Hello dr. Chung! I wanted to ask about chronic fissures that have developed a scar tissue builds up at the edges and apex of the fissure- is there actually still a good chance to heal this with conservative methods? I read that when it's a case like this then there is less likelihood of successful conservative attempts at healing and the more likely surgical intervention becomes... What's your opinion about that? You haven't spoken about that in any of your videos if I'm not mistaken:)
I can’t thank you enough for the existence of this channel. Because of it, I found a pelvic floor physical therapist to help me with my chronic fissure that I’d had for months, and after only a few visits (plus a lot of “homework” in between), the anal spasms have stopped, I am having no more pain, hardly any blood, and the fissure is actually getting smaller! I made dietary changes too, and other changes you recommended on your channel, but if you hadn’t recommended physical therapy, I would have just been referred for an LIS by my PCP. This advice was life-changing! Thank you so much 🙏
I realized that controlling my ibs actually helped my healing journey, I still have it but no pain as no hard stood or hard bowl movement any more 😊 thanks to you who gave me hope to stick to my medication and taking care of myself properly
I love this channel. Been struggling with an anal fissure on and off for 6 years (finally getting Botox tomorrow!) and I like that you take no detour and explain things carefully. thank you for all you do.
@@Koubiak that's good, I had Botox in mine and it healed it, praying it does the job for you 🙏 it's very effective in paralyzing the muscles up there to allow blood flow and it heal up. Just be prepared for faecal incontinence/leakage for a while. Wear pads and bath 4 times daily
@@Koubiak I think you should contact your physician asap. Maybe they will give you a micro enema. Are you drinking lots of water? Prunes, fruit n veg? And walking x
My rear end had previously been invincible but in my mid 40’s I had fissures most of last year, with spasm which pushed me over the top…along with probably hemorrhoids causing more pain. I couldn’t stand to drive, had lots of blood in stools, spasms that lasted most of the morning, trouble sleeping with the pain. I broke down and went to a specialist. She caused me a ton of pain looking around, said I had a tag. Just recommended more fiber, prescribed a nifedipine/ lidocaine ointment and wanted to schedule a colonoscopy. I just wanted to say thank you for your TH-cam videos. They provided support and information that I wasn’t able to get any other way. I was wondering what was going on down there! It took a long time to heal but I have been pain, spasm and blood free for about 8 months now. I just take a half dose of miralax every evening and now have a potty routine. Anyway without your videos and help I would have been lost and probably still in pain. I think they would have recommended surgery. Thank you so very much! I also wanted to say to those suffering with no end in sight that things can and will get better.
Diet also play an important role. In India Doctor recommend patient to eat plain rice instead of Bread 🍞. And also mild morning walk for at least 30 min maximum, no running or heavy excercise or sports. That way you will have soft 💩 without suppliment.
I believe that soft, more consistent stools are the answer to most butt problems. The problem is getting that. Until I started keeping a written record of what I was taking and when I was taking it I just rocked back and forth between hard rocks and lava flow. Now I can adjust the things I'm taking to get more control of what comes out. It's not perfect by a long shot, but it's a lot better. I can live with it.
@@gopzz908 Drink a LOT of water. Fibre rich food helps a lot like fruits and vegetables . Avoid fibre deficient foods. Some specific fruits work like charm in softening stools. But at last you will have to learn by trial and error, keep track record everyday and see what type of stool you had next day, then try to guess what might have caused this. Then increasing/decreasing amount of that.
Thank you for this short yet comprehensive overview. You can't leave these issues to most doctors, first, because they can take months to book, and second, you get as little as 10 minutes of their time. And like many other comments here, they tell you to drink more water/add more fiber (duh), give you yet another list of what not to eat (leading to a more and more restrictive diet), and tell you to reduce your stress (the stress they have just added to). I have been dealing with hemorrhoid's, IBS, anal fissures, and rectal pains since childbirth, which have only got worse with age. I've done nearly 'all the things' but keep discovering more. Diet, pelvic floor therapy, squatty potty, sits bath, laser treatment, and most recently Botox. I'm hoping with all of the above I'll be able to heal the fissures. Though with ongoing pelvic floor issues (including a rectocele and likely other external and internal damage) this may be ongoing treatment and I ultimately may need surgery. Whatever I can do to eliminate or minimize the need for surgery, the better. Folks who don't have these issues don't realize how painful and debilitating it can be. Good luck and good poops to all!
You have helped me so much and i wish i could come to you for removable of my thrombosed hemrroid , but im still working on getting better naturally with the sitz bath daily . Thank you.
Dr Chung you are doing a great job by educating us . My story dates back to the day I got an anal fissure which was wrongly diagnosed as a fistula.by a radiologist after an MRI scan .I underwent a fistula lay open surgery but my pain persisted for 3 long years .A proctologist during a visit tried doing banding of my haemorrhoids by giving me profuse pain . So I was in worst situation so much so that I didn’t eat much and in return pooped very little and in a matter of 5 to 6 days I became pain free. My family thought I was suffering from a mental illness and never believed me. I must tell you that soft stools and regular bowel habits is the only remedy to get rid of a chronic anal fissure .
Hi, great video. Like a lot of people, I was desperate to find someone who worked better than preparation H. And I did with trial and error! I used something most people have in their home. I used neospororin antibiotic cream. Within hours, I felt healing. It actually shrank them. Im just saying try it. It's not toxic to your body and works. I hope this helped someone.
