u/Kind-Antelope3801

Hi all, trying to get all my tips and experience down in one place. Not an expert. Just someone who finally heal after 10 years of fissures. Probably forgetting things and it’s already a long post. Most importantly keep experimenting-try new tips, new foods….etc…. you may just stumble upon a few key things that help.

history:

First couple of years, fissures reappearing about every six months. After that every 3 to 4 months flaring. Repeatedly saw a colorectal specialist and used all the prescription creams(discovered I’m allergic to lidocaine) but never could fully heal. The doctor never even offered surgical solutions. The scope they used seemed to re-rip me and I stopped going for about 7 months and at year eight got an infection ( fistula) and had a fistulectomy. Then ripped a brand new fissure three months later. It was about this time that I saw a gynecologist and discovered that I have a hypertonic pelvic floor ( which apparently can be a problem for all sexes and can inhibit healing of a fissure)and was referred to pelvic floor therapy. Saw two pretty awful therapists and finally found a good one. She gave me lots of stretches and core building exercises and the nerve pain shooting down my leg went away and the fissure kept getting better and better( along with lots of things listed on the sub Reddit guide-highly recommended reading).

Clinching :

Notice your sphincter during the day. Are you clinching or tensing? If you are lifting something or doing daily tasks… are you clinching? I was clinching doing everyday activities like picking up milk or even rolling over in bed. If you notice, take a deep breath and release the clinch.

Stretches( for all sexes) I learned from a pelvic floor therapist ( she told me not to do squats until I was healed)

I did each of these one minute each. More often and longer might help faster. Start out slow. Listen to your body. Increase in intensity if it doesn’t hurt.

A lot of the therapy involves deep diaphragmatic breathing as well.

Release a tight pelvic floor
https://youtube.com/shorts/OTrg7-MhEOU?si=Dx9bm_vITCp66E4w

Figure four laying down

https://youtu.be/Xb5gHdYtHnk

Inner thigh bent knee stretch

https://youtu.be/ZSNT6MgpK5g

Happy baby

https://m.youtube.com/watch?v=FDmV8IzrJa8&pp=0gcJCUACo7VqN5tD&ra=m

Groin stretch all fours

https://m.youtube.com/watch?v=bcz0YNHvs1I&ra=m

Supine stretch

https://m.youtube.com/watch?v=eKp2f5-jRbI&ra=m

Supine twist

https://m.youtube.com/watch?v=gaHGczx6-E8&ra=m

Child’s pose

https://m.youtube.com/watch?v=nMp3MlTz9fA&ra=m

Obturator stretch

https://m.youtube.com/watch?v=-WXDuhAFbdk&ra=m

It took months of doing these everyday along with figuring out my digestive system, hydration and tips from the sub Reddit guide finally helped me heal. Go slow. Gently stretch increasing in intensity over time as you feel comfortable. And only add a couple stretches each week.

Pain, itching, etc

I tried and found Sitz baths in hot water to be helpful. When I couldn’t sit it water or got tired of it, I’d lay down completely unmoving on my side ( absolutely still. Not one muscle moving) until the pain stopped.

Heating pad. I’d say it helps but I also got a fungal infection from sitting on it too long with all the warm and moisture. I’d try to keep the area clean and fully dry after baths and showers. I used wet wipes without fragrance. A bidet would probably be best.

I liked calmoseptine ointment when things were feeling a bit healed and itching. It has a cooling sensation. Tip for applying ointment of any sort- Doserite product was very helpful. And laying down on your side can help relax the sphincter more in my experience. Also if you need to practice inserting a finger or do dilation, laying down seems easier to me.

Stool softeners, fiber and hydration:

I used colace that comes in 50 milligrams capsules- that way I could adjust my intake based on my bms and not over do it ( especially when I started weaning). A lot of people really prefer MiraLAX and colace seems to not work. Idk. It works for me. Speaking of weaning- I didn’t stop stool softeners for about a year and a half this go around; I would not stop stool softeners even if you feel better. Recently discovered that eating 3-5 prunes at night along with my stool softeners was extremely helpful in smoothing out my BM. Now I still eat prunes every night even though I’m healed to keep things smooth and predictable. When I go out of town, I still take stool softeners and prunes to avoid hard stool just incase.

Drink so much water. I fill a jug each day and work on finishing it.

Foods that helped me:

In the morning, I’d drink two glasses of water and have a hot decaf tea( caffeine made me have more bms). There is a lot of online resources that say drinking warm water is helpful. And a high fiber cereal (17 g) called Natures path smart bran. Tastes a bit like wheat rice crispies but it’s fiber- you need to build up fiber slowly to see how your body reacts. If you read the nutritional labels, you’ll be surprised how little fiber is in food. Most oatmeal only has 4-10 g. Speaking of fiber -supplements- I could not tolerate. It made my bm so large it would rip my fissure open again. I tried adding whole food fiber ( see below)

Natural Fiber- I’d eat one or two of these in the afternoon and not eat a big lunch at all: Soaked chia seeds in water added to applesauce. Pears, kiwis, raspberries and blackberries. Could not tolerate oranges, watermelon or yellow dragon fruit- my stomach would just dump its contents in an hour. Some people suggest eating more regularly to keep food moving through the system. Experiment to figure out what works for you.

I’d eat a normal dinner. Heavy on veggies. Trying to limit constipating foods.

Also found magnesium hiding in my vitamin supplements. Worth taking a look if you take vitamins. I feel like it may have increased the number of bms I was having daily. Possibly causing loose stool. I bought supplements without magnesium instead.

Exercise:

Other than the stretching-lots of walking. Keep moving. I found walking could also bring on bms.

The Reddit guide major helpful tip for me:

Tons of awesome info and ideas to try but…..Lubing the rectum and breaking up hard poo inside with a sterile gloved finger was by far a big game changer. That hard tip of bm was ripping me daily. Moving it around inside before a bowel movement fixed my problem.

Other toilet tips:

Lots of breathing techniques out there… try mooing technique. But I definitely tried my best to breathe deeply into my abdomen while on the toilet. The goal is to breathe out the poo rather than push. Often difficult. I have a squatty potty type stool that I alternate using. I make sure my clothing is at my ankles and widen my knees. Often will lean down and touch my toes and breathe deeply. ( as long as the BM isn’t explosive or too loose, I can sometimes pass my BM this way too). I sometimes lean backwards with my feet on the stool. I try not to sit there too long. Eventually squatting can help bring on a bowel movement but my PT said to avoid until healed. But definitely breathe and consider lubricants and breaking up poo. There are also stretches that can help stimulate the need to go. And the guide on the sub suggested breaking up hard poo with a lubricated sterile glove. By far one of the best ideas to keep me from constantly ripping with every bowel movement.

Mooing
https://m.youtube.com/watch?v=QDk93cvZAuk&ra=m

Sites to check out:
I found yourfriendlyproctologist on YouTube to be very informative with treatments that were aimed at avoiding surgery. He has actually had fissures so he understands us.

Also the Bromley method on YouTube is a doctor that teaches pelvic floor info and stretches.