Before I start, I just want to thank you all for the posts in this forum, it has been a massive help. Problems like these can be really embarrassing so it's easy to feel alone. I've been lurking for a while, but figured it might be good for me to share my story in case it resonates with anyone.
I've been having issues in this area for almost a full year now. It started as hemorrhoids which I had for a few months. Occasionally I would have times where I would be in absolutely crippling pain for hours after a BM, which I'm thinking now may have been fissures/spasms. A horrible couch and a good deal of stress were huge factors, I think.
I went through cycles of things being better or worse, seeing the doctor twice. The second time I was having intense pain after BMs but the doctor found no hemmies, but he had me continue the cortisone cream I was on and had me start taking Metamucil. I went to Boston for the weekend, and for the first time felt painless for two days (I'm telling you, STRESS!). I didn't drink much water while I was there, which would come back to bite me.
That next week, I had BMs every other day, and they were massive and insanely painful. It took up to an hour and a half to pass, and finally it got so bad I actually blacked out. I got in to see a CRS and he confirmed that I had fissures.
He gave me diltiazem and had me start on miralax (a HUGE help). Things seemed to be getting better gradually, still lots of pain after BMs unless I laid down but I felt like I was making progress. When applying the diltiazem I noticed my sphincter was actually loose, whereas before it had been rock hard.
One issue I had and continue to have is that I feel like I have kind of a lump on the inside. It gets pushed down when I BM and then gets sucked back up. It hurts a lot if I push, I assume it's an internal hemorrhoid and it gives me some soreness but it's not my greatest concern.
One night I started getting a crazy intense itch, and everything went downhill. I felt like I had three or four papercuts down there which gave me constant, stinging pain, and the itching drove me out of my mind! The diltiazem started to burn really bad, and it seemed like I had a rash or something. I tried everything from goldbond to aloe to tinactin, everything worked once or twice then only made things worse. I think it was just really irrtated, and I know other people have had diltiazem turn on them.
I went back to the CRS who said surgery might be next, but I'm still not sold on LIS, I know it can be great but I've also seen lots of cases where it doesn't seem to have done the trick and the whole idea just makes me nervous. He said we could try nitroglycerin for a few weeks first.
Since stopping the diltiazem the rash and papercut feeling is gone. The main fissure I had is acting up again, perhaps thanks to the gentle exam I got at the CRS. The nitro itches and burns a bit when I apply (they told me to do it on the outside), I don't get headaches but a little dizziness which is fine. I feel like it's getting better slowly but it's hard to really tell; I've only been on it for about 5 days, the last two seemed a little less good.
I still have to lay down for at least 3 hours after a BM. Sometimes after that I feel much better if I sit down or go out, sometimes it makes it worse. The fissure pain seems to be worse at night. Like a lot of you I think I've been dealing with this so long it's hard to know whether or not things are actually getting better.
Anyway, that's my long-winded story! If anyone has any insights I'd be glad to hear them. If you got better on nitro, I'd love to know what the process was like. How many times a day did you use it, and how much? Did you still have pain the first few days? They told me to give it 2-3 weeks before we decide how effective it's been, I'm caught between being so tired of these issues and scared of surgery that it's tough for me to know whether or not I'm actually doing better!