I started hurting at the beginning of this year by February, I scheduled an appointment with a gastroenterologist. Later that month, I had a colonoscopy, mainly because I was bleeding and some discomfort. After the procedure, my doctor said no cancer and he wanted to see me in ten years. In April, I went to see the doctor again. The bleeding was getting worse, and he recommended fiber and referred me to a surgeon. Anyhow, I just saw the surgeon/proctologist like a week ago. The whole consultation lasted about 5 minutes, and he recommended lots of fiber, and he wants to see me again in six weeks. It was a three hour drive to go see the doctor, and he spent around 5 minutes on me. I'm going on 10 months, and the doctors have really disappointed me. I'm still bleeding and in pain/discomfort. Both the gastroenterologist and the proctologist live about 150 miles from my hometown, so this is getting extremely frustrating. If anyone has any suggestions, please don't hesitate. I've been thinking 🤔 of visiting this TH-cam proctologist. Sorry, I still haven't memorized his name. Thanks
Can't stress enough the importance of using gtn ointment or diltiazem cream correctly and regularly throughout the day. You might not want to apply it up there at first because it's painful but it DOES reduce the pain and heal the area. Have a warm bath before applying 🙏
I’m so happy to have come across your channel doctor. I have been experiencing fresh red blood in the stool couple weeks. I saw my doctor last week and was told I have hemorrhoids. I’m scheduled to see the GI doctor for colonoscopy next week, but I’m a bit worried. I don’t feel any pain at all. Just blood in stool. What should I do in the meantime? I will definitely get in contact with you. Thank you.
I wonder if a 40 day water fast will fix most fissures. With out bowel movement constantly irritating, scratching and infecting the wound, logically you give time to your body to close the wounds and fight off the inflammation. Or a liquids only diet design carefully for the water to be absorbed slowly through the day(so not to accumulate and discharged violently)
Oatmeal and pears and plums and lentils have been so helpful for me. As well as a powder magnesium supplement (actually softens stool and most people are deficient). My Dr also prescribed me a cream that helps healing. And mild cardio during the week. Pain free and no blood for a while now. I think I’m healing! ❤️🩹
Im taking those 2 but one year later is not going, slow progress its way less painful than what i felt when was new cut a year ago and i can let go the softners for day or two without problem but it always return im starting to think of surgery
My surgeon told me that if I was a male, he would suggest surgery as male muscles recovers faster than female. For me he just performed a small procedure only to remove a small lump. Since then my focus is to keep the stool soft bcz my surgeon said this problem needs lifelong care and keeps the stool soft. Also I follow a good technique while bowel movement without putting pressure at the bottom end.
I just recently had all three of my hemorrhoids banded and was so excited about not being in pain anymore and I still am because of a fissure and skin tag. Will this ever end?
Sorry to bother you Doc, I have a hemorrhoid which just prolapsed two days ago. Very painful at first now OK, have not been able to push it back in. Doesn’t seem to be improving either. I presume Grade 4. Should I be seeking a referral for surgery? Thank you.
Hi Dr Chung! Thanks a ton for your videos which are very inspirational and have the right kind of information! I would like to ask you about your suggestions on how to have small size poop as u mentioned too much fiber gives you large poop size so how we find that balance? I have been having anal fissures for almost 10 months now. Awaiting your revert at the earliest! Thank you once again
@@yourfriendlyproctologist would you be able to give some hint or initial impression of your to-do laser surgery and fissure video and what you think about the approach?
Doctor I want to buy pranicura 5 cream. I have Searched it in Amazon. But couldn't find it. I live in South Asia. Is there any way I can get this cream? Plz help me
Dr. Chung can you discuss differences in treatment options for infants with fistula? My 9 month has been dealing with a transphincteric fistula since he was 3 months old and we’re heartbroken
Hello Dr chung hello everyone I just wanted to share my experience with you all I suffered from a chronic anal fissure for 3 years trust me I tried everything and I gave up hope . After change of diet for life and 2 botox injections later I was able to avoid the surgery which i was dreading. Sitz baths do not work My anal fissure has healed 95% br Because of my diet change plenty of fruit and water and less fatty food and stay away from all white food eg: whitel boiled rice , white sugar, milk etc And please please everyone use BLACK REFINED CASTOR OIL EVERYDAY after a bowel movement , use it inside and outside the anus Take my word for it it will work this is coming from someone who actually knows what you are going through Use oil forever do not stop best of luck everyone
Ok so God used your story to give me hope again I too have been living with my for 3 years it legit changed my life. I had Botox done once and they “removed an anal fistula and my skin tag. Oh the Recovey process was tough as heck. And my surgeon wants to do a LIS surgery. I’m not for it. My diet has changed completely I only eat potatoes, chicken thigh, okra water every night, grain free chips, bean salad drinking lots of water daily no type of milk only oat milk and I mean it goes on and on. So there’s that. Maybe I have to get a second Botox injection cause the exit is smoother now but it’s the spams that lasts for HOURS that destroys my day. Anyways thanks for your feedback
It's been two months since I started using stool softener with gtn and lidocaine gel, no bleeding or pain for a month. Should I now assume that my fissure is healed?
@@marcogonzalez8701 I used cremaffin syrup laxative I know it should not be used for long but I had no other choice if I got constipated even one day during the treatment then all my efforts would have been wasted Alhamdulillah I am fine now.
the first time I bought one of your products it was the bath salts and I hated how slippery it made my tub the 2nd time I got the cream and it is a life changer!
In the beginning when it happened to me I was actually seeing blood clots too but then days past and I didn’t see it as much . Now when the bleeding happens it’s only on the poop and some drops of blood
@@nickstars3790 hi it did heal it up. Thank God 🙏 the ONLY thing to heal it in one and half years. Make sure you get Metronidazole for straight after the surgery. This antibiotic will cover you
I am your huge fan . I also have internal hemmorids at age 17 only and always feeling constipated almost 2 years and still now .Use 1 year laxative and it slow down my natural process . I don't feel urge to poop everyday . Please suggest me what to do.😢😢
Dr. I came to know that I have chronic anal fissure with a sentinel tag of less that 5mm. I m just 22 yrs old girl. Is it required for me to go for surgical procedures and remove it or will it heal over time. Pls reply.
hey dr chung so im from india i am looking at your bum soothing cream you suggest in your video there is not available in india can you suggest some alternative that available on amazon or internet i had chronic fissure it been 1.5 years and still cannot healing i visit 4.5 dr but every dr says you need surgery but i always go to surgery dr denied beacuse fissure is healing and aftersome day it getting bad..
