Hi all. I've been suffering with fissures and hemorrhoids for as long as I can remember. I'm a 32 year old female, and this started when I was around 10 years old. I do have multiple fissures (lateral and horizontal) and also hemorrhoids, and a single harder BM can flare them up. I am just fed up at this point so I will be going to see by family doctor and asking for a referral to a proctologist. I currently have a few fissures (some very small, some a bit larger) that flared up after a couple days where I didn't drink much water and was drinking alcohol. I have been using nifedipine for 2 weeks but so far it's not helping much. I don't have pain between BMs, but there is itching, either from the fissures or hemorrhoids. There is also intermittent bleeding (bright red, usually with minor pain). I guess it is hereditary, my mother recently had a thrombosed hemorrhoid and has had issues with a fissure before, but not like mine - it's been a lifelong permanent thing. Eventually the fissures stop bleeding and seem to heal but they always come back, and I always have at least some sort of multiple hemmorhoids (everything always looks "puffy" down there). I don't think I have IBS/crohns or anything like that because I have never had any major digestive issues, and I have no STIs. I did have HPV with anal warts a long time ago (when I was 18) but these issues preceded that and it was cleared 14 years ago. I am not too worried about malignancy as I feel like if it were an indication of cancer I would know something was up after almost 25 years of dealing with this stuff. I will be seeing a specialist to see what I can do and make sure there is nothing else going on, but I am not that hopeful for a solution. I feel like this is just something I will have to deal with for life and it's depressing. I eat pretty well, but the second I don't consume a ton of veggies for a coupe days it seems to come back, so I feel like I have to obsess over my diet. I am not overweight and have never been pregnant. I do have a desk job where I have to sit all day and I work a lot of overtime, so I'm sure that added pressure doesn't help. But it was not any different when I worked a retail job where I was on my feet all day. Sigh. Just fed up.... Feeling cursed with this. Thanks for reading.

Oh gosh, Angie, that sounds awful. I can't imagine suffering like that at the age of 10.
I wonder if something is up with the skin in that area that's weakening it and/or irritating it? It might be helpful to see a dermatologist. That may sound silly, but it's amazing what a dermatologist can recognize.
Seeing a proctologist also sounds like a good idea.
Nifedipine could take a while to start working, or may never work at all, so be prepared to ask for diltiazem or nitroglyerol if nifedipine never helps you.

If you have trouble controlling stool softness with diet, try miralax (also known as movicol). It can just give you a little help when you need it. Lots of people here take it long term.

Good luck!

Thanks very much for the reply, sorry did not see it til now. Never thought to see a derm but I am seeing my GP tomorrow so I might run that idea by her. Nifedipine has been totally useless for me so far, so I ordered this expensive "Dr. Wheatgrass" cream - it sounded too good to be true but I thought I would give it a shot. It's been 2 days and it already seems to be helping (less pain, less itch, bleeding has so far stopped) so I will keep up with that and see how it goes. Right now I am just drinking tons of liquid (mostly water/green tea) and eating lots of veggies and lentils/brown rice, and so far that seems to be doing the trick. I think for me it needs to be a really major effort to keep on top of the fibre and veggies and general good diet, and to get a large liquid intake each day. If I slip on that for a while it seems like everything goes to hell, so I guess it's all the more incentive to take care of myself. I am wondering too if wheat is an irritant for me as these issues seem to clear up a bit every time I cut it out, even though I don't experience the bloating or other symptoms people seem to get with a wheat intolerance. Anyway thanks again for the advice, much appreciated!

