Diet Changes ?( Seeds, Nuts, herbs and spices)

hi trillo, ty for replying. I had the cauterizing of the fissure done March 14th 2019. It is called the Kenalog Protocol by dr Feingold in NYC. I know I should not have sensitivity to any nuts or seeds but I do when it comes to wiping with baby wipes or applying ointments. I will see my surgeon as soon as possible. I hope I don't need another surgery. One for the anus is far too much already. I have Chronic upset stomach so diarrhea and constipation is part of my daily life. I try limiting how much I eat and have a fiber rich breakfast and lunch as much as possible in my case when vegetables are available due to funds. I will try to mix in metamucil so I can bulk up my stool so not to be just liquid most days. I just dont want spasms.

I read about the Kenalog Protocol and considered going to Dr. Feingold for that (I live in NYC). But the pain from my two anal fissures had been so bad during the seven months since I first became aware of them that I opted instead for LIS surgery. I had an Open LIS performed by Dr. Marc Sher, colo-rectal surgeon, on March 28, 2019. The first week after surgery was extremely painful, but then it became gradually better as I healed. Now it is 9 and a half weeks post-op and I feel that I am almost completely healed. I have no pain, only occasional slight discomfort from the sphincterotomy wound and from the scarring at one of the fissures, but this is WAY better than the pain I felt from the fissures. And that discomfort will gradually disappear also, according to Dr. Sher, who examined me last week. I hope that is true, but even if my condition remains the way it is I will be glad that I opted for surgery. I suggest that you consult a colo-rectal surgeon about getting an LIS. If possible, I would suggest going to a CRS who is experienced in CLOSED LIS. That is the only thing different I would do if I had to do it again. ALthough I think that Dr. Sher is an excellent surgeon and I felt comfortable with him, he only does OPEN LIS, and from what I've read, CLOSED LIS is less painful and provides a shorter recovery time.

Thank you, I will look into closed LIS. It's been A daily Hell with Sphincter spasms.

It seems that most colo-rectal surgeons do OPEN LIS, but CLOSED sounds preferable from what I've read regarding recovery duration. But more important is the skill and experience of the surgeon. Make sure that you go to a CRS who is very experiences at doing LIS, whichever he does. I would recommend my surgeon if you are here in NYC and you can't find a CRS who does CLOSED LIS, or if you just want to get this done ASAP. If I were you I think I'd just want to get it done ASAP. I know what you are going through; I, too, suffered horrible pain for several months. The pain is gone now, knock on wood, and I feel like I've gotten my life back.

PS: I should have said whichever he or SHE does. 😃

I see Dr Sher has a few offices in NYC, I live close to Howard Beach so I'll check to see if his office takes my insurance. Is there a main office to see him? I'm not sure If they will give me someone else. I was also considering going into Manhattan again but hate traveling there but willing for relief. Thank you so much Trillo.

Trillo have you seen this article?

https://www.ncbi.nlm.nih.gov/m/pubmed/15129311/

The study showed about the same between open and closed. I have to admit closed sounds better.

Yes, I 've seen that and other studies. The success rate seems the same. The only difference really seems to be that Closed leaves less of a wound, and therefore the recovery is quicker. That's why I would choose Closed if I had a choice. But as I said, the skill and experience of the surgeon is much more important, and if I were you I'd get this done ASAP by any experienced CRS who can do it soon. I wish I could recommend that you don't do surgery but when anal fissures are so severe it is very unlikely that they will ever heal without surgery.

PS: My CRS told me that he has done more than two thousand LIS surgeries, and I also felt comfortable with him: he was patient and friendly and answered all my questions. So even though I learned about Closed LIS shortly before my scheduled surgery I decided to go ahead with the Open LIS because I did not want to delay it any longer and I trusted the CRS.

I went to Dr Sher's office in Great Neck and the surgery was done at LIJ. I don't think it matters which office you see him at.

I was looking on google for closed LIS in NYC but nothing but articles about it. Seems I will have to ask the next CRS If he or she knows about that procedure. I hope I don't have to get another surgery too, Its just more agony and time to heal. Thank you for your helpfulness and sharing your CRS. Getting back to some quality of life is far better than my current existence 😃

You say that you hope you don't have to get another surgery. Do you mean in addition to the Kenalog procedure? Or do you mean that you hope you don't need an LIS? I wish there was a way of avoiding an LIS, but in severe cases such as yours (and mine) it seems to be the only cure. I've been on other forums and searched extensively and it is very rare to find anyone who claims to have healed a chronic anal fissure by diet or ointments etc. If you choose to continue to try those things I certainly wish you the best of luck.

