Patient 69

Date: Mon, 20 Jan 2003 16:57:59
Subject: This lady healed her AF with the Clear Liquid Diet and hydrocortisone suppositories.
To: jack1faf6.arc.nasa.gov

I healed myself from an extremely painful anal fissure with a simple remedy... it helped alleviate the pain for me within days. I did the healing, self-prescribed Clear Liquid Diet and then, when the rectal tissues and anal fissure had a chance to heal, I took doctor prescribed hydrocortizone suppositories. The information below will help if an individual is a working person who cannot take months off from work and needs to see results quickly - without surgery or nitroglycerine ointment.

I have had AFs since 2004 on and off. Usually, they would get worse right after I experienced some extreme stress in my life and/or carelessly consumed too much over-processed fast food, white bread, white sugar, pizza, burgers, pasta, white or brown rice, meats, eggs, sodas and dairy products with inadequate water intake. When the pain got too excruciating to handle, I began the Clear Liquid Diet to heal the damaged rectal/anal tissues and after I got better, I started the hydrocortisone suppositories; I am now pain-free.

What is the goal of the Clear Liquid Diet?

Goal 1 - Heal the traumatized rectal or anal tissue with some success within days
Goal 2 - Cause enough healing for the medication or suppositories to stay inside without hurting
Goal 3 - Make sure your re-structured diet helps your tissues heal, meal after meal
Goal 4 - Ensure this never happens again to keep the fissure from ulcerating or getting worse

Step-by-step plan for recovery from anal fissures

Here is my step-by-step plan for complete recovery that I adhered to faithfully. This took enormous self-control and discipline, but the results gave me relief.

Step 1: Understanding the Clear Liquid Diet

At the first sign of an AF or any pain during a BM, tearing or bleeding from the rectum or anus, I immediately began the Clear Liquid Diet the same day. This is not a new fad diet, just a common sense approach to speed up the healing. This is not for weight loss, but for healing painful AFs. My goal was to give the wound time to heal (just like any cut on the hand, head or leg; the Clear Liquid Diet is like a Band-aid on that cut) instead of repeating the injury cycle over and over with daily BMs, which created more pain and tissue/membrane rupture. I consumed no solid food when I did the Clear Liquid Diet for fastest pain-free results.

Remember, this is not for everybody. If a person has any other condition, the Clear Liquid Diet will exacerbate it. I would do the Clear Liquid Diet ONLY if I am in excruciating pain but am also generally in good health.

Step 2: Doing the Clear Liquid Diet

In the Clear Liquid Diet, I drank only liquids that are relatively CLEAR. They would pass right through my colon and be passed out through urine instead of ending up in the colon as matter. I wanted to make sure I didn't have a BM the next day and therefore did not inundate the colon with solid food just yet.

These are the ONLY things I consumed on the temporary Clear Liquid Diet:

• 2 glasses orange juice, without pulp (like Tropicana)
• 2 glasses grape juice, without pulp (like Welch's)
• 1 glass lemonade, fresh squeezed, without pulp, add cane sugar (unbleached sugar, available in Safeway) to sweeten
• 2 bowls clear chicken broth made with chicken cubes with some butter/margarine, pepper and cardamom powder in it for taste
• Lots of fresh, pure drinking bottled water
• 2 vitamin supplements a day (with the chicken broth which you can drink twice a day or more) to keep you going energy-wise for a few days

How long did I do this?

After my last horrific experience, I did this religiously for at least 4 days back to back to promote quick healing of the injured rectal and anal tissue. Even the thought of a BM made me unable to sleep at night for fear of what pain was lying in wait for me in the morning. The Clear Liquid Diet temporarily stopped BMs for those 4 days and gave the highly traumatized tissues time to self-heal.

What about weakness?

One can get a bit weak by this, so I wouldn't do it if I was traveling, driving or doing a lot of heavy-lifting or outdoor work. If you are a child, pregnant, anorexic, weak, a heart patient, sick or elderly, or are on a special doctor-prescribed diet, DO NOT DO THIS DIET! If you're relatively healthy and wish to give this a chance, then take a few days off from work (you owe it to yourself) to stay at home in a calm, peaceful, stress-free environment and then try the Clear Liquid Diet.

Step 3: Eat a diet that ensures a very, very soft BM post the CLD

I finally took solid food on day 5. I applied Vaseline on the anus overnight to soften the area for the BM that would occur the next day. I had a BM the next day on day 6 (see below for what I ate for a soft BM). I noticed that there was a little more ease in evacuating my bowels. There was lessened pressure on the rectum and anus, and best of all, no tearing or fissure rupture.

The healing had begun slowly; it did not occur overnight of course, but I had to help it along by being proactive. Then the next day, I went back (counter-intuitive, but worked for me) to the Clear Liquid Diet for another 3 days, just in case some part of the rectum/anus tissue had not properly healed. On day 4, I ate a meal. I checked my BM the next day, day 5, for improvement, and found marked improvement in the pain level due to healing. I had a completely painless BM. The tissues, rectum and anus had healed up considerably. It was shocking in a nice way.

