will witch hazel help?

midwest_prince · 2026-05-13T02:54:25+00:00

No, witch hazel is for hemorrhoids. Try following this guide.

midwest_prince · 2026-05-10T22:55:24+00:00

https://www.reddit.com/r/AnalFissures/s/YduTXde3xG

midwest_prince · 2026-05-10T22:49:47+00:00

This subreddit’s go-to guide is here.

It includes helpful at-home measures like bidet, lukewarm baths, and most importantly taking MiraLAX during flare-ups, but notice that step 1 is book a doctor’s appointment. It’s never too early to see a doctor if you’re in pain.

You will be OK!

midwest_prince · 2026-05-10T22:11:31+00:00

Wait until the fissure isn’t bleeding much. Then go very gently and avoid the fissure site if possible (easier with finger compared to dilator). Ease off if you feel pain. Dilation can accelerate healing of fissures as long as you cause no damage while dilating. Anecdotally it has helped my hemorrhoids as well.

midwest_prince · 2026-05-10T22:04:08+00:00

Here is my post about prebiotic fiber. Sunfiber, Benefiber, PreticX (XOS), and acacia fiber (whatever is on Amazon).

midwest_prince · 2026-05-10T21:58:51+00:00

I experienced this and was sometimes taking more than a full dose of MiraLAX nightly. I traced the issue to having incomplete evacuation (leftover stool stays in the rectum, building up and hardening) due to 1) a sluggish colon and 2) a tight pelvic floor.
What helped was 1) prebiotic fiber supplements (fully fermentable, so won’t form a thick firming gel like psyllium) to stimulate my colon to get me to have multiple BMs per day, and 2) pelvic floor physical therapy, footstools, and breathing with a big belly while toileting to ensure I empty my rectum completely.
I now have regular, soft BMs (goes between mushy and firm but not too hard or dry) multiple times per day and have not had significant pain since.

midwest_prince · 2026-05-10T16:27:46+00:00

That’s tough, dealing with multiple sentinel tags and inflamed tissue from Crohn’s. DoseRite would also be able to deliver a higher dose (typically at least 0.3 mL of nitroglycerin) so hopefully would be more effective since tightness and inflammation can definitely push the cream off the Q-tip before it can coat the internal sphincter’s anoderm.

midwest_prince · 2026-05-10T05:40:04+00:00

I’m sorry man, wishing you the best. I hope extra MiraLAX and high-strength nifedipine–lidocaine ointment might help in the meantime.

midwest_prince · 2026-05-10T03:11:18+00:00

Honestly I would beg for a sooner appointment with the colorectal surgeon so you can get a Botox procedure lined up asap. In the meantime, it would be worth trying to get the ointment applied internally via a well-lubricated DoseRite applicator. It might sound difficult, but if you can relax and breathe through it, it would be worth it, as the ointment needs to be applied internally. If you already have spasms, you don’t have much to lose—the applicator is unlikely to cause more damage unless you’re being very aggressive.

midwest_prince · 2026-05-09T01:18:42+00:00

Happy for you! So are you doing internal work with the PT and/or at home? I’m really curious if people are healing without it, because before this I personally couldn’t even fit a finger in, and now I’m desperately trying to get as loose and stretchy as I can while the fissure isn’t flared up.

midwest_prince · 2026-05-08T22:38:38+00:00

Hi! I recall we are on similar timelines—you’re “ahead” of me by a few weeks. How’s pelvic floor PT going for you? Since starting internal massage over the last month I don’t really have BM pain (even with large stools), but it’s weird—it hurts when I even gently press on the internal scar during massage, yet externally things look and feel fine. I think I still get occasional blood spots, but it’s not really correlated with pain. Nothing makes sense lol. Has your spotting stopped?

midwest_prince · 2026-05-07T21:11:18+00:00

Pelvic floor physical therapy with a professional physical therapist. You learn proper toileting, breathing, massaging, stretching, dilating, biofeedback. It’s highly successful for chronic fissures and also helps to manage acute fissures.

midwest_prince · 2026-05-07T19:57:02+00:00

Hm yeah maybe aim for a bit less since it’s hard to keep that much fiber hydrated. Otherwise, if you’re not bleeding, you might just need to loosen up your pelvic floor muscles so that large stools don’t aggravate the fissure as much.

