Mypoorbutt - same here. I only ever really eat banana as far as fruit goes, and not very ripe banana. When I am doing well I may eat strawberries, blueberries or melon, but that's all. I can tolerate lightly cooked carrots and green beans, as well as romaine lettuce and cucumber in small amounts, but that's as far as my fruit/veg intake goes!! Oh and potatoes! Yum. I try to follow FODMAP diet closely, it has helped me lots.

I am really starting to think much of my ibs is actually connected to these pelvic floor issues...our bodies are so connected, especially where the digestive system is concerned. Ugh what a life

I tried to reason in my mind which should be addressed. It's insanely frustrating how there is this line of demarcation (the perineum) that seems neither fun nor colorectal will cross and they don't communicate well. I get like the middle man and I'm the one with the least understanding. The only thing I can say is if your fissure starts showing signs of healing and pain relief deal with that first and immediately. I was scheduled for my eua/fissurectomy/Botox in mid October but it got cancelled. I then pushed to have both done at the same time Nov 4. By nov 4 I get like I was at the 2/3 healed mark and my pain was bearable for about 2 weeks. Going back to square one has been devastating.

I can only have a few pieces of pineapple or a few blueberries and that is all I can have fruit wise and only then if my colon is going through a good patch. Veg is normally better if my bowel is playing nice it's only carrots I can't really have.
It's just so frustrating as I would love to eat healthy foods only they don't like me.

It is so frustrating I know vem4kids!!! Too many problems to deal with for one person. At least you've had your surgeries - hopefully that means things can only improve from this point on! Fingers crossed.

Mypoorbutt, same here!!! I'm a personal trainer and my clients ask me what I eat and I laugh haha. I'm not a good example! Do you tolerate dairy?

Another rough day today. This has become a bit of a diary which I think is probably a good thing.

Same bad morning bm as yesterday, except repeated this afternoon also! Argh. I will be taking half of an Imodium tonight to see if that slows things down. I'm eating soooo very little (like 2 small homemade banana oatmeal cookies, a glass of almond milk, and two tsp of peanut butter on two soda crackers, and water) I don't see why the bms have so much total volume.

The pain has been worse than it was a couple days ago, but better than last week slightly. I am having an easier time urinating and the morphine seems to be lasting longer. I have also not had bleeding for 4 days. Things feel slightly "looser" down there when I am trying to insert creams - and by slightly I mean very very slightly ha.

I'm hoping that these are small but important signs of improvement.

I overdid it a little today as I realized this morning that I did not have enough morphine to last me through the weekend. Panic!! The doctors have been very stingy about prescribing it, understandably. I had to go to a clinic and explain my situation in detail again, and have my chart brought up, before the doctor finally agreed to give me enough to last a month. At least I avoided the emergency room this time around!

Took half an immodium before bed, and bm this morning was small and easy to pass! Hoping I can keep this up - it's so difficult for me to stay on the line between too constipated and having to go often/too much.

Also no bleeding! This is the longest I have gone without bleeding so far - hoping to stay that way.

The plan is to rest today, and then I have to go to the hospital tomorrow to get bloodwork done and to deliver a stool sample. My gastro wants me to do this new test that he's offering, which measures intestinal inflammation from stool analysis...no idea how it works, has anybody had it done before? Will be researching today.

If I can have three days like this, I'm going to go out and do some shopping later this week! Never been so excited to run errands.

Glad your fling better today, hopefully it will start to improve now.
I'm sure you will get some answers when you go to see the consultant tomorrow...it's good that your getting tests to find out what's going on Hun.
Oh yes it's so nice when we can do normal things hope it continues

1) MIRALAX- or generic propylene glycol. This is an osmotic laxative and works by drawing water into the colon to soften stool. It's safe even long term (I've been using for over 3 years) and doctors use it for constipated children. It's non habit forming, non stimulating, and almost none is absorbed into the blood, or processed by the liver (don't believe the scare sites online about propylene glycol, it is not metabolized or broken down by the body and passes through pretty much unmodified). Take 1 full cap of this daily to start, move up to twice daily after a few days if necessary. Aim for a soft served ice cream consistency for your stool. *this can allow you to broaden your diet and eat whatever you would like while you have a fissure (no nuts or seeds though).

2) Magnesium Citrate- This is another stool softener that is very safe and very effective (most people are actually deficient in magnesium). This works but pulling water into the small intestine. I recommend taking 400mg daily in the evening, as it also helps promote deep sleep.

3) SQUAT- No more sitting on the toilet conventionally, as this puts a kink in your rectum and makes full elimination more difficult. "Squatty potty" makes a small stool that helps to elevate your feet into a squatting position while on the toilet. If you're nimble enough, just place your feet on the toilet rim and squat over the toilet bowl. *Bonus tip: Place your hands on the toilet seat behind your feet, and lean slightly back when in this position almost like your reclining in a chair. This will take some of the stools pressure off the posterior part of the Anus (where most people have a fissure) and put more pressure on the anterior which is uncompromised (this is similar to standing while going).

4) 2% Diltiazem- This is a calcium channel blocker that comes as a cream and works topically by pulling blood into the anal sphincter and relaxing it. This helps stop the spasms that occur after going to the bathroom. It is great for overall pain control and helps with the pain from walking by relaxing everything. Apply first thing in the morning before a bowel movement, and reapply after, at least twice daily. Use as long as possible, it takes over a year of healed time before the Anus recovers 50-60% of its pre fissure strength back. Using this daily 2-3 times for 6 months or more will help the area heal faster.