Hi there! I too was wondering - is multiple anal fissures a common thing or it is happening in my case only. My condition is very much similar to yours and my age too, co-incidently. Since childhood, I have struggled a lot with hard stool medical condition. At that time, I never used to get a BM for 2-3 days which used to cause a very hard BM later and straining of-course. Later, when I realized I have got Piles and constipation, I opted for Yoga, cycling, morning-evening walks and homeopathy as well, as I had researched enough knowing Ayurveda doesn't help much while Allopathy too has side-effects (as in trouble while driving a two-wheeler). I have lived with a Sentinel Pile and a Chronic Anal fissure for almost 18 long years. Till date, I haven't undergone any surgery, but have taken homeopathic treatment whenever I noticed blood after passing a hard stool. In my case, I have realized that blood in the stool or a hard bowel arise mostly during winters and summers. In winter, because less water gets consumed and in summers because we get more de-hydrated. For the major part of my life, I was a vegetarian but very fond of spicy food. I think that has worsened my condition a lot. Though I started eating meat (mostly due to partying with office colleagues )only 3-4 years ago, but it is in this period where I developed multiple anal fissures sadly. And since 2 months, I am facing continuous blood in stool and hard stool. Though I am taking the same homeopathic medicine, I now feel it isn't working for me these days. Sitz bath does give relief for some days i.e. to lessen the anal swelling and to relax the sphincter muscles. Similarly, cleaning the anal area after each BM, intake of a high fiber diet, 3-5 liters water, semi-solid food, a daily walk, etc doesn't guaranty total absence of a hard stool nor does it ensure complete recovery. I think, the medical condition has become a way of life now. I have read on many forums about 'Lateral Sphincterotomy Surgery' but want to know does it really benefit in the long run? I do not have other colo-rectal diseases as my GP has verified the absence of their symptoms. He says, there is no need for Surgery too. But with each passing day, only I know how I manage to defecate and how it hurts and worsens day-by-day. Should I opt for Surgery or shouldn't, is my concern. I understand that straining only worsens the anal mucosa but I don't really understand how to pass the already hardened stool w/o applying pressure? Every sunrise brings a new experience.

Ugh, sorry to hear you're suffering the same problems. I feel for you but it's sadly kind of nice to know it's not just me who's has these problems for so long. It's been a lifelong annoyance and I've just come to accept that it will probably never go away entirely. I'm just not capable of having Sitz baths every day, only eating vegetables and whole grains, never drinking alcohol, and always having 8 glasses of water very day of my life... Just not possible. I've been a vegetarian my whole life and never had any major issues with constipation, but we all have the odd movement where we have to strain - that's life. Plus, sometimes a harder bm will arise even when I'm perfectly hydrated, exercising and eating healthy, so it just seems useless to be so strict. Since i made this original post, I did end up seeing a colorectal surgeon/specialist, and he did a DRE and sigmoidoscopy and found no polyps or cause for concern. He diagnosed me with hemorrhoids (which I already knew) which he said didn't look severe or abnormal in any way, and "abnormally thin anal skin prone to tearing" which obviously would not be helped by any sort of surgery. There were no fissures visible at the time of the exam, but for some reason I became extremely constipated following it and that led to another very bad episode of tearing and bleeding. I'm just resigned to the fact that this is probably a permanent annoyance I will have to deal with forever. I can go for quite a few days/weeks feeling pretty normal and pain/itch-free, and even when I am bleeding every time I visit the bathroom for 2-3 days, it does always seem to just disappear again randomly. I don't drink much alcohol at all anymore and I no longer have any coffee, and I do find that has helped a bit - less flare-ups now, but of course it does still happen off and on. I just tell myself I could have much worse problems, I suppose. It was at least reassuring to get confirmation from a specialist that there wasn't something more serious going on. Thanks for sharing your story as well.

I feel I have the same issues as you! Glad to share stories. I have suffered for yearsssss with anal discomfort. I had a colonoscopy done years ago when I was diagnosed with anal fissures and everything was negative. If it weren't for taking miralax daily I would be in big trouble. Just recently though I am having anal irritation even though I'm on miralax and it feels like several fissures are going on. I give up! I wonder if I had thin skin as well like your dr told you. I feel like the slightest hard stool cuts me up. Glad to hear your story .. Hope we can continue to share the pain!