by boulderguy » 10 May 2014, 11:30
I'm a serious Colorado recreational cyclist. Not long after doing a 3-day, 200 mile ride last summer, my hemorrhoids got so severe that I required surgery in late July. At that time the surgeon found an anal fissure, which has been the bane of my existence for the past 9+ months. His recommendation was to eat two cups of brown rice a day and eat mostly vegetables. He kept telling me that in a couple weeks I would be fine.
After two months of this and NO relief (and no cycling, either), I became more proactive about my own care. Started using wheatgrass cream, which did seem to help. But over and over again, just when I would think that things were finally turning around I would have a hard stool and be thrown for a loss. I've tried a variety of other remedies, with very little providing any kind of long-term relief. Staying off the bike definitely seemed to help, so I had to interrupt my training for weeks at a time. Accustomed to riding 4-5 days a week, this was very hard for me to deal with. I've gone through bouts of mild depression, withdrawal and just not feeling very sociable at all.
In early spring of this year I was back riding again at a regular clip when I had the dread re-tear. At the urging of an old friend who's a doctor, I went to see a different CRS. He prescribed me nitroglycerin ointment. I don't know why my original surgeon never mentioned this as a possibility, but after a few weeks things were noticeably better and I resumed my training. I went back to see the doc and he said the fissure was healing nicely and after about 3 weeks I should be able to stop with the cream.
You probably know what happened next. Yet another painful blowout. I gave it a few days off and then rode that weekend. Just an easy one-hour ride left me in excruciating pain. With a trip to Japan (and a 12-hour flight) coming up, I gave up on cycling for at least the next month. That trip is just a week away now and I'm hoping to get it together enough to deal with being on an airplane.
In the meantime, I have been using Miralax every day, also inulin and, at night, a docusate sodium stool softener along with some magnesium. I clean with Balneol after every BM. For me, nothing has helped as much as the nitro ointment, which I apply morning and night using a Q-Tip. It's obvious (as both the surgeon and the Korean healer warned me) that riding a bike causes the sphincter muscles to contract, which leads to re-tearing of the fissure. This time I'm resolved to stay off my beloved bike until it's totally healed. Then comes the work of weaning myself off all the laxatives and getting my body to do the job on its own. As has been mentioned elsewhere, more fiber and lots and lots of hydration are important. When I'm at one of my low points it's hard to believe that this will EVER go away, but in order to stay sane I have to assume that it will. I'm still hoping to do a couple century rides in the fall, but I guess we shall see.
