My lengthy experience with anal fissures

My experience with anal fissures started in 2003! I didn't even know what it was at first, just spent upward of an hour or more on the toilet, straining like crazy during BM and feeling very relieved when they were over. There was not much pain post-BM and if there was it was minimal.

A year later, after another bout, I had a colonoscopy and was diagnosed with moderate hemorrhoids. But my issue never responded to hemorrhoid medicine. So eventually my PCP said it was most likely an anal fissure and prescribed NITRO-BID, which was a life-saver on multiple occasions. After a bout with the fissure, I would take a hot bath, put on the NITRO-BID ointment and voila! after as few as one or as many as three applications, my issue would resolve. Back to normal BM with no straining. I would have a fissure roughly once a year from 2005-2018, use the NITRO-BID, and problem solved.

Then came Dec. 13, 2019. Strained during a BM at O'Hare Airport and had blood with the stool. Immediately knew what it was but since I was traveling I didn't have my NITRO-BID. Took a hot bath and thought it would go away but it didn't. Had a colonoscopy in late January but the GI specialist was looking for cancer, not anal fissures, so didn't really have much to say about it. After initially giving me Rectiv and it not doing anything, I asked for more NITRO-BID. The first time I used it, I experienced the expected relief and I thought that was that. But a day or so later, I had another straining BM and found that the NITRO-BID no longer worked! I wasn't sure what to make of it and thought maybe my problem would just go away like it always did. It didn't.

Complicating things, the pandemic started. I couldn't get in with a colorectal surgeon for a few months while everything was shut down. Finally, I got in to see him in May expecting we could schedule surgery. But he wanted me to try fiber supplements and Diltizam (sp?) cream for six weeks. The fiber helped soften the stools but the cream did nothing besides make me cringe three times a day when I had to stick my finger up there. While the BM themselves were mostly better (only occasional straining required), the big issue was the post-BM pain of 12 to 15 hours EVERY TIME. Oddly, the first hour after a BM would always be pain-free but sure as the sunrise, an hour afterward the pain would start and typically be from a 2 to a 7 on a 10-point scale. Sometimes it was tolerable and others excruciating. Life was miserable for half my days! I actually cut down on the fiber, using it only as a BM was imminent, in an effort to reduce the number of BM because I knew the pain was inevitable and it made no sense to have more BM as opposed to fewer. If I could get through a day without having one, it was a victory.

So anyway, I finally was able to schedule surgery since nothing was working. I had the sphincterotomy yesterday. Procedure went about as expected except he found some hemorrhoids that required puncturing and suturing. There was minimal pain afterward (the surgeon said the pain was related to the hemorrhoids, not the fissure) and no sustained bleeding. BUT...first BM this morning was a big disappointment. I drank tons of water knowing the BM was imminent but there was still straining involved and the same post-BM pain, which I am enduring as we speak (or at least as I write). I'm hoping the straining is related to opiod use for the pain and having maybe been a bit dehydrated after the procedure, but the bigger disappointment is the lingering discomfort.

So I wanted to know if anyone had anything similar and what ended up happening (i.e. if there is hope for me). I wasn't expecting to feel better in a day, but maybe a little relief post-BM. Right now I'm headed for another warm-water bath while hoping to ward off the anxiety associated with worrying about dealing with this for the rest of my life!

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