Hello there Dr chung Hope you are good,,your videos are very productive i appreciate I have chronic anal fissures and grade 2 hemorrhoids chronic constipation I have been give medicines Such as ditialzem, caldoberg,zulu SP,and dulphalac, Your videos has helped me encouraged me alot,am still progressing with my medications thank you sir. Does anal fissures affect other parts of the body such as lower back pain etc
@@yourfriendlyproctologist actually I want to tell you something, I had been diagnosed with intersphinteric fistula at 6'o clock position of 1.5cm long in Dec 2023 then I tried many different things to cure it but it didn't helped that much but I researched a bit and read a study where doctors put FIBRIN GLUE into the tract which helped it to heal then I researched about fibrin glue and got to know that it's kind of collagen. So I thought of doing it on my own but didn't find it anywhere then I thought why not try something that helps the collagen production in the fistula tract and I found that HYALURONIC ACID can do this so I bought hyaluronic acid serum from the market which has salicylic acid and vitamin c in it and I put it into my fistula tract for about 5-6 months and then I went for the MRI again (June 2024) and it showed 0.8cm at the same 6'o clock position (with closure of the external opening, internal opening is still there) so whether am I successful in shrinking it?? Or if I continue with the hyaluronic acid will it completely seal the tract? I am confused whether I should continue this hyaluronic acid thing or should I go for the surgery?? Can you please give me some genuine advice? Because I consulted 3-4 surgeons including Proctologist but everyone has different opinions like some saying don't go for the surgery and the other one saying without surgery it cannot be healed, I am confused 😕.
@@yourfriendlyproctologist actually I want to tell you something, I had been diagnosed with intersphinteric fistula at 6'o clock position of 1.5cm long in Dec 2023 then I tried many different things to cure it but it didn't helped that much but I researched a bit and read a study where doctors put FIBRIN GLUE into the tract which helped it to heal then I researched about fibrin glue and got to know that it's kind of collagen. So I thought of doing it on my own but didn't find it anywhere then I thought why not try something that helps the collagen production in the fistula tract and I found that HYALURONIC ACID can do this so I bought hyaluronic acid serum from the market which has salicylic acid and vitamin c in it and I put it into my fistula tract for about 5-6 months and then I went for the MRI and it showed 0.8cm at the same 6'o clock position(closed external opening) so whether am I successful in shrinking it?? Or if I continue with the hyaluronic acid will it completely seal the tract? Please give me genuine advice should I go for the surgery or continue this hyaluronic acid thing because I consulted 3-4 surgeons including Proctologist all have different opinions some say go for the surgery other say you don't need surgery. I know it's hard for you to advise without evaluating me in person but it's impossible for me to meet you as I live in India. Please I request you to kindly advise me should I go for surgery or continue what I am doing, I need an expert opinion.
@@yourfriendlyproctologist actually I want to tell you something, I had been diagnosed with intersphinteric fistula at 6'o clock position of 1.5cm long I thought why not try something that helps the collagen production in the fistula tract and I found that HYALURONIC ACID can do this so I bought hyaluronic acid serum from the market which has salicylic acid and vitamin c in it and I put it into my fistula tract for about 5-6 months and then I went for the MRI and it showed 0.8cm at the same 6'o clock position(closed external opening) so whether am I successful in shrinking it?? Should I go for surgery or continue hyaluronic acid??
We all talk about our anal fissure “healing”, but then we list some crazy lifestyle that clearly cannot be kept up with once we get older in life…. And the moment we stop medications like miralax, or sad depressing diets, etc… our fissure immediately comes back. So why do we all say we are healed? It’s like an addict who always goes back for another drink after months of sobriety, the fissure is like our bodies addiction…just never ending. Its always just a matter of time until it rips back open. My question to you all is why is everyone so against LIS surgery? Is this not the only way that will actually fix us long term without relying on all this crazy medication and unhealthy diets ( high fiber for some, or low to no fiber diets for others). I truly love and respect Dr. Chung for his honesty and intelligence……but guys, why do we lie to ourselves that we can do all these crazy “anti fissure” lifestyles that are really just short term relief……when theres a surgical option that may very well allow us to begin living and eating and drinking and breathing like a normal human again?❤
I think they might be avoiding it because there is a huge risk of incontenance involved. I am not a doctor but i saw studies on internet and they mentioned how prevalent is incontenance in LIS. Its almost about 15-20 percent in longer term (in short duration after surgery its much higher, but it reduces).
I had a colonascopy. They removed 8 polps but just noted I had 3 hemmroids. No shxt I've had them since my last child in 1985. Why did they not remove them. I'm constipation is so bad I use a laxative once a week. Rest of time I'm bloated feel pain in gut. I have ibs. I'm miserable.
Here is my experince, that improved my overall status. 1- take sits bath after each bowl movment 2- dring a lot, and alot of water 3- get ride of fast food ( any fried food in general is bad) 4- balanced diet (mix between carbs, protein, and fibers) Using deltazime mixed with lidocaine and put it on the anus (externally) Using antiflamtion cream called quadran or somthing like that
I wish the 15 minute appointment I paid $90 copay with insurance for would have told me half the things this 20 minute free video did. At least next time (if there needs to be a next time, with any luck, perhaps not), I will know to tell them upfront I am seeking a PT referral and to ask about inspecting/removing the skin piles. Do the skin piles ever exfoliate themselves without professional intervention?
Do you know what helped me get ahead of my chronic fissures? Reducing my fiber intake. The doctors I saw never told me about that. The internet did. I should clarify. I was one of those eating too much fiber. Like 50g+ a day. It was too much for sure.
Doctor I have got developed external hemorrhoids after treating mu anal fissure.. And please guide me do they go away after lifestyle improvement or are there other options to treat external hemorrhoids without surgery. Please guide sir.
Ive just been told i have an anal fissure after multiple visits to urgent care and emergency, they have me on .6% nfed cream and also gave me an over the counter lidocaine cream, so far it seems liek theres no releif and ive been noticing sexual intercourse or masturbation causes the pain to get worse :( i feel like there is no escape from this pain.
Dr Chung has said that he hasn't done a surgery for anal fissure in 5 years :) I'm wondering that if the scar tissue builds up at the edges and apex of the fissure, then is there actually still a good chance to heal this with conservative methods? I read that when it's a case like this then there is less likelihood of successful conservative attempts at healing and the more likely surgical intervention becomes...
@@ccxmeow I hope I am able to get a refill without hassle. It’s ridiculous. One CRS I saw said she didn’t see the fissure. After other Drs did. And I know.