Here is my regimen:

• Day 1: Clear Liquid Diet
• Day 2: Clear Liquid Diet
• Day 3: Clear Liquid Diet
• Day 4: Clear Liquid Diet
• Day 5: Eat solid foods that will give you the SOFTEST possible BM the next day:
  • I started my day with 2 tablespoons of Indian Isabgol (known and marketed in the U.S. as Metamucil); I took the Isabgol and mixed it in a large glass of water and drank it, then had 1 grapefruit or orange, including the roughage.
  • Where to get Isabgol: I picked up fresh Isabgol at my Indian (not Native American but South-East Asian Indian) grocery store. This will be in dry, white flake form, not in capsules. I took two tablespoons of the loose Isabgol from the packet, added it to a tall and full glass of water and drank it down gently. Over the next hour, I sipped another clear glass of water to help the stomach incorporate the Isabgol, water and fruit. This helped to soften the initial part of the stool, which usually causes me the most grief, as it is extremely hard to pass.
  • A few hours after consuming the Isabgol-water drink, I ate boiled spinach with a bit of Canola oil or salt, I ate this with Ezekiel bread, which I found to be the gentlest on the colon. Wheat or bran breads sometimes contain a bit of white flour, which is injurious to the colon and creates a terrifically hard stool, which could tear me up during the next BM. So, I used Ezekiel bread.
  • Later in the day, I ate a simple salad without any meats (chicken/tuna) at this point; I would introduce meat later (some weeks later) or after I was healed. Meat tends to harden the stool for me, which could cause needless re-tearing of the delicate rectal and/or anal tissues during a BM.
  • I scrupulously stayed away from any foods that may cause gas; I was in true pain, passing gas or urinating may also caused me pain. I avoided beans and broccoli due to gas. If the Isabgol caused some gas, I reduced the amount a bit. The gas reduced once my body got used to the therapeutic effects of natural, fresh Isabgol.

The check-up at the doctor's clinic

After this self-healing I got myself examined by a doctor. I preferred to do this after I had experienced some tissue healing with the Clear Liquid Diet, then the doctor could check me without my wincing or feeling too much pain. This reduced a lot of the anxiety for me.

For sensitive women or petite females:

If you are a petite female, seek out a petite doctor. When the digital rectal exam is performed, her smaller gloved finger may be easier to endure. Then request the doctor to use a pediatric anoscope to check you; the adult anoscope may cause bruising in an already traumatized area.

Apply Vaseline before you go to the doctor's office, so the anoscope slips in easily during the exam.

Request the doctor to check you very gently; sometimes you have to say it out loud to remind them. Most are happy to make this a very comfortable experience for you.

Hydrocortizone suppositories

After my tissues were more healed, the BM pain was reduced tremendously. I then went to the doctor and she prescribed hydrocortizone suppositories for me to use twice a day. I could now use them without pain and keep them in for a much longer time, so that the tissues could absorb the medication. The suppositories were able to do their work more efficiently as I had already caused some major tissue healing to occur prior to the suppository usage.

When the initial part of the stool is hard to pass

For those of you who have trouble passing the initial part of the stool, which can be incredibly hard, using a saline enema can help, as it can soften the initial part of the stool. But do this only after you have seen some healing of the tissues with the Clear Liquid Diet; the enema can hurt if the tissues of the rectum/anus are swollen or inflamed, which can cause further bruising.

What if the Clear Liquid Diet doesn't work and you have a hard stool despite doing the Clear Liquid Diet?

The answer is simple. When I first did the Clear Liquid Diet (while expecting magnificent results and feeling quite smug), I had some tearing of the rectal and anal tissue and was very dismayed. I thought to myself, I have stayed away from the food that I love and gone through so much anxiety. What did I do wrong? Why was my stool so hard? Why am I having a BM at all? I haven't eaten a thing! Then it occurred to me. When we eat something solid, whenever we consume it, we cannot tell if the bowel movement we are having is from the food we ate yesterday, the day before or even earlier than that. The hard stool I had was from a few days before and I had not shed it completely earlier. Having stayed in my colon for so long, it hardened when I finally tried to pass it, causing needless re-trauma to the rectum and anus, which could not stretch over the hard stool. The solution is to start with a clean slate (an empty colon), which is why I did the Clear Liquid Diet. Now, whenever I have a BM, I made sure all of it is shed. Drinking a large glass of water before the morning BM sometimes helps flush out the stool more adequately. When I did the Clear Liquid Diet after ensuring that my bowels were clean and devoid of any unshed fecal matter from a few days ago, the solid food that I consumed after I ended the Clear Liquid Diet was very soft and easy to pass.

Hard stool due to pain-killers or sleep medication

Tylenol or any other pain medication, Ibuprofen, Advil, or any sleep medication tends to harden stool. During the CLD, it helps to avoid these as the colon must be empty. This might interfere with the healing process. I avoid anything that will disrupt the progress I have made so far. I also gave up tea, coffee and milk. Milk causes constipation and tea and coffee tend to dehydrate when I'm trying to hydrate my body and colon.

I know that many people who have AF cannot imagine giving up solid food. But this was something that I had to do, as I could not think about submitting myself to any serious surgical procedure or countless expensive check ups; I have no health insurance. Doctors will usually give a dire assessment when they see that your anus and rectum are too sensitive to touch and examine. When you heal up a little with the CLD, they can then see inside you more easily and hopefully not recommend surgery of any kind. Our bodies can and do heal themselves over time; a little self-discipline goes a long way.

At some point, after full healing, one should be able to eat a sensible diet with proper portions of meat, fish, dairy, etc. The CLD is not forever, but it will tide a person over if the pain is unbearable.

The information above is to be used with common sense and of course, at one's own risk.

Good luck to all of you and God bless you for having this webpage.