5) NO supplemental fiber- This is a big one for initially healing a deep fissure, and I may get some flak, but hear me out... This goes against what every doctor will tell you, and for good reason. You will need lots of fiber later on, but not initially when healing the fissure. The reason is this... Fiber supplements like psyllium bulk and soften the stool. This bulking is counter productive because you're trying to heal a deep cut. Your stool is constantly stretching this area and tearing it open again from the bottom, even soft stool will do this when it's bulky. The Miralax and magnesium will keep the stool very soft, so it's really a matter of keeping the diameter of the stool narrower for a few weeks. Try to get as much fiber as you can through your diet, this can be anything from cereals, whole grains, fruits, beans, vegetables, etc. Fiber from food doesn't seem to bulk the stool as much as psyllium husk supplements do (at least in my experience).

6) Vaseline- This is gross but will help immensely, especially if your stool is on the hard or bulky side or has a dry tip. Right before you go, put a little Vaseline on the end of your little finger and get it up in there. Squat over a small mirror as it will help prevent injury. This will help the stool slide out with much less friction, pain, or irratation. This step is a life saver if you're constipated.

7) Soft wet toilet paper- find the softest and thickest toilet paper you can and get it wet with warm water to wipe. Most baby wipes are horrible for your septic system (even ones that claim to be Flush able) and will not deteriorate much over time, leading to expensive repairs in the future.

Lifestyle habits- drink as much water as you can, this will make sure your body has what it needs to pull into the colon and keep stool soft. Take ibuprofen as needed for pain, it's also a good anti inflammatory. No codeine, as its constipating. Be active, as this helps keep your digestive system regular. The steps above will help ease the pain enough for you to get a walk in daily. Change your diet to incorporate fiber rich foods like whole grains, fruits, vegetables, etc. We all know what we SHOULD be eating to be healthy. Avoid fried foods, red meats, and anything that won't break down well like nuts, seeds, etc. Chew your food extra thoroughly, especially meat, before swallowing to aid digestion. Consider taking a probiotic daily as this can help keep your entire digestive system healthy and moving things along.

-------LONG TERM-------

Try to lower your dose of Miralax gradually after a month or so of the fissure healing (no blood, little pain) to 1 cap a day for 5 days, then 3/4 cap for 5 days, then 1/2 cap, etc. The goal is to be off of it completely at some point. You may find you need a 1/2 cap or more for many months and that's perfectly fine, it's non habit forming for the colon. You're going to want to start introducing supplemental fiber at this point, because it's very difficult to hit the daily intake of fiber with food alone, every day. This will also help bulk your stool now that you have some strength down there, and help to spread scar tissue out and gain some elasticity back. I like organic psyllium husk (NOW organic whole psyllium husks is great). I would recommend 1 tbsp morning and night long term, use as much as you need but introduce fiber very slowly. Start with 1 tbsp a day for a week or so and then slowly move to 2 a day. You don't want to bulk the stool too quickly or you will tear the fissure open again. I would highly recommend taking the 400mg of magnesium daily as well, as there's no down side to this, and it will always help to soften your stool (the body does not build tolerance). Stick with the diltiazem for as long as possible, I would even use it 6 months after the fissure has healed because it's helping to increase blood flow below the surface and heal you faster.

----Some other suggestions of things that may help:

*Cut out caffeine completely (for some it's important and that's fine, it's not a deal breaker for anyone to heal).

*Enemas if you're severely constipated

*organic Virgin coconut oil is a great Topical with antiseptic properties, can be eaten daily also to help lubricate your digestive system

*Topical zinc creams can be helpful and will promote faster wound healing

*Oral zinc supplement (orotate/picolinate are most bioavailable) is a very important mineral in the body for healing injuries in the skin.

*warm sitz baths after bowel movements to ease muscle spams.

There are countless other Topical treatments people will tout online and try to sell you, honestly I haven't tried many of them so I can't say they won't work, but I caution you that MOST will not do much. A deep fissure is not going to be miraculously healed by an herbal cream or extract. Thankfully this area of the body heals quickly, but this is a physiological problem that needs to be addressed through long term lifestyle changes. Increasing fiber in your diet, and cutting out constipating foods...softening the consistency of your stool, and removing strain by changing your posture... relaxing the sphincter spasms and increasing blood flow into the area...and keeping yourself regular with excessive and fiber supplements is what will help you the most.

THAT IS IT! I will go as far as to promise each and every one of you that this will drastically help you with your fissure. With this routine I've healed at least 15 fissures, many extremely deep, typically in less than 2 weeks. The key with any fissure is persistence, and patience. Unfortunately mine come back when I have a night of drinking or forget to take fiber, magnesium, etc. But right now I'm making a conscious long term effort to stick with my steps because they really do work. I've addressed universal reasons why our fissures don't heal, not offered you some random cure that only works for my body. I know it can feel like a curse dealing with this problem, and I want you to know that there is hope for you (without surgery) no matter how bad your fissure is. It just takes time and commitment to these types of life changes. Keep on keeping on!

Thanks Rosco9 - thanks. All advice I've already received - some works and some doesn't. Actually things like miralax and stool softners don't work for me due to ibs and pelvic floor dysfunction - I need to make stool LESS soft. Important to rembember that one size doesn't fit all in this complicated issue!

I've had two good-ish days...managed to do some baking yesterday and made it to the hospital for bloodwork. Today I tried to do a little shopping, but spasms set in BAD after about 30 min and had to head home. I'm greatly missing my old busy and active life, and I'm so worried about the Christmas season. My family REALLY celebrates - it's about 4 straight days of lots of extended family, travel and parties. I just don't think I'll be able to handle the pain thrhough this, not to mention fielding everyone's questions about my health, boyfriend (from whom I've split after 3 years, mostly because of this stupid fissure), etc.