Hi Everyone,
I'm new here, but have been coping with a painful fissure for a little over a year or so. It began with a particularly dry and painful movement in the middle of the night while I was on vacation (I tend to forget about eating well and keeping hydrated on vacation). I eat a relatively healthy diet and am very regular, but hydration had been an issue for me. That one injury sent me in to a downward spiral of pain and misery.
I am just now lately beginning to experience freedom from pain. Several months ago I read testimonials which seemed more extreme than my case. I remember falsely thinking that my situation wouldn't get as "extreme" but it did. At my worst, I spent one full hour of agony trying to pass one tiny stool. I was sweating, moaning, crying out - thank god I was alone that day, I cannot imagine what my husband would have done - he probably would have gone insane for not being able to help me in that moment. I can honestly say that I'd rather give birth again than pass another stool like that.
Here are some of the things that I recommend based on my experience (and also some things I recommend avoiding).
Do:
1. If you must have coffee, drink it black ONLY and always drink twice as much water along with your coffee. I typically drink about 12oz. of black coffee a day.... but I drink two full 16oz. glasses of water along with it. The coffee itself has a diuretic effect, which is excellent for moving your BM along before it has time to "solidify" further in your intestine. BUT it also has a dehydrating effect so you must drink plenty of water.
2. Take stool softeners... along with plenty of water to ensure they "work". Without water, you may not notice any effect. This took me a while to figure out. I was taking the softeners with just a small glass of water but then I was also drinking soda later in the day (which is basically like negative-water). The soda undid any hydration I had and the stool softeners had nothing to work with.
3. Use some kind of "healing" oil for your rectum. I had success with both coconut oil and a special "Fissure Healing Oil" I ordered off of Amazon. The oil will not only make the rest of your day or night (after having a BM) wayyy more comfortable, but you will notice that your next BM will be much less painful and come out easier. After I began trying the oils, my pain level during a BM went from a 10 to a 2 in about 24 hours. I apply the oil with my clean finger - I am not convinced that a cotton swab would really get the oil "in there" like it needs to be. I do this after my BM to help with healing and pain, and also sometimes before a BM if my outer rectum feels "dry". The oil helps the stool to slide out better.
4. "Listen" to your rectum during a BM. It is my understanding that fissures are caused by injury but are also linked to muscular spasms during and after a BM. I noticed that right as my movement "peaks" my rectum feels like it "pulls back" and tightens up however my voluntary muscles are doing more of an "opening"-type thing to let it out. This is the most painful part of a BM for me. It is during this spasm that I have felt the most extreme tears and injuries to my rectum if I do not try to "control" the spasm some way. This sounds strange, but once I understood, I began to use my voluntary muscles to "mimic" the involuntary "pulling back". This doesn't particularly feel good internally... as you can often feel your feces being forced back in. But it allows me a few extra seconds to give my sphincter a break and "relax" to allow the stool to pass without so much tension. I find that if I do this, my sphincter will eventually calm down and allow my stool to pass a little easier. After I started this, I noticed I have less blood and less tearing. The stool softeners also help. Now what ails me may not be what ails you... but if you feel this "tightening" as I feel it right before your feces "peaks" you may want to try it and see if it works for you.
5. If you have fissures near the opening, try using your clean fingers to "hold them" if you have to. This may be gross to some, but if you are as desperate as I was, you may try it. I could feel the tears near the outer part of my rectum very easily... as if it were a clock I knew I had "external" tears at 12, 4, and 5. For some reason, the tears at 4 and 5 had a harder time healing, even with the oil and stool softeners. At my wits end, one day I reached back there with a clean hand, and just used the tip of two fingers to press against the side of my rectum, forcing the soft stool to pass by them, and keeping those tears from re-injuring. You will have to wash your hands, of course, but this method has really helped me. It is crucial to mention, however, that if your stool is not totally soft you will risk pressing a hard stool against the opposite side of your rectum and possibly creating new tears there). SO BE SURE YOUR STOOL IS SOFT!
6. Grab a mirror and LOOK at your rectum. Listen, I didn't want to do it either. But after I looked, I really understood. I could see the worst external fissure, see how deep and long it was. It shed a lot of light on why I was in the pain that I was in. And it really validated everything that I was going through. Up until I looked I had a hard time understanding what was going on "down there". Now I not only understand, but I am not as afraid of it. Before I was even also afraid to touch it, but now that I have looked, I am less afraid to do what I need to do with my finger to apply the healing oils.
My little list of don'ts:
1. I did not have success with taking fiber supplements. I thought perhaps it would be "gentler" and more natural for me than having to take the stool softeners every day... but little did I know that the fiber I was taking would cause my stool to be "sticky" around the outside, but not necessarily soft. Also while taking the fiber I noticed a "jelly" residue in and around my rectum that was difficult to wipe off or out. This jelly stayed up there all day, and eventually burned and burned. My most painful stool was also while taking the fiber. The stickyness of the BM made it difficult to "exit"... I had to strain and push so long that I literally cried out for more than an hour in pain. It is also of note that I was taking stool softeners AS WELL AS the fiber, but my theory is that the fiber "absorbed" all of the liquids in my intestine (turning it into that jelly) and left no hydration for the softeners to work, even though I was drinking about as much water throughout the day as I could. I read in a forum that fiber isn't right for everyone (especially if you are already quite regular, which thanks to black coffee everyday and a relatively healthy diet, I was). As soon as I stopped taking the fiber, my stools were easier to pass.
2. Don't sit on your butt all day. Now, this is a dumb suggestion but it was one that was difficult for me to follow. You see, my profession requires me to sometimes be in a chair working for up to 12 hours in a single day. But during my free time what did I choose to do? You guessed it, sit on my butt even more. I learned that the longer you sit, the more you limit the blood supply to your rectum. Less blood supply = less of a chance for your fissures to heal. My fissures appear to be less healed after days where I must sit... and more healed after days where I am moving about.
3. Don't hold your BM back long enough for the urge to purge to pass you by. Here's what I mean by this... before I began having fissures I noticed that if I didn't have a BM in the morning like a usually do, but then had to go to work I would often (usually around lunch time) feel the urge. Now, sometimes at work I can't always take a bathroom break for a #2...it just so happens that our bathroom at work is also a dressing room. Often I would hold the urge back for about 10 minutes and then miraculously, the urge would vanish for the duration of the afternoon - often returning after I had eaten something else during dinner. Before fissures this was common and actually quite easy for me to do. However, after I began having fissures I did this once... and I swear I'll NEVER do it again. When the urge returned (after holding it back and it vanishing at work) I was met with more pressure than my sphincter could handle and also it's my theory that my stool was also larger (wider) as a consequence. What ensued was a quick "delivery" but one that absolutely ripped me right open the worst it's ever done. I honestly feel that if I'd allowed myself to go #2 earlier in the day when I initially felt the urge, the BM would have been smaller and come out slower.
Well, everyone I really hope these suggestions help you as they have for me. Right now I feel like I am on the road to recovery for the first time (actually healing). I know that with these methods, it will not be a quick heal... but one that I am more comfortable with than surgery.
xoxo

Hey stitchwisdom: Welcome
Sorry for the delayed response as it seems summer and sitting in front of a computer does not mix with many.
I like your techniques especially No.5 in the do's section. That actually works for me too and I listed it as a technique while your constipated here not to long ago.
Yeah those dry hard bm's are the worst aren't they, yikes.
Anyway looks like your well on your way to beating these assassins at their own game.....Stay hydrated now
GL

stitchwisdom Hi there, thanks for the advise is very much welcome here for all of those that are dealing with the painful experience of fissure.