Regarding closed LIS, you could ask any CRS's receptionist whether the doctor does closed or open LIS before you make an appointment. And I would google any CRS before scheduling surgery to get an idea of their rating and experience. I would not ask for a closed LIS if the doctor says that he/she usually does open but will do closed for you. I would want a surgeon who is VERY experienced in the particular surgery they do on me, whether it's closed or open.

I agree, With Chronic AF we need surgery. That's why I had the Kenalog Protocol done in Hope's of healing. Unfortunately that surgery did not work out the way I had hoped for. I did not want LIS because of incontinence. Wearing a diaper the rest of my life is not exactly ideal, but to overcome horrible pain I can live with that. I'm going to search around for CRS and make my decision on who has the best credentials. I like the relief of ointments but I know it's not a permanent fix to AF. An aid yes, but nothing more.

Did the Kenalog Protocol help at all? It's very unlikely that you will have to wear diapers for the rest of your life. Most patients experience little or no incontinence after LIS and it goes away within a few weeks or months. And the incontinence is mostly serum, not feces. I haven't had any incontinence. I do feel a greater urgency to move my bowels than I did pre-LIS, but I've always been able to hold it in, I haven't had any accidents. I still get a small amount of discharge, but it's serum from the wounds, not feces. I was assured that that will stop soon.

I had two anal fissures, so I had a double fissurectomy (removing dead skin from around the fissures and then sewing them up) PLUS a sphinterotomy (LIS). PLUS Dr. Sher removed two sentinel piles. So I had a LOT of cutting down there, but I think it was necessary to allow the fissures to heal. When you speak to a CRS ask exactly what he/she would do, i.e. would they ONLY do the LIS? Or would they trim and sew up your fissure? And would they remove any sentinel piles if you have any? Since you had a failed surgery already I think you would want to make sure that this time everything is being done that is possible to make sure that you will heal.

I saw a CRS a few times about my AF in Long Island. He made LIS seem like a very bad idea. last option for AF basically. That's where I get LIS Anxiety from, about incontinence. What you are telling sounds much better than what I was told. I'm seeing Dr Deborah Keller in Columbia Presbyterian hospital on this Thursday to see about LIS, same place I had the Kenalog Protocol. Dr Feingold left his practice there. Dr Keller seems to use less invasive surgery so I hope I can get the help with minimum time to heal. I'll bring up what you been telling me. I agree this is not something I want to revisit. From the tightness of my sphincter spasms I get some incontinence already. One reason I hardly leave the house. Thank you for advice and insight Trillo, much appreciated.

Who was the CRS who scared you about LIS? I've just googled Dr. Deborah Keller and I see that she has excellent ratings from patients. She sounds like an excellent choice for you to see and to do your LIS. I'll be interested to hear what she recommends for you.

I was seeing Dr Proccacino, he made LIS sound very bad and really last resort. I was looking for alternatives to LIS which is why I has the Kenalog Protocol. I wish I found this forum earlier but no use crying over that. I gotta get the help I need. I cant wait to see Dr Keller. I hope she can give me more hope with LIS.

I saw Dr. Procaccino also! One time early this year. He told me that if my symptoms are not too severe and I can live with them then I should just do that. At the time my symptoms were not so severe so I followed his advice. But then my symptoms got a lot worse again so I went to Dr. Sher who strongly suggested that I do LIS. I'm surprised that Dr. P scared you about incontinencel; he told me that he has "never" had a patient who became incontinent after LIS. Oh well, it seems most of these surgeons say weird or false things. From what I've read of other's stories the CRS's rarely tell the truth about the recovery process. That process varies greatly - some lucky patients heal very quickly and easily, but most patients experience a lot of pain in recovery and it takes longer than predicted by the CRS. That is true of my experience. Dr. Sher told me that I should start feeling better right after surgery. But the first week after surgery was EXTREMELY painful - worse than before the surgery. He also said that I will be completely healed within about seven weeks after surgery. It is now nearly ten weeks after surgery and I am not completely healed. But I do feel that I am NEARLY completely healed, and if I had to do it over again I would definitely do it.

