My problems started a little over a year ago. In my early twenties I never used to work out, but after finally getting started, I did a year of heavy fitness + weightlifting (3 times a week), I started having pain in my butt. I used to drink a lot of protein shakes when I worked out, and I often used quite a lot of pressure during my BM, I think that's what caused my pain in the first place.
At first my doctor thought it was a hemorrhoid, he gave me some pills to stick up my butt, they didn't help at all, then I tried all kinds of different ointments, including nitro, which only gave me a headache and didn't really help.
I was then sent to the hospital, to a specialist, he said he didn't see anything or that it was already healed, but I insisted that I felt pain and he gave me some diltiazem hydrochloride, which, along with psyllium seed husks, seemed to heal me a bit, but I still had pain after the 8 week period.
After the 8 weeks, I went for a checkup at the same hospital, the Dr. said he couldn't see any fissure, but as I insisted that I still had pain, he scheduled me for a botox injection.
A few weeks after that I was scheduled for the botox, but when the time came and I was lying on the operation table with my legs apart and sleeping (due to anaesthesia), they decided not to give me the botox as the surgeon said it probably wouldn't help me. After I woke up the surgeon basically told me to "suck it up" and use some zink-creme to alleviate the pain if I had any during a normal day.
I then spent a month fightning with my private health insurance, to get the botox at a private hospital, after a lot of phone calls and yelling at the insurance people, they finally said they would pay.
The private hospital doctor told me he couldn't see any fissures either, but he gave me the botox and then told me to make sure I had soft stools 100% of the time.
I am now 3 weeks after my botox injection and I still can't feel any improvement :'(
I drink lots of water, eat 4 spoons of psyllium seed husks (2 in the morning and 2 in the evening) and generally have a healthy diet, and soft stools, but the pain just will not go away.
On a scale from 1 to 10, the pain is hovering at around 2, with occasional spikes around 5. It seems as if I eat nothing but lean meat, salad, fruits, berries, etc. the pain stays at this level. But as soon as I:
- Lift anything (it doesn't even have to be anything heavy)
- Bend over too quickly
- Get an erection
- Get up from a sofa without using my arms to get up
- (there's more, I just can't remember it all now)
I get this dull throbbing pain inside the anus up against my back. And if it's bad I get this stinging constant pain, which is particularly bad up to (1-5 hours) before I have to go to the toilet (BM).
I feel like I've hit a dead end, this fissure is destroying my life, I constantly worry about it hurting if I do something wrong. And the weirdest thing is several doctors have said they could not see any fissure, but WHY am I still in pain then?!
It's destroying my relationship with the woman I love more than anything, as my mood is very shifting. I can't do all the stuff I wan't to and sex is basicly a no-go because I have to hold back and she's afraid to hurt me.
I'll end with some questions: What the !#¤& do I do from here? I'm going back for a check-up at the private hospital in three weeks. Do I have to live with the fact that my relationship is going down the drain, that I can't do ANY physical exercise and that I'm basically going to suffer from this stuff for the rest of my life...? Or is there a way, it seems like I'm healed 80% of the way, but no matter what I do those last 20% just won't heal >_<
And why is it that I still feel pain, even when the doctors say they can't see any fissures when they examine me? I am going insane >_<
Thank you for taking the time to read my story!

Hey flaf,
I'm from the US and not really familiar with the health care system in Europe, but it sounds to me like you need a second opinion by a Colo-rectal surgeon. It's not unusual for fissures to not be seen or diagnosed. I had to see several doctors before getting a correct diagnosis by a CRS.
I know it's frustrating and everything in your life is on hold while suffering, but there is a light at the end of the tunnel. I had the surgery and it gave me my quality of life back 100%.
It's hard to stay optimistic and fight while you are suffering, but you have to seek out another CRS until you get diagnosed. There is obviously something wrong. You are in pain and you know your body more than anyone.
I have read of some CRS's finding a second fissure on the day of surgery while the patient was opened up, that wasn't visible before.
Don't give up! It can be a battle to get the right CRS.

Aw, these problems wont be forever, don't lose hope - you will beat this thing. If your girl loves you, she won't let this ruin your relationship.
First, keep calm! Doctors can't always see a fissure - that DOESN'T mean it isn't there. You aren't feeling all this pain for nothing - so something is wrong. And Dawn is right, if you see a competent CRS then they will take you seriously and help you.
A lot of us, myself included have had idiot doctors who say we haven't got a fissure/fistula, but we know we have.
If you have a small operation, LIS, it will heal up.

Hi Flaf
I can relate to your problem. My local Dr. couldn't see any fissure. The first CRS I saw said a small fissure but healing and later said it had healed. All the time I still had pain and even botox made no difference. Went to a 2nd CRS who says no fissure and it looks like a hemmahroid problem. Don't know why the 1st CRS couldn't see hemms. The whole CRS scene makes you lose faith. As the 2nd CRS has a high reputation I tend to trust him so I'll go with what he says about treatment (probably banding) next week. What can you do-- just find out who is the top CSR and go there no matter what it costs if its going to get rid of the pain.

Colonoscopy my friend