Jack,
Thanks so much for the self-help pages. The wide range of information and links to helpful sites truely made it a one-stop shopping experience. Just wish the motivation could have been less painful! But, since it basically started me on my road to recovery, I am truely thankful.
My history is a little different from most of the patients on your pages. I am a nutritionist and used to do nutritional consulting. So, even though I have not always practised everything I know (my husband is a junk-food addict and I sometimes break down and join him), my diet has tended to be high in fiber and healthy by North American standards. I virtually never had constipation and even tended more toward diarrhea because of liver damage I sustained from an unknown virus years ago.
Then a couple weeks ago I was given a bout of a wicked antibiotic which gave me diarrhea every half hour. By the third day I had an anal fissure, though I didn't know it, and was going out of my mind with pain (trying to "pass razor-blades" and having constant spasms which kept my entire Southern Hemisphere in pain - my butt hurt, my bladder hurt, my whole pelvis hurt, even my legs ached!). I thought it must be a hemorrhoid and 1) wondered how I could have hemorrhoids without being constipated, and 2) was totally bewildered how people with hemorrhoids go on with their life with this kind of pain. Then I found the term anal fissure mentioned on a website about hemorrhoids, looked it up thinking "I probably won't find anything" and eureka! there you were! What a big help! What a comfort to know I'm not just a wimp! The information as well as many of the suggestions were very helpful.
After reading many of the histories, I think that my case was probably mild and I am well on my way to recovery now. I hate to imagine what the pain of a severe chronic case must be like. But I did find a couple things helpful that I didn't see anyone mention. Feel free to use them if you find them helpful:
Anyway, PLEASE suggest to people that they NOT take mineral oil over long periods of time (preferably not at all.) It clogs up their system and can have a lot of bad long term effects (I won't write a treatise.) Suffice to say, flaxseed oil or lecithin or any other Essential Fatty Acid will work just as well to lubricate and soften stools, but they nourish the whole body and won't cause a worse problem (like colon cancer).
It's also important to remember that to heal anything (especially an area that's being continually bathed in bacteria and sewage!), your body needs the right building blocks. Vitamins C, A, E, and zinc are absolutely crucial to healing. Vitamin A and E could additionally be used by puncturing the capsule and applying topically.
Also, please be aware that refined sugar is an irritant to the whole body and BLOCKS healing. Adding naturally sweet high-fiber snacks like fruit to your diet makes it easier to cut down on sugar. I won't go on about this because whole books have been written about it. But if anyone is interested, I can help get started with some simple recipes and suggestions for natural snacks etc that help cut back on sugar and increase fiber.
BTW, from a nutritionists standpoint, the formula for the BF&C creme they are talking about looks very good.
Thanks again, Jack, for a fine site and for all the time you've put into this. I heartily agree with your nutritional advice in "what I would do now". And thanks to the many people who candidly shared their experiences.
Thank you Jack for creating your website. Before I go into anything personal, please make your readers aware of the cautions one must take before taking Celebrex. After reading "Patient 31" posted Feb 1, 2001, I was anxious to try Celebrex, so I called my dr. and he called in a prescription. As no other pain killers were working, I almost popped a pill in my mouth, but fortunately I read the pharmacy's insert. Contrary to what patient 31 said, this medicine may cause stomach bleeding and kidney problems! Also, it is a sulfa based medicine, and if you are allergic to sulfa, this could be disasterous!!! I am allergic to sulfa and have had extreme reactions. So, I'm disappointed that I can't try it.
I am in the middle of dealing with an anal fissure. Extreme pain started around Nov. 9, 2003, but I wasn't definitely diagnosed until yesterday. I requested an exam in the hospital with anesthesia. I'm sorry I didn't remember to ask the dr. to use a PEDIATRIC anoscope, as I am a relatively small woman. Of course, you would think the doctor would think of that, but he didn't. After the anesthesia wore off, I had the worst day and night of my life (and I thought I already had the worst pain on certain days in the last 45 days). NOTHING helped.....not the sitz baths, not the nitroglycerine ointment (.5%), not praying, NOTHING. I thought the pain would never subside. Thankfully, it did, but it was after 14 hours of torture. I am convinced that the exam with a regular sized anoscope traumatized me.
I also have IBS which the dr. says is hindering my recovery. As anyone with IBS knows, we have additional problems, like incomplete evacuation (ugh!) and in many cases (like mine) multiple bowel movements per day. Of course, this further irritates the fissure. During a bowel movement I found if I massage and squeeze the buttocks and the buttocks area, it is easier to defecate. Of course, right before, I apply the nitro and at the same time I try to drink one or 2 glasses of water. I didn't read those two hints on your website, so maybe this will help someone out there suffering like I am. I am encouraged by reading your postings that I will be able to overcome this WITHOUT surgery. Thankfully, my surgeon is VERY conservative and is encouraging me that I will get rid of this fissure on my own.
I hope I will be able to write soon that I have cured myself. Please do not post my email address. If I cure myself at a later date I will then try to help anyone who wants to write.
Hi Jack, maybe you should add my comments to the random list, also. There may be many readers who will miss the end of the patient #31 report.
Since I wrote to you last (Jan 17), I am practically pain free and am now dealing with my IBS symptoms to reduce the number of BM's per day. Here's something the surgeon told me that has actually helped reduce the BM's. He said to stop using the stool softeners as they would increase BM's. I didn't have hard stools, but the gastoenterologist told me to start using them a year ago. Also, Miralax increases the BM's and I stopped that. So, if anyone has too many BM's (due to IBS) which increases the constant irritation to the fissure, they should probably try to stop either the stool softeners and/or Miralax. I'm just using Metamucil once a day at night. The last time I saw my colorectal surgeon (which was only 3 weeks ago), he told me the longer I can endure my pain episodes, the greater chance I will have to cure myself. That comment helped me deal with the pain and be more optimistic. He had been encouraging me all along that I would "probably" cure myself, but somehow that last comment did it for me. I also did something which I believe was a form of my own biofeedback technique. I found an excellent picture of the sphincter muscle in a reference book and used visualization techniques while in the tub. I imagined the muscle relaxing and helping to close up the fissure. I sang to the muscle, as if it were a person, and made up my own rhyming lyrics. Since I am a type A all the way, I know my whole body was relaxing during my "bio" time. I even imagined the sphincter muscle talking back to me in a positive way to help close up the ugly fissure. I hope some of this will help someone.