Hi Everyone, I haven't posted since 2013 but lurked around ever so often.

I have been dealing with a fissure since middle 2013, right before I had moved to Berlin, Germany. I was 25 at the time and now 29. 60 kilos.

The six months or so before leaving I saw every specialist in the book, both Western in medicine and Chinese medicine (acupuncture, herbs, creams).

Here was my original post.

In short here are the methods I have tried:

- Diltiazem (developed a rash a week or two in)
- Nitroglycerin
- Anusol
- Coconut Oil
- Sitz baths (x2 daily, 20 minutes)
- Fibre (psyllium, did this for years before switching to just more fruits and veggies)
- Retterspitz Wund- und Heilsalbe (Amazon.de)
- Hydrocortozone suppositories
- Witch Hazel suppositories (iherb)
- Enzymatic Therapy, Hem-Care (pretty much since 2013, iherb)
- Miralax (Did this for two years)

My diet is mostly gluten and lactose free, trying to follow FODMAP. I drink on occasion but not so much. Maybe once a week?

Breakfast:Green tea, fresh squeezed lemon water, probiotic pill, hem-care vitamin, organic muesli (unsweetened banana chips, freeze dried raspberries, oats, coconut flakes, with almond milk)
Lunch: Salad with gluten frei toast
Dinner: normally chicken (rarely red meat) with veggies

I do have a bad habit of snacking on crap-food sometimes. Gummy bears after dinner, chocolate, not always, but sometimes. I also smoke half a pack to a pack a day or so.

I drink about three litres of water a day. (Usually non-caffeinated tea such as peppermint and any "stress relieving" types)

Exercise:

Walk to work: 20 minutes
Walk home from work: 20 minutes
Walking my dog (three times a day, for 20 minutes each)
Gym daily (15 minute run with 10 minutes of weights)

About four/five months ago I developed a fistula and had to go to the ER. The crazy thing here was that the fissure healed while the fistula was healing. I had no problems for an entire month. Sweet, but temporary, bliss.

I saw two proctologists once I moved here and they both kept telling me it is a micro tear and hands me lidocaine suppositories and sends me home. I hate going back to the proctologist as for him to examine me he needs to look in the anal cavity which just makes it worse for a week. Like so many of you out there, the doctors always just brush it off. "Ah, you will be fine!"

I am going through a bad stretch at the moment as I am bleeding every morning, for the past two weeks, during my normal bowel movement. it is only on the first wipe. I go once a day, every morning, naturally, after breakfast. On occasion, after lunch as well. My stools are like, well ice cream, usually a great consistency. I do notice that in the middle of a movement, it almost feels like it either gets bigger and harder to pass or my body and thats when the pain comes. I also use sensitive (perfume, alcohol, etc, free) wet wipes. Haven't used toilet paper since 2013.

After my bowl movement, I immediately use the shower hose to gently spray the area, then take a sitz bath with epsom salt and coconut oil for 15 minutes. Then apply some coconut oil to the area and get dressed.

I am also go to Therapy once a week to help with some minor generalized anxiety issues.

I don't want to go the surgery route as my fissure does heal every so often but tears again.


So here I am, I feel like I spend so much time worrying about what to eat, what cream to try next that I am just making the whole thing worse. It is so incredibly hard not to want to focus on it when you can't even sit down with it feeling like you are sitting on glass! (Well the pain, to be honest, is bearable, but it just gets so god damn exhausting)

Maybe this is all just my internal anxiety, my body not relaxing those muscles? Can you recommend natural remedies to relax that area?

So, does anyone have any advice? Should I just accept it at this point?

Thanks for taking the time to read another long rant :)

Hello nprospekt

You have an amazing routine!! You said the stool gets bigger at some point. Maybe you need to eat less but enough to have a bowel movement everyday. Sometimes when Im in pain all I do is eat a medium size breakfast with small amounts of fruit for lunch and a Medium size dinner with lots of water throughout the day and that works like a charm. The next day the BM comes out like toothpaste. lol Oh and keep using the coconut oil

Unfortunately if you have a high resting pressure then no matter what you do you will end up re tearing your fissure. Is there a reason you don’t want to have the LIS as it really does help 97% of people and they are totally healed after.

Thanks Vishal and Mypoortbutt for the replies.

