Hi.
I think its about time that I make one of these diarie threads so that I can keep track of how things are going while getting some input from the rest of the board members.
To make a long story short I will tell the following. I have had problems on and off (mostly on) with my anus and bowel movements since summer 2012. At first it turned out to be a fissure in the 6 aclock position which I was able to heal without prescribtion creams. I had this for about 4 months I think. This was followed by a couple of months with no symtoms at all but at some point I started to get the itch, minor pain during bowel movements and burning right after BMs which was greatly reduced with sitz baths. Not half as bad as having a fissure but still enough to send me back to my GP.
He diden´t find any fissure but was able to see that the anal lining was red and irritated and that one of my veins was somewhat enlarged but he said that it wasen´t a hemorrhoid.
I was send home with a steroid creme (one of the strong ones) which was combined with some anti fungal/bacteria drug.
I knew that this could thin the skin but went for it anyway as I was fissure free at the time. I used it 8 days, 2 times a day. The itch and burning went away after 2 days or so and I had some swelling which was significantly reduced. I had this swelling for so long that I diden´t even know that something was wrong with it as I haven´t noticed that it was developing so must have been over a long period of time. After stopping the cremes it only took a few days and I was back to the same as before the cremes.
A few weeks went on with no improvement. At some point I ran into some serious constipation. I still went everyday but it was like I was having some kind of obstruction. I diden´t pass ANY gas for like a week or so and my stools were very hard and dry so I had to strain a lot to get it out. After a week or so it cleared up but I was left with a very tight anus and had to keep straining a lot even with soft stools.
I went to the GP again and got a digital rectal examination + the standard fissure check (visual while spreading the skin). This was extremely painfull. My GP said that he diden´t find any hemorrhoids and no bleeding or mucous on the glove. I did however have 4-5 anal fissures!
He wanted me to try the steroid creme again but I refused. Instead I asked for Diltiazem, which I got and have been using for a little more than 3 weeks now and it seems to be doing nothing for me.
As mentioned in the titel, I think that my fissure situation is rather atypical and here is why:
On the positive side:
I have no bleeding what so ever.
I have only minor fissure related pain while having a BM and most of the time I have no fissure pain while having a BM.
I don´t have pain after bowel movements other than some minor sting pain from time to time, not everyday at all. This is very wierd to me as I do have some severe spasm. At least I think its a spasm. My anus is very tight all the time so I can feel that it feels different than it should but its not a pain per see.
On the negative side:
I have abdominal pain 9/10 days and have had this since the constipation mentioned above. My GP seems to think that this is due to the anal fissures which I find doubtful. I think that I might have some kind of IBD or at the very least IBS. I know that I should get a colonoscopy but I just can´t make my self go for it due to severe anxiety. I mean, I almost can´t go to my GP anymore, how the hell am I going to make it through this procedure, I´d rather die.
I have to strain a lot while having a bowel movement, even with picture perfect soft stools. A lot of times it happens that Im able to get a few cm of stools out and then my anus just shut tight again while having the freaking BM! So of course, I will have to strain even more to force it open once more. I have tried to apply Diltiazem a few hours before having a BM and I have tried to use heat before having a BM and it makes no difference what so ever. The straining is by far the worst of my fissure problems right now as my pulse gets sky high, I get dizzy and sometimes it even hurts my intestines! The anxiety before and during + the depression afterwards combined with OCD research has completely taken over my life even though Im not in constant pain in the anal area as some of you are. I have the abdominal pain seveal times during the day instead.
Not one but multiple fissures (4-5)
I get small tears in the skin around the anus from time to time for apparently no reason. These will heal in a matter of a few days only to occur again, sometimes in the same place and sometimes in a new place.
I have a lump right under the surface of my anal skin. I would think that this was an external hemorrhoid but my GP has not mentioned anything about this. I did ask him if it might be an abscess but he said that it wasen´t but probably just some swelling due to the anal fissures. I think this might be part of the reason why I have to strain but on the other hand, I did have this even before this straining hell began.
Anyone else had symptoms like this? Any suggestions to what I might do about it? Im already doing the following:
Probiotics 2 x a day
L-glutamine once a day
Multivitamin once a day (100 mg vitamin E)
Fishoils once a day
Magnesium glycinate once a day + magnesium oxid several times a day. A total of 750 mg oxid and 200 mg glycinate.
A shot of flax seed oil + olive oil once a day
One table spoon of cocunut oil once a day
Sitz bath after every BM which is 2 times a day most of the time
Sitting on heat pad at low temperature several times a day, especially before and after BMs.
Movicol/miralax 2 x 4 g a day.
One walk for 30-45 mins a day
Diltiazem creme 2 times a day
I do a full squat right on the toilet seat and most of the time I support the area with my hand as mentioned on this forum
I drink 2-3 liters of water everyday - no coffee at all and only a very small amount of alcohol from time to time.
No gluten and only one portion of low fat yoghurt a day as the only dairy product.
Red meat only in small portions (max 100 g) and only 1-2 times a week.
Prelubrication with cocunut oil.
I have stopped smoking in order to improve bloodflow and reduce inflamation among other things.
Other than this I try to get some exercise other than walking but its hard due to depression. I used to use my indoor exercise bike but Im afraid to use it now.
I try to do yoga but once again I find it hard to stick with it due to depression.
I did have a package on its way with some digestion enzymes, chelated zinc + carnosine, Rutin, bioflavonoids from citrus fruit, Magnesium citrate, trace minerals and some vitamin c ascorbate but it have been lost by the postal service so I will probably have to wait a long time (once again) before I receive it.
Other than this Im considering trying the following:
Wheatgrass - either topical, orally or both in combination
L-Arginine - either topical, orally or both in combination
Nitro creme - in case this will do a better job than the Diltiazem.
Anal dilation at home - don´t think I can go through with this but on the other hand I will prefer this to LIS or botox anyday as I can do it in the "confort" of my own home.
As you can see Im running out of options and the straining has to be stopped or else it will only be a matter of time before I have to deal with anal prolaps and hemorrhoids too. The abdominal pain also have to stop as it is very painfull and sometimes wakes me up from sleeping several times. The spasm/contraction also has to stop or else the fissures won´t heal. Oh and the constipation that comes out of nowhere also has to stop or else I will get retears everytime I heal (if I ever achieve this that is).
Any advice will be greatly appreciated.