@@naturegirl4074 that’s frustrating when you know your body is feeling a certain way and the doctor is saying no… were you able to get one? Unfortunately this is my last refill and I feel like it’s something I’m going to need on and off long term. So frustrating and annoying. :(
I got a fissure at 6o clock position before 30 days and got perianal abscess and i have done insertion and drain in 20 days back and i get tight stool for two days from Sunday and Monday and visited the hospital yesterday and they told me that the fissure is back ....what should i do?...they gave me a cream named cremagel and I can't insert my finger into anal cavity with finger cot but i applied outside and pushed the cream inside with finger....but i feel pain something like irritation there
No, the fissure can still heal with the tag there. I wouldn't advise anyone to get the tag removed after fissure healed as I did recently. Tag was removed successfully but I developed another fissure and tag during surgery so absolutely no point. Trust me. I was being vain and it taught me a big lesson
Hello Dr Chung. I tried to have an online appointment with you but having some money issues at the moment. I would like to ask here if its okay. I had 2 hemorrhoid surgeries in the past. more than 4 years after I still feel pressure and sometimes pain in my anal region. all doctors i went to saying everything is fine...some said high muscle tone and some said inflammation. I went also to PT and she gave me some exercise to try home. because i didnt get any 100% sure diagnosis its hard for me to know what way to go... i am thinking of botox but afraid the doctor will not do it the same way you do it and afraid it will make it worse...
I bleed very little when I have hard stools but doctors didn't see any fissure. I didn't bleed at all before I had the hemorrhoid surgery by the way. I want to believe its muscle spasm and maybe the skin became sensitive because of the hemorrhoids removal. I would like to hear your opinion. Thank you :)
Please anyone answer to me i have anal fissure my doctor advised me to do harmonic operation does anyone have experience with it if it’s much pain or not which better harmonic or leaser
Hello, my adventure with fissure started on April and since then it keeps coming back. Doctor I've last visited told me that it's due to scarring and this material it's not stretchy and that's why it has a tendency to break again and again... What is interesting all doctors say I don't have anal spasm and there is no tension... Does anyone have a similar story?
I eat lots of fiber. I dont drink soda, consume cheese, eat fast food, and get plenty of exercise. My bowels are very regular and soft. And yet, I still have this problem recur. No matter how soft the stool, I still need to push a bit to relieve myself, and a tear happens. Why?
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Hello dr. Chung! I wanted to ask about chronic fissures that have developed a scar tissue builds up at the edges and apex of the fissure- is there actually still a good chance to heal this with conservative methods? I read that when it's a case like this then there is less likelihood of successful conservative attempts at healing and the more likely surgical intervention becomes... What's your opinion about that? You haven't spoken about that in any of your videos if I'm not mistaken:)
3:13
You’re the best health care provider on TH-cam!
I can’t thank you enough for the existence of this channel. Because of it, I found a pelvic floor physical therapist to help me with my chronic fissure that I’d had for months, and after only a few visits (plus a lot of “homework” in between), the anal spasms have stopped, I am having no more pain, hardly any blood, and the fissure is actually getting smaller! I made dietary changes too, and other changes you recommended on your channel, but if you hadn’t recommended physical therapy, I would have just been referred for an LIS by my PCP. This advice was life-changing! Thank you so much 🙏
I realized that controlling my ibs actually helped my healing journey, I still have it but no pain as no hard stood or hard bowl movement any more 😊 thanks to you who gave me hope to stick to my medication and taking care of myself properly
I have IBS too and I am miserable. How did you learn to control it?
My soft muddy poo due to IBS makes the fissures worse. At this moment Just don’t know what works and what doesn’t for my gut.
I love this channel. Been struggling with an anal fissure on and off for 6 years (finally getting Botox tomorrow!) and I like that you take no detour and explain things carefully. thank you for all you do.
@@Koubiak that's good, I had Botox in mine and it healed it, praying it does the job for you 🙏 it's very effective in paralyzing the muscles up there to allow blood flow and it heal up. Just be prepared for faecal incontinence/leakage for a while. Wear pads and bath 4 times daily
@@Amy-i8d right now I’m having the reverse issue - no bowel movement since Sunday (it’s been 5 days).
@@Koubiak I think you should contact your physician asap. Maybe they will give you a micro enema. Are you drinking lots of water? Prunes, fruit n veg? And walking x
This is the first time I've had the best advice ever.U are amazing.
My rear end had previously been invincible but in my mid 40’s I had fissures most of last year, with spasm which pushed me over the top…along with probably hemorrhoids causing more pain. I couldn’t stand to drive, had lots of blood in stools, spasms that lasted most of the morning, trouble sleeping with the pain. I broke down and went to a specialist. She caused me a ton of pain looking around, said I had a tag. Just recommended more fiber, prescribed a nifedipine/ lidocaine ointment and wanted to schedule a colonoscopy. I just wanted to say thank you for your TH-cam videos. They provided support and information that I wasn’t able to get any other way. I was wondering what was going on down there! It took a long time to heal but I have been pain, spasm and blood free for about 8 months now. I just take a half dose of miralax every evening and now have a potty routine. Anyway without your videos and help I would have been lost and probably still in pain. I think they would have recommended surgery. Thank you so very much! I also wanted to say to those suffering with no end in sight that things can and will get better.
try cutting out gluten in your diet for a few weeks and see if you get by without taking miralax. Gluten was causing me issues with hemorrhoids.
Diet also play an important role. In India Doctor recommend patient to eat plain rice instead of Bread 🍞. And also mild morning walk for at least 30 min maximum, no running or heavy excercise or sports. That way you will have soft 💩 without suppliment.
Incredible story! So glad the videos helped you!
Thank Almighty I found you after diagnosing chronic annal fissure
I believe that soft, more consistent stools are the answer to most butt problems. The problem is getting that. Until I started keeping a written record of what I was taking and when I was taking it I just rocked back and forth between hard rocks and lava flow. Now I can adjust the things I'm taking to get more control of what comes out. It's not perfect by a long shot, but it's a lot better. I can live with it.
