Hi all
Good to read many of the helpful posts on here, I've been a silent observer for some time. I exercise a lot, drink lot of water, don't eat red meat, or, for the most part, white flour (just to prefix my perhaps familiar tale!).
First fissure, acute, was three years ago. Has 'waxed and waned ' since then. I have a small, healing fissure(at present - it varies from week to week, was open two weeks ago after I was a bit rough with toilet paper), and now have excruciating haemorrhoids too. Am awaiting an appointment date with NHS for sphincterotomy, although this week my CRS said he couldnt see the fissure on this occasion, but I believe I am getting the operation all the same, he said 'there's probably a fissure in there somewhere' (even tho he saw a small 'high' one in Jan, and ruled out fistulas) and I am now awaiting a date from his secretary (tho I read somewhere if a fissure heals, the NHS don't operate - not much good for us chronic sufferers who are up and down, if that's so!). I have been taking movicol for a few months since the fissure reappeared properly, and tried moving over to lactulose two weeks ago as was worried I may have been ingesting too much potassium (tho GP was sceptical), but the lactulose was a bit liquid-inducing, and made me sore, and gave me this haemorrhoid flare up the pain of which seems worse than the chronic fissure has been of late. I also refused the offer of botox this week, as have been feeling LIS long-term is the better option, and the CRS saw them as two separate routes, plus he cited a roughly 98 per cent lack of AF re-occurrence rate, compared to 60-85 for botox. I now slightly regret not having the injections I was scheduled for however, as might have been feeling better by now... I have all but given up on creams though have some proctosedyl ointment for the external (or just slightly internal) piles, and diltiazem for fissure. Being on an SSRI, I can't take ibuprofen either. Sitz baths, ice pack, movicol (one sachet, half am, half eve), paracetamol, and two sachets of fybogel daily, not to mention lots of water and fiber (rye breads, fruit, veggies), cycling, jogging, are how I am treating this. I haven't cut out dairy yet... (have tried, previously, but tempted back each time)
A period of time I blame for my current troubles was my overuse, over say 6 months a couple of years ago, of glyceryl suppositories - my lower bowel just lost the motivation to do anything itself. If I don't take movicol now for a day it kinda feels like the same story, no movements, and then constipation. How wretched I feel sometimes over-relying on these things. It hasn't all been doom or gloom - a year or so ago I was having regular easygoing BMs, with only very faint spasm, or pile pain briefly afterwards.
Does anyone know if the LIS operation decreases likelihood of getting haemorrhoids too? ( I feel my unwillingness to 'stretch' during BMs has helped haemorrhoids appear, even if it has, in last week, helped the fissure to superficially heal). I know piles need bulky soft stools to heal, whereas AFs perhaps a little 'thinner'. Anyone got any advice on how to move forward conservative management-wise, finding a route through 'the twin beasts' of fissure and piles?