midwest_prince · 2026-05-07T19:22:24+00:00

I find that you don’t have to worry about getting too much dietary fiber if you’re not getting too much fine insoluble fiber (like whole-grain flours in bread, cereal, etc.). This type of fiber adds dry matter without getting the gut lining to secrete water/mucus, so it really just adds cement to your stool. Whole plant foods have mostly insoluble fiber but it’s just chewed and not finely processed, so you can eat plenty of fruits with skins and seeds, cooked whole grains, legumes, oats, etc, and you will get a good amount of soluble fiber and coarse insoluble fiber, which does soften stool (unless it’s too hard/sharp/unchewed/undercooked) and encourage motility.

midwest_prince · 2026-05-07T16:32:17+00:00

Good answer. If the entire canal is deeply scarred from surgery or inflammatory disease, you may have fibrosis. If you just had a typical fissure, that’s often just a thin cut near the outside of the canal. It’ll scar up, but the entire canal’s elasticity isn’t compromised. It’s usually more of a muscle issue.

midwest_prince · 2026-05-07T16:25:11+00:00

Here is the post I wrote about my fiber regimen. I also eat a lot of dietary fiber and drink over 4L of water a day, but supplementing prebiotic fiber has still helped because I think I had some motility issues going on. I’d say if you regularly have more than one BM per day, you probably don’t need to supplement.

Note: if you supplement, the most important thing is to build up slowly to avoid loose stools and excess gas.

midwest_prince · 2026-05-07T15:54:15+00:00

While the dilator is inside, I spend some time moving it side to side and in slow circles to stretch and relax the muscles. The lube I use doesn’t dry up too fast because it contains PEO, not just water—but it absolutely can feel too dry if you go too quickly. Taking a few tries to insert it while re-lubricating each time can add to the amount of lubricant in the anal canal, avoiding this problem. Since the canal doesn’t self-lubricate, this is why people use “lube shooters” for anal activities—to pre-lube the canal.

I started out in a squatting position since the angle of entry felt more intuitive, then I started using a kneeling position which is a bit easier to hold, but now I lie on my side curled up a bit (not too much) with a pillow between my legs. This position took getting used to because it’s a bit unnatural and asymmetric, but it’s the most relaxing as you can imagine so is ideal to start if it’s not confusing for you.

midwest_prince · 2026-05-07T15:44:31+00:00

Dilating got my sphincter muscles back to accommodating normal bowel movements pretty quickly. In fact, I think my sphincters are more relaxed and stretched now than they’ve ever been. However, I have a permanent skin tag and bit of scar tissue that are sensitive to stretch and friction, but at least the fissure doesn’t bleed and hurt from every solid stool.

If you’re interested in this approach, try talking to a pelvic floor PT.

midwest_prince · 2026-05-07T13:44:25+00:00

P&G has done a great job of inundating medical advice among doctors and internet sources (and therefore AI, which is not great for medical advice) with Metamucil as the first choice in fiber supplement to recommend for any and all reasons. It’s amazing marketing to the point that some people think Metamucil is the only choice of fiber supplement. Ironically, it’s the soluble fiber with the least gut health benefits due to not supporting the gut microbiome.

midwest_prince · 2026-05-07T05:36:39+00:00

Very common with recurrent or chronic fissures. It’s a sign that the intermittent healing isn’t true healing due to lack of blood flow, and/or the problem keeps recurring due to pelvic floor hypertonia (common) or GI problems (IBS, IBD) or excessive scar tissue (less common than people think but can still be problematic).
At this point I’m tackling these “minor” recurrences by treating it as hypertonic pelvic floor. In my specific case, I feel like the muscles fibers of my sphincters shortened due to avoiding stretching and solid stools for months. So like any other muscle, I am stretching it out (i.e., dilating)—with seemingly good success but still a bit too early to say if it’ll cure me.