Please share what helped to get soft
@@gopzz908 Drink a LOT of water. Fibre rich food helps a lot like fruits and vegetables . Avoid fibre deficient foods. Some specific fruits work like charm in softening stools. But at last you will have to learn by trial and error, keep track record everyday and see what type of stool you had next day, then try to guess what might have caused this. Then increasing/decreasing amount of that.
The pranicura is a miracle! Thank you Dr. Chung!
Is it healing your fissure? How long did it take? Glad to hear it’s helping!
Pranicura doesnt help at all...@@rottenL
Did it actually heal it ???
I didn’t have a fissure. But the hemorrhoids are 90% better!
@@randymaged804 will it work for a fissure to ?
Thank you for this short yet comprehensive overview. You can't leave these issues to most doctors, first, because they can take months to book, and second, you get as little as 10 minutes of their time. And like many other comments here, they tell you to drink more water/add more fiber (duh), give you yet another list of what not to eat (leading to a more and more restrictive diet), and tell you to reduce your stress (the stress they have just added to).
I have been dealing with hemorrhoid's, IBS, anal fissures, and rectal pains since childbirth, which have only got worse with age. I've done nearly 'all the things' but keep discovering more. Diet, pelvic floor therapy, squatty potty, sits bath, laser treatment, and most recently Botox. I'm hoping with all of the above I'll be able to heal the fissures. Though with ongoing pelvic floor issues (including a rectocele and likely other external and internal damage) this may be ongoing treatment and I ultimately may need surgery. Whatever I can do to eliminate or minimize the need for surgery, the better. Folks who don't have these issues don't realize how painful and debilitating it can be. Good luck and good poops to all!
Another great video!
Good Intel much appreciated.
You bet.
You have helped me so much and i wish i could come to you for removable of my thrombosed hemrroid , but im still working on getting better naturally with the sitz bath daily . Thank you.
Also dealing with thrombosed
Dr Chung you are doing a great job by educating us . My story dates back to the day I got an anal fissure which was wrongly diagnosed as a fistula.by a radiologist after an MRI scan .I underwent a fistula lay open surgery but my pain persisted for 3 long years .A proctologist during a visit tried doing banding of my haemorrhoids by giving me profuse pain . So I was in worst situation so much so that I didn’t eat much and in return pooped very little and in a matter of 5 to 6 days I became pain free. My family thought I was suffering from a mental illness and never believed me. I must tell you that soft stools and regular bowel habits is the only remedy to get rid of a chronic anal fissure .
After do 1x operation to remove hemorrhoid, anal fissure, skin tag & polyp on Nov last year, thank God I free from pain now.
Hi how is ur fissure now and surgery name can u mention pls
I'm feeling a small lump inside anus it doesn't hurt or bleed.. I don't know what is it
@@pharhunt2989 hi how is ur fissrue now
Fistula@@Leic0199
Hi Doc. how are you, very good explanation.
Excellent video as always Doctor Chung. No more mention of Pranicura?
Pranicura is still a sponsor and supporter of this channel. Check them out at www.Pranicura.com!
Yep on my second jar actually.
Does it actually work or is it just a sponsor ?
Do you put the panacura on top of the fissure medicine?@@yourfriendlyproctologist
@@marcogonzalez8701 it really works
Thanks doctor for usual helpful vedios.
Hi, great video. Like a lot of people, I was desperate to find someone who worked better than preparation H. And I did with trial and error! I used something most people have in their home. I used neospororin antibiotic cream. Within hours, I felt healing. It actually shrank them. Im just saying try it. It's not toxic to your body and works. I hope this helped someone.
I started hurting at the beginning of this year by February, I scheduled an appointment with a gastroenterologist. Later that month, I had a colonoscopy, mainly because I was bleeding and some discomfort. After the procedure, my doctor said no cancer and he wanted to see me in ten years. In April, I went to see the doctor again. The bleeding was getting worse, and he recommended fiber and referred me to a surgeon. Anyhow, I just saw the surgeon/proctologist like a week ago. The whole consultation lasted about 5 minutes, and he recommended lots of fiber, and he wants to see me again in six weeks. It was a three hour drive to go see the doctor, and he spent around 5 minutes on me. I'm going on 10 months, and the doctors have really disappointed me. I'm still bleeding and in pain/discomfort. Both the gastroenterologist and the proctologist live about 150 miles from my hometown, so this is getting extremely frustrating.
If anyone has any suggestions, please don't hesitate.
I've been thinking 🤔 of visiting this TH-cam proctologist. Sorry, I still haven't memorized his name.
Thanks
Why do 99% of doctors not care about their patients 🤔 they really do not want to hear what we as patients have to say... they just don't give a damn
follow dr Chungs advices. There is also a good video on YT channel Pelvic floor empowerment regarding healing anal fissure
@@karolinakazmierska5196 never heard of pelvic floor empowerment ... Thanks, I will
Can't stress enough the importance of using gtn ointment or diltiazem cream correctly and regularly throughout the day. You might not want to apply it up there at first because it's painful but it DOES reduce the pain and heal the area. Have a warm bath before applying 🙏
I’m so happy to have come across your channel doctor. I have been experiencing fresh red blood in the stool couple weeks. I saw my doctor last week and was told I have hemorrhoids. I’m scheduled to see the GI doctor for colonoscopy next week, but I’m a bit worried. I don’t feel any pain at all. Just blood in stool. What should I do in the meantime? I will definitely get in contact with you. Thank you.
I wonder if a 40 day water fast will fix most fissures.
With out bowel movement constantly irritating, scratching and infecting the wound, logically you give time to your body to close the wounds and fight off the inflammation. Or a liquids only diet design carefully for the water to be absorbed slowly through the day(so not to accumulate and discharged violently)
Oatmeal and pears and plums and lentils have been so helpful for me. As well as a powder magnesium supplement (actually softens stool and most people are deficient). My Dr also prescribed me a cream that helps healing. And mild cardio during the week. Pain free and no blood for a while now. I think I’m healing! ❤️🩹
❤ thanks a lot
That sitz bath stuff is awesome and provides relief. I invested in a sitz bath that’s fits on toilet. Both together offer some relief .