I'll be interested to hear what Dr. Keller tells you. I hope that she does the closed LIS, but even if she only does open LIS and recommends to do it, if I were you and you feel comfortable with her I would do it ASAP. It is your best chance of a complete recovery. And it is a very good chance indeed. Statistics say about 95% success rate. And if the surgeon is very skilled - as Dr. Keller seems to be - then the success rate is even higher. Best of luck!

Yeah sadly Dr Proccacino wanted me to avoid LIS at all costs. With Chronic AF Just from the pain and no hope of healing with ointments I decided to get treatment. Dr Feingold was very honest with my surgery. He couldn't give me an exact time frame when I was going to be healed. From the feeling of my AF I still get horrible spasms. I'm not upset at Dr Feingold in any way. I got to seek help like we all are doing to get some quality of life back. With laxatives and stool softeners I noticed I tend to over exert myself going on the bowel. Meaning I will have multi BM's and like a explosive push that I cant control. From there more spasms and more pain making me not want to go. I'll bring that up tomorrow with Dr. keller.

I don't take laxatives and stool softeners the same time or same day just to be clear. I know some ppl do but for me it's too much.

Thank you for mentioning this I once almost healed my CAF and then took mineral oil and next morning was back to square one with insane spasms that made me black out.

Today I am feeling much better by just taking Metamucil and eating only once a day and drinking juice for the rest of the day. The trick I have found with this thing is to eat tiny tiny amounts of food, only enough to keep yourself from getting diarrhea due to stomach acid.

I spoke with my doctor here and she told me to avoid surgery at all cost. Since I am 33 years old I am hoping and praying that this would allow me to heal soon. I hope in the morning everything goes well with my bowel movements.

There is one sure way to heal these things tho, if we eat nothing for 2 weeks and just drink water and take vitamin supplements and drink water, I don't see why it won't heal enough to slowly take in food. The main reason these things don't heal has to be because it is being torn open every day. This thing is just a cut, think about it.

I don't trust my country and its surgeons cause its public health care and they really don't care what they do to you.

I envy you guys in the US you got the second amendment, if I had that here I could have put an end to this nightmare already. Get something extremely powerful like a magnum and then try surgery and if it turns out I have to wear diaper for the rest of my life then and only then I would pull the trigger. That would be my solution in all honesty, the last resort stuff.

Maybe your doctor is telling you to avoid surgery at all costs because she is not experienced in this surgery. Try to find out if anyone in your country is experienced in it and consult with that surgeon if possible.

Even if you fasted for two weeks or longer - aside from the health risks of starving to death - it still might not completely heal your fissure. When a fissure is chronic there usually is also a sentinel pile and also jagged edges to the fissure. These things make it more difficult to heal even if there are no bowel movements. That's why the surgeon usually cuts away the sentinel pile and smooths out the jadded edges (fissurectomy) and stitches up the fissure, in addition to doing a sphincterotomy. Plus, with a very tight sphincter blood flow is restricted to the fissure, which makes healing difficult. For all those reasons, I believe that an LIS by an experienced CRS is what is necessary for chronic fissures. I wish there were other ways; I would have done them myself. But I found that nothing else healed my two fissures - diet changes, drinking tons of water, hot baths, various creams and ointments etc. Nothing worked...until I had surgery. Now I feel that I am nearly completely healed, 10 weeks post surgery.

If you don't get the surgery I certainly hope that the other things you are doing will work. maybe they will work for you. But please look into how you might be able to get the surgery done by a qualified CRS. Do NOT get it done by a general surgeon!

I, too, felt despair and at times thought of suicide because of the horrible pain. But these CAN be cured. I wish you all the best.

I'm on my home from seeing Dr Keller. She checked to see what was wrong and her examination was thorough. She feels I dont need another surgery, that the Kenalog Protocol just takes longer to heal. I was put on a regime of Ibuprofen, ointments, laxatives, stool softeners. Then a follow up in a month. Turns out I have 2 AF's that was treated in March. It's no wonder I been in so much 😦. I feel better with Dr Keller diagnosis. Ttyl. it's hard to type was sitting in a moving vehicle.

