Hi all,
I am a 29 year old male, otherwise in good health.
I have been dealing with a fissure for a about two and a half years now, it seems to have started with a bowel movement following a long bike ride in March 2011. It wasn't very painful and unfortunately, I didn't deal with it promptly and let it linger on. Also, the GPs treated me for hemorrhoids rather than a fissure. However, it was more of an occasional nuisance rather than a severe problem. Sometime in March 2012, I developed post-antibiotic IBS which aggravated the problem slightly. In about August 2012, I occasionally started having bowel movements where the first piece to come out would have a sharp leading edge, which would tear me up. My GI(who I was seeing for the IBS) put me on Miralax and citrucel and I seemed to have found a sweet spot at 1/2 a dose of miralax and three citrucel tablets a day. My IBS more or less resolved in September 2012 and since then I was doing pretty ok on the miralax and citrucel. My only complaints were mild bleeding (usually a reddish tinge on a toilet paper) about once or twice a month, mostly after a hard bowel movement, which in turn was usually a result of me slipping up on miralax/citrucel/water intake or occasionally after prolonged periods of sitting. In Dec 2012, my GI examined me with an anuscope and didn't find anything.
However, since mid April 2013, I seem to have taken a turn for a worse, out of nowhere I had some bleeding and I also slipped up on Miralax/Water intake which resulted in a few hard bowel movements. I started the usual tricks that I had learnt here, like applying vaseline before a bm, sitz baths after a bm etc. However, the problem persisted through May. I started to develop pressure like pain in my buttocks after periods of sitting and some external hemorrhoids, which would occasionally appear and disappear. In early June I saw my GI who found a fissure on a digital rectal exam and put me on Rectiv, I went for a followup in Early July when he examined me and said that the fissure was healing, though it wasn't completely healed yet. The two times he examined me, he didn't see any external hemorrhoids. He also told me that if I develop a fissure in future, I should consider surgery.
Also, starting in May, I started to develop pressure like pain in my buttocks after periods of sitting. The pain seems to be concentrated in areas (buttocks and upper thighs) which are supporting my body weight and not in the rectum. The pain is more or starts earlier when sitting on harder surfaces and also seems slightly posture dependent i.e. if I can lean back and transfer some of the weight to the back then I am less prone to pain. Also, getting up and walking around seems to temporarily help ease the pain. My bowel movements (except maybe for 5-10 days in May/June) have been practically painless. The pain is not a spasm like pain that people here report and if I am able to go about my day without sittings for more than 30 min. (on weekends), I can completely avoid the pain. Due to these reasons my GI feels that this pain is unrelated to the fissure and is probably something like sciatica. The GI (through my GP) has referred me for a pelvic MRI.
I am going to visit a CRS for a second opinion this week as I find it hard to believe that this butt pain is something else. I just wanted to see if someone here has experienced something similar or can shed some light on this.
Thanks,
Arbguy