The flaming poop is spot on lol that's how it feels.... Lol
Pranicura 5 excellent..but expensive....i recoment
Hi doctor. Could you make a video about the "comet poop"?
My fissure healed by taking psyllium husk and movicol everyday before sleep. Sitz bath and Pranicura helped a lot.
Im taking those 2 but one year later is not going, slow progress its way less painful than what i felt when was new cut a year ago and i can let go the softners for day or two without problem but it always return im starting to think of surgery
@@FordCVS th-cam.com/video/QDk93cvZAuk/w-d-xo.htmlsi=KVsQkC7arb6Wbfwu
My surgeon told me that if I was a male, he would suggest surgery as male muscles recovers faster than female. For me he just performed a small procedure only to remove a small lump. Since then my focus is to keep the stool soft bcz my surgeon said this problem needs lifelong care and keeps the stool soft. Also I follow a good technique while bowel movement without putting pressure at the bottom end.
Can you guys explain to me your symptoms please? I want to see if we have common symptoms ?
I stopped using dry TP years ago it's barbaric
LOL! Things I wish I knew earlier.
This has been the key for me! Life saver (mostly)
Remember the TP shortage during 2020? 🤣 I think it was an iQ test.
I just recently had all three of my hemorrhoids banded and was so excited about not being in pain anymore and I still am because of a fissure and skin tag. Will this ever end?
Sorry to bother you Doc, I have a hemorrhoid which just prolapsed two days ago. Very painful at first now OK, have not been able to push it back in. Doesn’t seem to be improving either. I presume Grade 4. Should I be seeking a referral for surgery? Thank you.
I use a “travel bidet” to wash my bottom end after a movement.
I’m thinking a fast would help heal too
What about the scar tissue in chronic fissures? Is it possible to heal it for good? So it won't break again and again?
I have the same issue from anal fistula surgery.
@@limkientiong the scar?
Hi Dr Chung! Thanks a ton for your videos which are very inspirational and have the right kind of information! I would like to ask you about your suggestions on how to have small size poop as u mentioned too much fiber gives you large poop size so how we find that balance? I have been having anal fissures for almost 10 months now. Awaiting your revert at the earliest! Thank you once again
What is your opinion about laser surgery? The woundhealing process is better and the risks are overall very low as I heard
That video is on my to-do list! Thanks for the suggestion!
@@yourfriendlyproctologist would you be able to give some hint or initial impression of your to-do laser surgery and fissure video and what you think about the approach?
@@yourfriendlyproctologistyes please
Hi there! 😀
Doctor I want to buy pranicura 5 cream. I have Searched it in Amazon. But couldn't find it. I live in South Asia. Is there any way I can get this cream? Plz help me
Go to their actual website
@@marcogonzalez8701what is the name of the website
Dr: does the laizer final solution for the fissure?
Yeah. Doesn’t help I had rectopexy and have to manually remove stool now 😢Still have rectocele hernia
Dr. Chung can you discuss differences in treatment options for infants with fistula? My 9 month has been dealing with a transphincteric fistula since he was 3 months old and we’re heartbroken
17:57 that’s it. I have high tone pelvic floor dysfunction too and tight internal spinchter, rectocele. I’m effed Dr. Chung
Same here been 5 years now. Miserable. Pelvic floor hates me
@@marytaylor2824 I’m so sorry. This stuff is no fin
Hello Dr chung hello everyone I just wanted to share my experience with you all I suffered from a chronic anal fissure for 3 years trust me I tried everything and I gave up hope . After change of diet for life and 2 botox injections later I was able to avoid the surgery which i was dreading.
Sitz baths do not work
My anal fissure has healed 95% br
Because of my diet change plenty of fruit and water and less fatty food and stay away from all white food eg: whitel boiled rice , white sugar, milk etc
And please please everyone use BLACK REFINED CASTOR OIL EVERYDAY after a bowel movement , use it inside and outside the anus
Take my word for it it will work this is coming from someone who actually knows what you are going through
Use oil forever do not stop best of luck everyone
Ok so God used your story to give me hope again I too have been living with my for 3 years it legit changed my life. I had Botox done once and they “removed an anal fistula and my skin tag. Oh the Recovey process was tough as heck. And my surgeon wants to do a LIS surgery. I’m not for it. My diet has changed completely I only eat potatoes, chicken thigh, okra water every night, grain free chips, bean salad drinking lots of water daily no type of milk only oat milk and I mean it goes on and on. So there’s that. Maybe I have to get a second Botox injection cause the exit is smoother now but it’s the spams that lasts for HOURS that destroys my day. Anyways thanks for your feedback
Oj forgot to add I used organic castor oil and will resume to be more consistent and use it daily. But the itching is wild to as times
I’ve been using castor oil on my face and hands. Now another area in need, Thank You!!!
It's been two months since I started using stool softener with gtn and lidocaine gel, no bleeding or pain for a month. Should I now assume that my fissure is healed?
What kind of stool softener did you use
@@marcogonzalez8701 I used cremaffin syrup laxative I know it should not be used for long but I had no other choice if I got constipated even one day during the treatment then all my efforts would have been wasted Alhamdulillah I am fine now.
No
What’s gtn?
@suzanmiller558 Serch on Google it is a medication that used to treat anal fissure without surgery
the first time I bought one of your products it was the bath salts and I hated how slippery it made my tub the 2nd time I got the cream and it is a life changer!
Did it get rid of itching for you ?
What cream ?
@@marcogonzalez8701 Pranicura 5, yes it works.
Hi doc, how about if there's blood and blood clot when pooping? is it dangerous?
In the beginning when it happened to me I was actually seeing blood clots too but then days past and I didn’t see it as much . Now when the bleeding happens it’s only on the poop and some drops of blood
Is it possible at all to heal it completely from chronic anal fissure?
Yes. I had one then had Botox because it wasn't healing after a year n half. It did heal.
@@Amy-i8d so Botox did help? Was it painful after the surgery?