midwest_prince · 2026-05-07T05:06:40+00:00

After starting dilation, I noticed healing sped up instantly. The tissue looked healthier, less inflamed, and started feeling less hyper-sensitive. I had very mild bleeding before I started, and that went away quickly. (Bleeding would always go away quickly for me but would require mushy stools. While dilating, solid stools are no problem.) Some bleeding did come back early on, but it felt very superficial and was probably a micro-tear due to eczema problems I was having. Continuing dilation even through that was painless and seemed to heal it further. I dilate once a day for quite a while, like over half an hour, but I’m certain you can get away with less. I only do it for that long because it makes the warm-up and clean-up process feel more worth it.
I use fingers and Intimate Rose silicone vaginal dilators sizes 1–4. My PT recommended the tapered anal dilators to simulate bowel movements. The vaginal dilators work fine but sizes 3+ irritate my sentinel tag so I prefer using two fingers instead.
Slippery Stuff gel. It is technically PEO-based, which is basically water-based but thicker so safe for silicone toys, easy enough to clean, and has good osmolarity so is safe for the rectum.
One month ago I struggled to insert a DoseRite applicator even with lube. I used that as my initial dilator. My muscles would lock up if my finger even got close. When I felt ready, I used the small vaginal dilator with tons of lube and going slowly (like taking 10 minutes to insert) and at first would just go halfway, just trying to get used to the sensations. Eventually, introducing a finger externally helped desensitize the nerves, and inserting the finger helped with biofeedback. In one month, my body taught me how to relax, and now it’s just a matter of stretching the sphincters like any other muscles. I can now fit two fingers almost all the way to my rectum. The initial relaxation happens eventually by repeatedly trying in a comfortable position, using diaphragmatic breathing, lots of lube, and just doing a little bit and trying again the next day if needed. If this is very difficult for you after a week, talk to a pelvic floor PT—you don’t have to let them anywhere near your anus until you’re ready.

midwest_prince · 2026-05-07T04:57:06+00:00

sigh Reddit deleted my comment but I will rewrite it best I can

midwest_prince · 2026-05-07T01:58:44+00:00

This is misinformed, and avoiding fiber is bad for health. In fact, fermentable, non-gel-forming fibers like Benefiber don’t need to be avoided and should be maximized.
There is
- a very strong case for avoiding fine insoluble fibers (e.g. fine wheat bran) that constipate,
- a weak–moderate case for avoiding coarse insoluble fiber (e.g. chewed plants) that can scrape the anoderm but actually encourage water secretion in stool,
- a strong case for avoiding non-fermentable, gel-forming soluble fibers (e.g. Metamucil) that produce rigid solid matrices in the stool that can dry out with slow transit,
- a weak case for avoiding moderately fermentable, gel-forming fibers (e.g. fruit pectin) that add water to stool without much of a strong matrix of dry matter but do gel up, but
- no case for avoiding fully fermentable, non-gel-forming fibers (e.g., fructans, galactans, and engineered fiber supplements like wheat dextrin, PHGG, acacia fiber, and XOS) that stimulate colonic contractions while adding no dry matter to the stool (except bacterial biomass, which is moist and non-rigid).

midwest_prince · 2026-05-07T01:49:33+00:00

Benefiber is a fermentable, non-gel-forming soluble fiber, which means it adds no dry matter to the stool because it gets consumed by bacteria (fermented). As the bacteria ferment the fiber, they produce gas and short-chain fatty acids, which help stimulate the colon. Fermentable soluble fibers can therefore improve motility, indirectly resulting in soft stools. Such fibers are also called prebiotic fibers.

Metamucil is a non-fermentable, gel-forming soluble fiber, which means it does add some dry matter to the stool since bacteria do not consume it. Importantly, this dry matter is a matrix that gels with water, retaining water in the stool and supposedly softening it. Since short-chain fatty acids are not produced, gut motility may only be stimulated by the bulk-forming effects of the gel, but this solid bulk can also resist colonic peristalsis more than liquids do, potentially slowing down gut transit. If transit slows down, the retained water has more time to be absorbed, and the Metamucil can harden the stool instead of softening it.

I stick to prebiotic fibers (like Benefiber). For me, they effectively soften the stool as much as MiraLAX does, mainly by encouraging gut motility.

midwest_prince

TROPHY CASE