I reluctantly went on a one-week trip to Mexico. I was scared that going off my routine would make the anal fissure worse but surprisingly my stools came out like toothpaste while I was there. What was I doing differently?

1. As I stayed at a hotel, I had the same breakfast of omelet, some refried beans, and some fruits and vegetables in the omelet such as tomato and onion. I would also take a glass of orange juice followed by taking 2 capsules of psyllium husks.

2. I also walked for most of the day as I was traveling and lunch would be Mexican food such as tacos, enchiladas, 'sopes', (corn based flour, meat, cheese, and some vegetable garnishings) as well as the occasional seafood. I rarely had any grains such as the usual white rice I would eat or oats for breakfast.

3. During the night, I would eat very little but it was always very alcohol filled. More cocktails and hard spirits.

I noticed that I didn't take the psyllium husk tablets after I had left the hotel for the day and didn't apply Rectogesic at night as I thought it would interfere with the alcohol.

Back to blood

I then came back home and resumed my diet and noticed that I would have constipation again and even more pain and bleeding (which led to me howling in the toilet for most days )

What I am doing now - June 7th 2022

Thinking back, I realised that maybe I should revert to the diet I had in Mexico with eggs, seafood, meat and some vegetables. I saw a video on how psyllium husks would bulk up the stool if not taking with enough water so I have stopped taking these completely.

1. I normally have a bowel movement in the morning or I induce it now with prune juice and magnesium citrate tablet the night before. I have a warm shower and apply coconut oil with a finger cot before the bowel movement and while doing so I can sometimes feel the tip of the stool which I try to mush but it doesn't always work. The blood and pain is still there so I am not sure whether I should use vaseline which worked in Mexico but is it good for the anal canal? I take a sitz bath afterwards but it stings rather than relaxes my anus

2. For breakfast I am trying eggs and a fruit. For lunch, I try to go with a meat or fish with some vegetables and prunes I take my magenisum citrate tablet here. For dinner, again I go for a meat or fish and some vegetables. I heard that meat or fish will give smaller stools than if I had too much fibre which would give a bigger stool.


3. I do a daily walk.

I feel so alone and drained but it is nice to see a community here! If you have tips please do share and I know we can heal together :)

Will try and update again tomorrow.

June 8th 2022

Surprisingly I didn't have a bowel movement in the morning despite taking magnesium citrate and drinking some prune juice before bed yesterday.

However, good news? was that the doctor prescribed me with Diltiazem ointment because the recotgesic didn't work for 8 weeks. I also said my stools were soft so he prescribed me with lactulose too. I'll be sticking with these religiously for the next 6 - 8 weeks, as well as using coconut oil before my bms, squatting when passing bms and also taking sitz baths and a bidet with warm water after.

The slightly concerning thing was I can actually feel fissures even more when I apply the cream and there is a numbing pain even though before it felt itchier but less painful?

After taking some lactulose in the morning and having a brunch consisting of just scrambled eggs, avocado, cucumber, blueberries and then a lunch afterwards with 4 chicken drumsticks (with minimal seasoning), cucumber and a mango smoothie, I eventually had a surprisingly toothpaste like bm at 6pm. Although I did still have a few slight involuntary spasms afterwards there was no pain or blood.

I had a big dinner having Japanese food in the evening. Miso soup, dumplings, seaweed, salad, eel, tofu and something I haven't had for a while - white rice. I was hesitant as I wanted to avoid all grains in case they made my stools hard and bulky but heard that white rice is a low residue food so hopefully most of it will be digested.

Will update tomorrow but hope that I will have another toothpaste like bm to aid with my healing!

June 9th 2022

Seems like Lactulose is keeping my stools soft and today I had a bm without pain and bleeding.

June 10th 2022

Ugh...back to square one Went out for a few drinks (cocktails) at the bar yesterday and although the overall stool was soft, the tip of the stool was a bit hard and I felt moderate pain upon my bm today (I did do a hot bidet prep, Diltiazem cream as well as coconut oil before the bm) and saw blood on the stool and blood again upon light wiping. It might also be because I didn't use the ointment yesterday night in case it would react with the alcohol.

Didn't eat much today (eggs, sausages, blueberries, peanut butter and banana for breakfast and only a second meal of 4 dumplings and cucumbers at around 5pm and a few prunes and prune juice here and there).

Hopefully I will have a good bm tomorrow too :) Let's heal soon!

June 11th 2022


Wa worried for my bm this morning but the stool came out smoothly. Not as smooth as the bms earlier this week but there was no blood upon wiping and just a bit of pressure when it was coming out. Maybe I should up the dose of lactulose (I'm taking 30 ml per day split between a day and evening sitting.

Will see if my outdoor trip today with a lot of walking will make a difference. I had fish for lunch with potatoes and salad, hope the potatoes won't also my stools to become too bulky. Also had a large Japanese bento box with lots of deep-fried food (tempura). Eek.

June 12th 2022


Morning bm again and surprisingly no blood and no pain but a lot of stools came out, maybe from the large meals that I had yesterday. Seems like lactulose and diltiazem is working...

June 13th 2022

Third time a charm? I always get so nervous before my bms and do a hot water bidet before hand and try to apply the diltiazem before the bm to loosen up the muscles and then wait a bit before applying coconut oil to help it slide out. My stools were wanting to come out before I applied the coconut oil and I felt the tip of it might be too hard so I tried to 'mush' it with my finger using a finger cot. There was no bleeding but maybe a slight pain when coming out? Immediately took a sitz bath after to try to calm anything down.