@@nickstars3790 hi it did heal it up. Thank God 🙏 the ONLY thing to heal it in one and half years. Make sure you get Metronidazole for straight after the surgery. This antibiotic will cover you
I am your huge fan . I also have internal hemmorids at age 17 only and always feeling constipated almost 2 years and still now .Use 1 year laxative and it slow down my natural process . I don't feel urge to poop everyday . Please suggest me what to do.😢😢
Dr. I came to know that I have chronic anal fissure with a sentinel tag of less that 5mm. I m just 22 yrs old girl. Is it required for me to go for surgical procedures and remove it or will it heal over time. Pls reply.
hey dr chung so im from india i am looking at your bum soothing cream you suggest in your video there is not available in india can you suggest some alternative that available on amazon or internet i had chronic fissure it been 1.5 years and still cannot healing i visit 4.5 dr but every dr says you need surgery but i always go to surgery dr denied beacuse fissure is healing and aftersome day it getting bad..
Is there a risk for cancer due to anal fissures?
can you talk about if there is a relationship between chronic fissure and frequent urination? since fissure can cause pelvic muscles to contract
If you are constipated,yes frequent urination is a possibility.
So good to know 1:22
Hello there Dr chung
Hope you are good,,your videos are very productive i appreciate
I have chronic anal fissures and grade 2 hemorrhoids chronic constipation
I have been give medicines
Such as ditialzem, caldoberg,zulu SP,and dulphalac,
Your videos has helped me encouraged me alot,am still progressing with my medications thank you sir.
Does anal fissures affect other parts of the body such as lower back pain etc
Please tell me whether I should go for LIFT procedure for my Intersphinteric Fistula (0.8cm, at 6'o clock position)??
Hard for me to say..I would need to see you before I can guide you with treatments. Best to you, Dr Chung
@@yourfriendlyproctologist actually I want to tell you something, I had been diagnosed with intersphinteric fistula at 6'o clock position of 1.5cm long in Dec 2023 then I tried many different things to cure it but it didn't helped that much but I researched a bit and read a study where doctors put FIBRIN GLUE into the tract which helped it to heal then I researched about fibrin glue and got to know that it's kind of collagen.
So I thought of doing it on my own but didn't find it anywhere then I thought why not try something that helps the collagen production in the fistula tract and I found that HYALURONIC ACID can do this so I bought hyaluronic acid serum from the market which has salicylic acid and vitamin c in it and I put it into my fistula tract for about 5-6 months and then I went for the MRI again (June 2024) and it showed 0.8cm at the same 6'o clock position (with closure of the external opening, internal opening is still there) so whether am I successful in shrinking it?? Or if I continue with the hyaluronic acid will it completely seal the tract?
I am confused whether I should continue this hyaluronic acid thing or should I go for the surgery?? Can you please give me some genuine advice? Because I consulted 3-4 surgeons including Proctologist but everyone has different opinions like some saying don't go for the surgery and the other one saying without surgery it cannot be healed, I am confused 😕.
@@yourfriendlyproctologist actually I want to tell you something, I had been diagnosed with intersphinteric fistula at 6'o clock position of 1.5cm long in Dec 2023 then I tried many different things to cure it but it didn't helped that much but I researched a bit and read a study where doctors put FIBRIN GLUE into the tract which helped it to heal then I researched about fibrin glue and got to know that it's kind of collagen.
So I thought of doing it on my own but didn't find it anywhere then I thought why not try something that helps the collagen production in the fistula tract and I found that HYALURONIC ACID can do this so I bought hyaluronic acid serum from the market which has salicylic acid and vitamin c in it and I put it into my fistula tract for about 5-6 months and then I went for the MRI and it showed 0.8cm at the same 6'o clock position(closed external opening) so whether am I successful in shrinking it?? Or if I continue with the hyaluronic acid will it completely seal the tract?
Please give me genuine advice should I go for the surgery or continue this hyaluronic acid thing because I consulted 3-4 surgeons including Proctologist all have different opinions some say go for the surgery other say you don't need surgery.
I know it's hard for you to advise without evaluating me in person but it's impossible for me to meet you as I live in India. Please I request you to kindly advise me should I go for surgery or continue what I am doing, I need an expert opinion.
@@yourfriendlyproctologist actually I want to tell you something, I had been diagnosed with intersphinteric fistula at 6'o clock position of 1.5cm long I thought why not try something that helps the collagen production in the fistula tract and I found that HYALURONIC ACID can do this so I bought hyaluronic acid serum from the market which has salicylic acid and vitamin c in it and I put it into my fistula tract for about 5-6 months and then I went for the MRI and it showed 0.8cm at the same 6'o clock position(closed external opening) so whether am I successful in shrinking it?? Should I go for surgery or continue hyaluronic acid??
We all talk about our anal fissure “healing”, but then we list some crazy lifestyle that clearly cannot be kept up with once we get older in life…. And the moment we stop medications like miralax, or sad depressing diets, etc… our fissure immediately comes back. So why do we all say we are healed? It’s like an addict who always goes back for another drink after months of sobriety, the fissure is like our bodies addiction…just never ending. Its always just a matter of time until it rips back open. My question to you all is why is everyone so against LIS surgery? Is this not the only way that will actually fix us long term without relying on all this crazy medication and unhealthy diets ( high fiber for some, or low to no fiber diets for others). I truly love and respect Dr. Chung for his honesty and intelligence……but guys, why do we lie to ourselves that we can do all these crazy “anti fissure” lifestyles that are really just short term relief……when theres a surgical option that may very well allow us to begin living and eating and drinking and breathing like a normal human again?❤
I think they might be avoiding it because there is a huge risk of incontenance involved. I am not a doctor but i saw studies on internet and they mentioned how prevalent is incontenance in LIS. Its almost about 15-20 percent in longer term (in short duration after surgery its much higher, but it reduces).
Bc it can cause incontinence which is permanent
Thank you 16:44
I had a colonascopy. They removed 8 polps but just noted I had 3 hemmroids. No shxt I've had them since my last child in 1985. Why did they not remove them. I'm constipation is so bad I use a laxative once a week. Rest of time I'm bloated feel pain in gut. I have ibs. I'm miserable.
I need to see you I am on Medicaid will you help me me please 😢
Doctor im getting leakage of stool in fistula track after surgery is that ok??? please reply 😭
Any advice on how to stop prevent spasms after the fissure is healed? Still get spasm pain even tho my fissure is fully healed
Dr C 🎉
"a cut in the butt" - hahaha
LOL.
