Now based on some posts here I am trying Primal Defence Vegetable caplets. After 1 week no change!! Am I being impatient? Does it really work?...I truly hope so. Not to be overly dramatic...this ailment affects your whole life. I am an upbeat guy but this totally affects, in a negative way my interaction with people. The discomfort is on my mind all the time! Help!!
I’m so very grateful to have found this blog site during the worst of my episodes of severe pain spasms after bowel movements. The descriptions of pain were dead on, and it gave me hope when doctors couldn’t name what was happening, let alone find a solution. The spasming could last two to eight hours after going #2 (it was like moving razor blades through followed by then unremitting pain throbs after) and this problem basically lasted for 11 months.
Most days I couldn’t sit, or think because of the pain or pain meds. I’m not a doctor or nurse, but this is what helped me through it and eventually, I pray, out of it. Medical people and I tried plenty of things big and small, as people have suggested on this blog site. I hope some of what follows can be helpful to others.
Eight months in and when acupuncture no longer helped at all, I had the procedure, basically a Botox shot where the sun don’t shine—botulinum toxin injection during (surgical) anorectal exam with anesthesia done by my colorectal doctor. It helped me pass stools without the usually blood streaks, so I believed the anal fissure was healing. However, the pile-driving pain in the hours after stool passing did not abate for another two months when I think the small things I’d been trying for almost a year, along with the fissure completely healing, finally gave me a chance at normalcy.
Those small but essential things:
• Strict militancy about 8 to 10 glasses of water daily. Liquid in; easy, soft stools out.
• Grease the skids before evacuation: Vaseline preferred and inexpensive.
• DIET: Paying careful attention to food that pulled water into the stools during digestion (good fibers in diet), and avoiding those that pull moisture out. Moving away from gluten products seemed to help me. Now I’m big on gluten-free.
• It took six months of this difficulty and two months of aggravating physical therapy (competent anal-massage) to find out there was such a thing as Diazepam (valium suppositories) which were a lifesaver. (Go through medical websites before searching for anal-massage, otherwise you’ll get porn.)
• Very last resort for pain: “medical” marijuana.
• Compounding creams (first Nifedipine and then Diltiazem 2%) for the anal-sphincters’ canal helped things heal and I still use them when discomfort returns. (They’re very expensive; only made at compounding pharmacies by elves who work overnight; and not covered by my insurance.) I was quite allergic to Nitroglycerin ointment (Nitro-Bid 2%), though “the clinicals [research] are good” for those not allergic.
• For anal area on the outside, I use for rawness or discomfort: Resinol (sample jars) and cooling hemorrhoid ointment. Easy on the lidocaine cream (external)—good for pain relief but can desensitize skin. Dab instead of wiping—too much of any kind of wiping can abrade sensitive skin.
• Stool softeners (docusate) twice a day and similarly a little prune juice or prunes keep things moving smoothly for me.
• My colorectal specialist doesn’t like those donut butt-pillows—squeezes things in too much—so I use flat, thick seat-pillows. Lots of Sitz baths in the bath tub during my troubles.
• Fasting is part of my protocols then (at my worst when I couldn’t bear more than one BM a day) and even now when I deal with discomfort on some days. Not recommended by any medical people, but it works for me and some dieting places use it for weight loss management, so fasting is part of my repertoire. (Though not weight loss; I’m down 30 pounds, trying to gain some back.)
• The problem was finally identified by my colonoscopist: pelvic floor dysfunction. Which seems an umbrella category for many possible causes and solutions. But at last I had a name for it. However, learning to relax my pelvic floor area, and not driving all my stress there, was easier said than done.
• And finally I got mood meds too from my family practitioner—Duloxetine, 30mgs.—which helped a little. I moved up to 60mgs./day in one pill, but the diarrhea made the solution worse than the problem, so I said to myself, “CBD pills work just as well and without the diarrhea.”
• I do (my learned) anal-self massages only on days everything feels fine, or when I’m sensing tightness in the area coming back (from overdoing lifting; stress in life; overdoing frequency of sex—really, are all kegels bad?)
• Journaling helped me see patterns (esp., relation of diet to what came out the other end), but mostly it was something to do with my mind and distant hope.
• Exercise saved me because some days it was the only thing getting my mind off pain-spasming. Not-sitting for hours was and is part of my protocols on bad days, so exercise and being useful around the house, around the neighborhood, passes time productively; the opposite of depression.
• Massaging the gluts, the perineum and the outside butt area, helps with relaxation as much as the deep breathing and visualizations I do with it: “Waves of deep breath to my pelvic floor…to my perineum…to my anus…to my sphincters” (who knew we all had two). “As easily as I breathe in and out, so too my sphincters open and close easily as needed…so too my anus …” [Repeat as long as needed].
Did I say I’m 70 years old, retired? So I have time for all of this. I can’t imagine what it’s like to work (sitting) or travel. Hang in there; if you’re young maybe you will heal faster. I’m male also, so I don’t know where this problem came from, except maybe I have been a tight-ass all my life. (smile) So back to the meditation thing and being positive and staying relaxed. The proportion and balance of protocols varies every day still.
(signed) Tentative in Milwaukee
I'm in my 60's now & have spent a lifetime suffering, because my fear caused my conditions to get out of control. I have IBS, DIVERTICULITIS, INCISIONAL HERNIA, HIATAL HERNIA, ULCERS,ETC. JUST HAD TRIPLE BYPASS, MY ULCERS HAD TO BE CAUTERIZED TO STOP ME FROM BLEEDING OUT, A COLONOSCOPY TO REMOVE 7 POLYPS & MULTIPLE INTERNAL HEMORRHOIDS, TREATMENT IS STILL ONGOING FOR PANCREATITIS. SO MANY OF THESE PROBLEMS WOULD HAVE TURNED OUT BETTER IF HANDLED AT AN EARLIER STAGE.