@Mypoorbutt - I feel like it will just tear again after the surgery then I will have gone through the entire ordeal for nothing. If my anxiety is causing my stomach aches and random intolerances to random foods, then shouldn't I be focusing on getting that under control? (Which I am already and have been doing for quite some time).

I just don't want to deal with surgery along with possible risks if it isn't addressing the core problem.

I am really at a loss here. I took off work today to see the proctologist again, I will have to wait hours as I couldn't get an appointment but I am really going to make him focus on the fact that this hasn't gone away, it isn't going to go away and I have done ever single thing imaginable (surgery/botox aside) to assist in healing.

Should I try the nitro route again? (I only tried it at the beginning in 2014 and my eating habbits, routine wasn't as good as it is now)
I have to nix the Diltiazem as it gave me a bad rash in the middle of the treatment.

Perhaps Botox?

I had LIS and had a crohns flare 2 weeks after the op believe me it was agony with full on spasms but my fissure healed by week 12 and I have been pretty much pain free since. I now have a new fissure 26 months after the LIS as the IS will regain tone over time. But I would have the LIS again to have 2 years pain free.
I agree that it would be best for your recovery to get the intestinal issues sorted before you have the LIS but if that doesn’t work and for some people there are no easy answers then I personally think LIS is worth it. It can not prevent future fissures but it ensures they heal quicker and with less pain.
I think it depends on how bad your spasms are mine were horrendous and lasted 24 hours after a BM, I lost 8 stone in just under a year and could not function on days when I had a BM, I have children and a job and crohns so I could not continue like that...it got to the point where I was only eating 3 days a week and on those days it would only be a few slices of bread with a little bit of meat, for me the only option was to try everything to live my life.

I found Botox really helpful as in it stopped the spasms from day 1 and gave me months free from pain. Lots of members have been healed by Botox including mamafizz and BumUK both wrote diaries about their journey. Nitro has always helped me and again has helped many people heal fully.

Everyone is different and no fissure is the same or for the same reason, we have to do what is best for our lives.

Thanks for the insight Mypoorbutt. I am taking everything into account here.

I just got back from the proctologist and he can confirm the presence of an internal fissure. He did mention that it is not on the outside of the anus and that it is not chronic as he can find no tags, scar tissue, etc. The exam hurt like a b**** and I am about to jump in the bath.

He wrote me a Rx for GTN. I did use nitro back in 2013 but I was only applying it outside the anus.

From my understanding, I will use this for 6-8 weeks, put 2,5cm internally 2-3 times daily.

Has anyone used anything in combination with the GTN? (Natural suppositories, creams, etc?) Or is it just best to stick only to the GTN?

He did also mention that my muscles down there are very tight which are why this isn't healing and/or recurring. He said that I could start using a dialtor twice a day for ten minutes each session for about two months to get those muscles down there to relax a little.

I am starting a meditation schedule, ten minutes a day, twice a day to start calming my self a bit more. Does anyone here have any recommendations to get those muscles to relax? Perhaps I should start a new thread.

Thanks all for your support

Owch yes those exams really hurt, when my fissures are bad I use a barrier cream before a BM as it stops any residue getting into the fissure which can help reduce the pain/spasm cycle.
Quite a few people on here have had success with dilators....I myself am looking into them at the moment but as I have quite a few hems I’m a bit scared lol
Any increase in cortisol will tighten muscle that operate without our effort such as the heart or the internal sphincter, I’m considering paying for a cortisol test, although I already do yoga and meditation so without winning the lottery there isn’t much I could do to reduce stress
Hopefully as the fissure isn’t chronic then the nitro will help heal it along with the change in diet and meditation
Good luck

Mypoorbutt - It is really nice to speak with someone who seems to have a similar set of problems and has been going through them for a while. I mean, I know a lot of people on this board go through similar things, it has just taken me a long time to become active here. I laugh at myself sometimes. I have one of those clear boxes full of creams, suppositoires, stomach medicine, etc. It is like a one-stop shop fissure toolkit. SIGH

When you were using the GTN, how did you know that you are getting the ointment in the right place? How did you apply it? I am putting 2.5cm on my (washed) finger and going in until the first fold.

I really tend to overthink everything, so sorry for all the questions!