That is really good news. I'm glad that Dr. Keller believes you will still heal without further surgery. And it's good that you have a followup in a month. If you are not showing signs of healing by then maybe Dr. Keller will recommend an LIS. But let's hope that the Kenalog procedure WILL be taking effect by then. So, when you are feeling down just remember that you have two good options right now for a full recovery: 1. Kenalog might still heal you with more time and following the regime that Dr. Kelly gave you. And if that does not heal you, then 2. I'm sure that next month Dr. Keller will recommend an LIS or something else that will heal you. So, I believe you are in good hands with Dr. Keller and that within the next few months you will be healed, one way of the other.

Dr. Feingold did not tell you that you have 2 anal fissures? Welcome to the 2 AF club! I'm also one of those 2 AF'ers, although I believe that they are both just about gone now. I'm sure that yours will soon be gone soon also.

Thanks but I can't afford such a surgery right now, my fissure is only 3 months old so I am hoping I can cure it. I did manage to find a way to improve my condition by 60% permanently. I only eat roasted egg plant at evenings and steel cut oats on mornings while drinking pineapple juice when I feel hungry and taking my multi vitamins I also take Metamucil 2 times a day. This very simple method has somehow miraculously improved my fissure spasm and overall fissure cut by atleast 60% in just 2 days.

My biggest issue I have found out is because I have not eaten any sodium in weeks I am urinating a lot and my body isn't keeping in water and is causing my stool to get hard. I assume this is the reason so I am taking a day off work today and will go back out monday so this will be 3 days of rest home. My job involves climbing a truck and offload goods like 110 pound sugar etc. It is very hard with this fissure it causes the fissure to burn like hell. I have to get this healed ASAP because I am paying for my HVAC schooling so my life is on the line.

I am going to the grocery in a bit and will get some Pink Himalayan salt, I cut out all diary products including beans, nuts, peas and eggs. A scientific study has shown that this type of diet makes chronic fissures hard to heal for many people. Since I cut those stuff out I noticed a huge improvement. I am learning to love oats now without any milk or anything.

I had assumed that you've had your fissure for a longer time. Since it is not very chronic yet and since you have found ways to improve your condition then yes, you may be able to heal it without surgery. You have done research and are diligent and very knowledgeable about this. Your plan sounds good, so it sounds like you have a very good chance of healing it on your own. I wish you all the best.

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Thanks, I am also going to a pharmacy today to have my Nitroglycerine 0.2% compounded and turns out its pretty cheap its only costing me $45 USD where I live, this is without any insurance. I believe this GTN cream and my diet will help me, I shall be sure to let you guys know how it goes. I notice Metamucil and pumpkin along with a table spoon of virgin coconut oil and tea spoon of honey makes your stool come out like oily ice cream next morning.

I had a slight relapse this morning because last night while I was taking a ps i felt like I was about to st myself, I foolishly held it back because I was standing and taking the p**s out in the lawn. This cause a little relapse and a lot of pain this morning cause it got a little hard, I will remember from now on to pee sitting down, I suspect this happened because of the honey and coconut oil I consumed in the night it may have caused a bowel movement.

Fingers crossed to see if this trick keeps up

Dr. Keller felt cutting the sphincter muscle was over drastic for my situation. At the most botox injection but nothing more than that. Keeping my stool as soft as possible is the key to healing at this point. Also using Nifedipine ointment and non of the OTC stuff.

Good to hear man, I am happy you don't have to cut the sphincter. This means your condition is NOT bad and you will heal I am so happy to hear this.

I just dropped off my Nitroglycerine prescription to my local pharmacy and they charged me only $44 USD this is with no insurance or anything. I am so happy with that price I am more than happy to pay it.

The only issue is the prescription didn't have what percentage strength, I got scared because I thought I had wasted an entire day but then I remembered from my internet research and from you guys here that 0.2% is the recommended and best strength. So I made up a story and told her the doc told me it was 0.2% and so they agreed to make it 0.2 for me. I will collect it tomorrow the tube will come with 48 grams of GTN paste.

The pharmacist said it will work and it will heal me. She asked if I was in pain and if I wanted to pay for a numbing agent in the paste I said yes absolutely.

I have a little doubt in my mind if I should have requested 0.4% but I didn't think it would matter.

that is great news John, I cant wait to hear the results from use. Nitroglycerin ointment can lower blood pressure thats why you dont use too much. 0.2% Is safe. I would ask my doctor if .4% would increase healing and less spasms. I'm taking lidiocaine 5% with NIFEDIPINE Ointment. I cant wait to feel better so I can go fishing trips and attend family and friends functions. God Willing soon.