Nearly killed 'im!

June 4, 2006 1:29 AM

RectumFilter.

How do I deal with and/or prevent repeated anal fissures? I am a male in his late 20s who does not insert things into my rectum but I get repeated anal fissures that leave a decent amount of blood on the toilet paper. I saw a doctor earlier this year who said my rectum and colon were in good shape but that I had several small tears around my anus. It seems to me that most of these occur when I move my bowels. He recommended a stool softener and Anusol -- which work well in healing them but I repeatedly get new ones. I'm tired of this!!! Any suggestions?

posted by anonymous to health & fitness (12 comments total)

Do you eat lots of nuts or, say, popcorn -- stuff that is hard to digest and can come out sharp?
posted by kindall at 2:30 AM on June 4, 2006

Drink lots of water and eat lots of fiber. That should do the trick. If you are often mildly dehydrated or don't get enough fiber your colon hoagies can be harder than they should be, which could contribute. Lots and lots of water and fiber.
posted by Justinian at 4:05 AM on June 4, 2006

My sympathies. I had a bad anal fissure when | was about 19 or 20. Bled like a stuck pig every time I took a dump. Painful as hell. Anusol was tried: did no good at all for me. Then I was prescribed an absolute bloody medical miracle (for me, anyway) called Proctosedyl. I had it as suppositories and cream and it did the trick. Since then I've had occasional recurrences of minor soreness and bleeding but nothing like the terrifying splatter-movie horror of the initial wound.

Also, take your doctor's dietary recommendations. You need to soften the old jobbies up a bit, but not too much.
posted by Decani at 4:39 AM on June 4, 2006 [1 favorite has favorites]

I should add that the suppository treatment worked much better than anusol for actually fixing a fissure; subsequent applications of the cream for a reasonable period of time seemed to allow longer-term avoidance of repeat events. I was pretty much clear (except for the aforementined occasional minor events) after a couple of months, if I recall correctly. It was a long time ago...
posted by Decani at 4:42 AM on June 4, 2006

See this page for a very wide range of first-hand accounts. Any individual account will just be anecdotal, but if you read enough of them, you should start developing a sense for what advice will work best for you.

My general sense is that a first-stage approach is modifying your diet by increasing the amount of fiber, water, and vegetable oil you consume, and decreasing the amount of hard-to-digest foods. Be warned that some high-fiber foods are harder on your digestive system than others; anecdotally (and in my own personal experience) oatmeal is much easier on the system than shredded wheat, for example.

If that doesn't work, you can move on to medical options; the page I linked to will tell you more than you want to know about the various topical and even surgical treatments.

(IANAD.)
posted by yankeefog at 5:49 AM on June 4, 2006

I've taken Miralax (a osmotic laxative powder). It works well for me.
posted by ShooBoo at 9:08 AM on June 4, 2006

Psyllium.Expensive from health food/nutritional shops.
Flea Seed husk(Sat-Isabgol).Cheap from Indian/Pakistani shops.
Same product,different prices.
posted by Dr.Pill at 10:32 AM on June 4, 2006

Take a look at your diet and make sure you are not heavy on the proteins. Often, they can make the problem worse by causing compact and hard stool. The addition of some healthy oils to your diet may help with lubrication. Problems can sometimes even come from a low / no fat diet. See this past post about some dietary changes you can make to help your body produce more lubricants for your stools.

Also, consider either very soft toilet paper or medicated wipes to add to your regimen. While not the cause of your problem, the sandpaper 1-ply stuff will surely not help with the healing process and the sensitivity.
posted by galimatias at 10:35 AM on June 4, 2006

Steel Cut Oatmeal. Eat it every morning. Takes about 30 minutes to make about 3 days worth at a time then refrigerate and reheat. Drink lots of water every day. They should heal on their own once they stop being irritated by the hard stools.
posted by any major dude at 7:25 PM on June 4, 2006

Sorry for your trouble. If you can consult with a nutritionist to see if your diet is supporting proper wound healing. You may be lacking a vitamin or mineral that your integumentary system uses to heal and prevent fissures.

Your doctor or the local hospital can provide you with a referal.

And when you need to go - go. The longer stool stays in the bowel the more water is absorbed out of it via the intestinal walls, thus that harder the stool becomes.

Good luck.
posted by dog food sugar at 6:49 AM on June 5, 2006

Fiber and water. You'd be amazed how many health and well-being issues I fixed by starting to eat a bowl of cereal and a banana every morning and drinking water throughout the day.
posted by mikeh at 7:09 AM on June 5, 2006

wipe with wetwipes or wet your TP before using it
posted by Furious Fitness at 10:17 AM on June 5, 2006