Today I had a lot more fibre than usual (spinach, aubergine, kimchi, beansprouts) and then had some pork sausages and eggs for lunch and some lebanese food (grilled chicken breast, salad, rice and lentil soup for dinner) I also tried to have a few prunes in between my meals and a avocado, almond cake (no flour, no dairy) and a soya alpro yoghurt.

I've lost loads of weight (10kg since the start of my anal fissure and haven't exercised at all so I am keen to get back in and regain my energy and weight)

Hope it heals soon!

June 16th 2022

It seemed like the ointment and lactulose was working until my bm today where I saw lots of blood and felt slightly constipated :'( Feels like I have gone back to square one although the pain was minimal and there were not really any spasms.

The culprit?

Brown rice! I had brown rice for the first time in a while yesterday and perhaps this made my stool bulkier and "grainier" than usual. Maybe it was too much insoluble fibre or maybe even too much grains as I had white rice earlier in the day. I had also stopped snacking on prunes and prune juice which was what I had been snacking on before to help keep my stools soft.

No brown rice from now and I'll see whether I can start recovering again...

June 17th 2022

Sad times again I had a bloody bm today but the pain was quite minimal. Does this mean I've gone back to square one now?

The bleeding started again when I ran out of my prune juice and prune snacks (I used to have either a glass of prune juice), or a few prunes after each meal to ensure I have a bm the next day. I found that if I left it for 2 days, the stool was always a bit hard.

I'm also wondering whether it is because it is summer time and I may be more dehydrated than usual which causes the stools to have trouble passing.

I've bought some prune juice and prunes today. Will have some with every meal. Will also do my routine of:

Preparation for BM
1. Wake up and have a hot water bidet on my anus to make things less tight
2. Put the ointment on so my anal sphincter can relax a bit
3. Apply coconut oil after waiting a few mins so the stool will slide out easier (I'm not sure if this makes it even more bloody by making the blood run faster?)
4. Clean with gentle wiping and then use a bidet with warm water to clean
5. Take a sitz bath

Morning
1. Have breakfast (no grains) - Some meat, some veg and egg (Have with a glass of prune juice) and have 15ml of the lactulose

Lunch
2. Have lunch (Trying to have white rice which I heard is low residue, meaning smaller stools? some meat and veg) have a few prunes after meal

Dinner
3. Have dinner (Similar to lunch) Take lactulose then

Before sleep
1. Hot shower
2. Manual dilation with a anal plug using the ointment

Need to stay positive! I will heal!!

June 18th 2022


Adding back the prunes and prune juice seems to have worked. A nervous bm today but there was no bleeding or pain.

June 19th 2022

Feeling so down today I've been doing everything I can to ensure I am healing but today I felt pain and bleeding during my bm. Was it because I had hot pot yesterday? I had a bit of lamb meat which I haven't had in a while so maybe that caused my stool to be harder?

As I was applying coconut oil today before the bm, I felt some pain closer to where the stool was so maybe my anal fissure is deeper inside than I thought it would be.

Demotivated but I will keep trying!

June 20th 2022

Feeling down again today because I had yet another bloody and painful bm despite doing everything the same as always This makes me suspect that it is definitely my diet that is the problem as I have been a little adventurous thinking that the ointment and lactulose will help soften my stools for every type of food.

Today, I've tried to revert back to the low fiber diet that I did when I was on my travels:

Breakfast
Eggs (Scrambled, omelete), beans and or vegetables but minimal. Orange juice

Lunch
Seafood or chicken

Dinner
Seafood or chicken

Will also continue with the prunes and prune juice as I read they are natural laxatives and stool softeners.

Will update on how my bm is tomorrow with this low fiber diet!

June 21st 2022

Seemed like my low fiber diet is working because I didn't have a bloody BM today, maybe some pain? But I wasn't sure if it was because I was anxious and anticipating it or because it was actually pain. I thought I was all in the clear but I had some smoked salmon and avocado for breakfast and 1 hour later took the usual 15ml dose of lactulose and an hour later I had my second bm - diarrhea It didn't hurt as bad but I bet it must've irritated the fissure even more.

I didn't eat much at all today and tried to limit my physical activity to conserve energy. I think I had one piece of fried chicken for dinner and that was it.

June 22nd 2022

Worryingly I didn't have a bm today despite doing my usual routine of using a hot water bidet, applying the ointment as well as having some prune juices, avocado, banana, lots of water and 15ml lactulose. I'm just worried that it will mean my stools will be harder the longer I leave it in. I'll try and take a bit more lactulose for my evening dose and have some prunes and some juice with flax seeds in it to help stimulate a soft toothpaste like bm.

I will heal!

June 23rd 2022


Now I know of the extent that an anal fissure has on your mood because I didn't have a bloody bm today, a bit painful but no blood and was over the moon :)

Yesterday's food were:

Breakfast: Scrambled eggs and smoked salmon with prune juice
Lunch: Miso soup and tofu
Dinner: Fried chicken and prune juice

Today will have scrambled eggs and pork sausages, tofu and miso soup for lunch and then some deep fried cod for dinner.

Will again follow my usual routine with the ointment, lactulose and coconut oil/vaseline.


June 24th 2022

Again today was a no bm day. Maybe the low fiber diet is helping go less but I'm always worried about the stool being harder the next day.

Breakfast: Scrambled eggs, fish sausages and mushrooms
Lunch: Miso soup, tofu and boiled eggs
Dinner: Grilled chicken, some Korean coleslaw but I only ate like a quarter of it, water, sashimi, a plant based milk shake and a plant base protein ball. 4 - 5 prunes also to hopefully help soften the stool.

Hopefully I'll still have a nice smooth bm tomorrow to continue with the healing!

Instilling the confidence that I will heal 100% :)