What has helped me is a two to three day fast and milk of magnesia.
Here is my experince, that improved my overall status.
1- take sits bath after each bowl movment
2- dring a lot, and alot of water
3- get ride of fast food ( any fried food in general is bad)
4- balanced diet (mix between carbs, protein, and fibers)
Using deltazime mixed with lidocaine and put it on the anus (externally)
Using antiflamtion cream called quadran or somthing like that
How to take sit bstz
I wish the 15 minute appointment I paid $90 copay with insurance for would have told me half the things this 20 minute free video did. At least next time (if there needs to be a next time, with any luck, perhaps not), I will know to tell them upfront I am seeking a PT referral and to ask about inspecting/removing the skin piles. Do the skin piles ever exfoliate themselves without professional intervention?
Yes it is 11:23
Do you know what helped me get ahead of my chronic fissures? Reducing my fiber intake. The doctors I saw never told me about that. The internet did.
I should clarify. I was one of those eating too much fiber. Like 50g+ a day. It was too much for sure.
What did you eat
What did u eat
Doctor I have got developed external hemorrhoids after treating mu anal fissure..
And please guide me do they go away after lifestyle improvement or are there other options to treat external hemorrhoids without surgery.
Please guide sir.
Ive just been told i have an anal fissure after multiple visits to urgent care and emergency, they have me on .6% nfed cream and also gave me an over the counter lidocaine cream, so far it seems liek theres no releif and ive been noticing sexual intercourse or masturbation causes the pain to get worse :( i feel like there is no escape from this pain.
Dr Chung has said that he hasn't done a surgery for anal fissure in 5 years :) I'm wondering that if the scar tissue builds up at the edges and apex of the fissure, then is there actually still a good chance to heal this with conservative methods? I read that when it's a case like this then there is less likelihood of successful conservative attempts at healing and the more likely surgical intervention becomes...
Oh dang ok I’m not using my nifedipine enough most days…
Same I’m using deltiazem twice a day and I didn’t notice a good improvement ( slight only) so I’m gonna use it 4 times since now
Yes!!! I use mine 3x a day and even tho my symptoms are almost basically gone, I’m getting a refill. 😅😅
@@ccxmeow I hope I am able to get a refill without hassle. It’s ridiculous. One CRS I saw said she didn’t see the fissure. After other Drs did. And I know.
Absolutely gtn ointment or diltiazem cream is a MUST
@@naturegirl4074 that’s frustrating when you know your body is feeling a certain way and the doctor is saying no… were you able to get one? Unfortunately this is my last refill and I feel like it’s something I’m going to need on and off long term. So frustrating and annoying. :(
I rarely get bleeding anymore. Maybe here and there for a day or 2 a couple times a month
Is that weird
Same for me but before it was a lot of bleeding. What do you do to help ?
I got a fissure at 6o clock position before 30 days and got perianal abscess and i have done insertion and drain in 20 days back and i get tight stool for two days from Sunday and Monday and visited the hospital yesterday and they told me that the fissure is back ....what should i do?...they gave me a cream named cremagel and I can't insert my finger into anal cavity with finger cot but i applied outside and pushed the cream inside with finger....but i feel pain something like irritation there
They asked me to take stool softener at night before sleep
Is it mandatory to remove skin tag?
No, the fissure can still heal with the tag there. I wouldn't advise anyone to get the tag removed after fissure healed as I did recently. Tag was removed successfully but I developed another fissure and tag during surgery so absolutely no point. Trust me. I was being vain and it taught me a big lesson
I find that coffee and some diet make my scar tissue (from anal fistula surgery) flare up and feeling like a lump inside.
Hello Dr Chung. I tried to have an online appointment with you but having some money issues at the moment. I would like to ask here if its okay. I had 2 hemorrhoid surgeries in the past. more than 4 years after I still feel pressure and sometimes pain in my anal region. all doctors i went to saying everything is fine...some said high muscle tone and some said inflammation. I went also to PT and she gave me some exercise to try home. because i didnt get any 100% sure diagnosis its hard for me to know what way to go... i am thinking of botox but afraid the doctor will not do it the same way you do it and afraid it will make it worse...
I bleed very little when I have hard stools but doctors didn't see any fissure. I didn't bleed at all before I had the hemorrhoid surgery by the way. I want to believe its muscle spasm and maybe the skin became sensitive because of the hemorrhoids removal. I would like to hear your opinion. Thank you :)
I’m using the cream it burns 🥵 and not healing the fissure
Please anyone answer to me i have anal fissure my doctor advised me to do harmonic operation does anyone have experience with it if it’s much pain or not which better harmonic or leaser
Ugh yeah no I’d rather be under general anesthesia 15:47 lol
Hello, my adventure with fissure started on April and since then it keeps coming back. Doctor I've last visited told me that it's due to scarring and this material it's not stretchy and that's why it has a tendency to break again and again... What is interesting all doctors say I don't have anal spasm and there is no tension...
Does anyone have a similar story?
A mild morning walk helped my anal fissure to heal properly.
Walking is great for the blood flow to the area to help the fissure heal 🙏
I eat lots of fiber. I dont drink soda, consume cheese, eat fast food, and get plenty of exercise. My bowels are very regular and soft. And yet, I still have this problem recur. No matter how soft the stool, I still need to push a bit to relieve myself, and a tear happens. Why?
Fibre is indigestible, is bulky and damaging.
My Cronic anal fissure seem to heal with Sucral Ano. But now im having itch a lot, specially in night and I'll scratch and it will be worst. 😢
What is sucral ano
What about a peri bottle. Sitz baths seem nasty for females
Are roti’s, white rice, pulses, boiled potatoes and lemon juice harmful during painful haemorrhoid?
Please do let me know 😢
No cure of inner fissure
Eating meat only has helped with my pooping issues. Just saying. Poop is better less pain.
Does mucus come out the anus when a chronic fissure is healing???
No. Maybe its infected or became a fistula. Go to a doctor ASAP
@@ferencferenc6849 yeah I’ve gone to the clinic, I was told it’s a fistula so I’m to come back in 6weeks time but I’m on antibiotics for now