What is Chronic Anal Fissure? | Dr. Chung's Treatment. 

Not suggesting surgery as a first option is a breath of fresh air. So there is Hope for me. Thanks Dr. Chung

sir you are the first sugeon who is not saying about surgery.... trust me its so relaxing to hear this..... Thank you so much for this positive video... ..

Dr Chang You Got an Oscar from me&all who follow you. I wish you Health.

Hi doctor, I’m from India and dental surgeon myself, I never had major constipation issues but 6 weeks back that one poop changed my entire anal story, the pain was terrific and literally felt like pooping mini glass particles, so I visited gastroenterologist and he did the finger examination and figured out that I’ve haemorrhoids and fissure both, he suggested me fiber supplement, stool softener, anovate cream available in India which is combination of beclomethasone, phenylephrine and lidocaine and antibiotics for few days, and ofcourse asked me to do sitz bath 2 times a day ( I do 3 times), in my journey I’ve seen all your and other videos related to it, even surgery videos on RU-vid, have read medical textbooks and even research papers related to it. Till 1.5 weeks from today I used to have pain while bowel movement, sometimes not able to poop enough or some days constant urge of pooping, I was literally exhausted and fed up of it and was begging to god why me? But what I did along with it is I restricted myself completely from refined flour, spices, oil and drank 4-6 liters of water everyday and 2km walk post dinner. Trust me the things are now working very well with me, at point I was thinking of undergoing surgery but now I’m able to poop within 5-10 mins with semi solid texture and with no pain, although slight discomfort is still there and I always apply cream there, and I’m very particular about what I’m doing and will continue to do it for next 2. Months at least, still I don’t know whether I’ll be able pass this thing but currently I’ve no pain while pooping and not later on as well, to all the affected people reading this comment I know what you’re going through but trust me you need that fighting spirit in you to defeat it and one thing I do while pooping is breathing exercise, I inhale deep breaths and exhale it, it helps to relax your constricted muscle down there and widens up your anal canal which allows your poop to get out without causing much friction. And just don’t care about whether it’s acute or chronic, surgery is last resort always, find measures to get rid of your constipation, do yoga if it helps you, soft poop is your best friend. And internal anal sphincter is your enemy. Thanks doctor chung your videos helped me in developing my mindset and allowed me to ask detailed questions to my gastroenterologist. Take care and I’ll win over it very soon

Thank you for enlightening me on sentinel piles! I thought it was a residual from hemorrhoids. I have had what I now know to be an anal fissure for 2.5 years now. After a year, I went to my PHP and after two years, I agreed to see a Gen surgeon. Both said everything looked “fine” externally, which left me amazed at what the average person must look like! I see you have a whole video focused on this issue so about to check it out now. Thanks again for this awesome content!

I’m so glad (not glad we’re in pain ) to see that I’m not alone on this and thankful to see others sharing their story this channel is the only place I can find comfort and peace knowing it will be okay and to stay strong and keep going with our strict routine to heal!! Sitz bath are my number one pain relief, along with triticum vulgare cream and relaxation /meditation. Or even Meloxicam for muscle stiffness which can help you relax

Thank you for these videos. I had this issue for almost two decades after childbirth and was always just brushed off when I brought it up with my doctors. No one ever even tried to address it. They just acted like it was nothing.

You’re the best proctologist!

Your attitude and knowledge have helped me greatly in my journey.

Doctor! You give me hope! Thank you so much!!!!

Great informative video. Thanks for sharing your information I'll have to look for your other videos on how to heal them.

I wish my doctors had your sense of humor ! 😄 I'm HOPING I won't need another surgery, so I'm going to try your cream.

Thanks for being here for us, you are making a difference in all of our lives. One question I have, can I still use my treadmill everyday, i only use it to walk not run.

Your videos always brighten my day, Dr. Chung! The positive attitude that you display is also important in healing, for the patient and the doctor. Congratulations on developing a successful method for curing anal fissures! It's almost unheard of that a surgeon would find a way to avoid performing surgery. Just shows how much you care about your patients!

Rye Bread has been my life saver. Stopped all my issues.

Hi Dr Albert ☺️ after seeing my doctor and finding out I had a fissure, I had been struggling for a while and was in constant pain. After finding your videos, I learnt more about fissures, and you have certainly guided me learning more about fissures and have given such valuable information. Thank you very much 🙂

Another great video, Dr Chung. Could you some day make a video on a topic most people are too embarrassed to ask: What is the proper way to poop, (in terms of posture, breathing and the right way to bear down)?

@Yourfriendlyproctologist Is it common to have a colonoscopy and a rubber banding done at the same time? That would be great. Also, is it common to have a colonoscopy and upper endoscope done at the same time? Thanks so much.

Thank you Doc for taking the time to educate the world. I had three banding procedure then one now in hospital under anaesthetic as each time l died from pain as the bands were sitting on the nerve, this was now successful but l now have a heamatoma , there’s no winning in all of this 🙈

Just dealt with this and the remedy is 1. eat fruits and pasta evryday 2. after using the stool take warm bath to soak the bum 3. after showering take triple antibiotics cream and massage on the wound and around the area. same thing with Vaseline. 4. try to use the still at least once a day ( i know it hurts but i was there too) even if you see blood. 5. continue the diet until stool is soft when coming out and the wound is healed

Hi sir, once in awhile I have very little currant like jello why is that? Thank you

You are a good man!

Nice explanation Doc. How do you differentiate between Chronic fissure and a normal surgery wound ? I have undergone Haemorrhoidectomy and Lateral internal sphincterotomy 9 months ago, i still have a small wound which gets irritated during BM. Is it a chronic fissure or a scar made out of surgery ? My surgeon said it is a depression/pit made as a result of surgery and it will heal on it's own in few weeks/months.

Hi Doctor I would like you to write down the link for the videos that you mentioned I just couldn’t find them 😅

Dr Chung it’s incredible you haven’t done the surgery for 5 years. I believe because in the UK I have not met a single CRS yet who has laid out all the factors at play when it comes to chronic fissure or recurring acute fissures. To clarify has your method worked on 100% of patients? And if it were to fail would you suggest surgery in that case if the patient wanted it? Thanks again for the videos. Keep them rolling please. I’m 16 months into anus pain. 2 GPs, 2 CRS and a pelvic physio and they still can’t solve the mystery. Gastroenterologist is getting involved now to get their perspective too. If I was in America I would come to see you. Thought about a virtual with you but I know ultimately I can’t get to you for an examination.

The enthusiasm in the first seconds frightens me! This must mean this clip's issue must be REALLY bad :(

guys, i went through this a few months ago. i just wanna say i feel you and you got this

Hello Doc, nice video. Where can I book an appointment?

Thank you Doctor from INDIA

I have this problem for almost 5 years. Fed up with this. I think for permanent surgery, surgery is the best i have to face it..

Hi Dr, hope you are doind well Reference to your last vedio as you mentioned it been heal and re occurred so is it chronic? Becouse in my case i thought its completely heal for whole week and suddenly came back. Your answer is really appreciated thank you.

Hello Dr After the chronic fissure healed ... it means leaving the patient with the scar and sentinel skin tag and posible abcess risk ? Thank you

Thanks Dr great video.

Thanks!!! xoxo The Clarences

OK I've just ordered this stuff. I've had my fissures for 6 years 😅. I'll let you know how it goes

Can you please dr. Make a vedios to explane the the difrences between the kind of fissur surgeries.becase there is many ways to to the surgery.

How does one determine if it's a superficial fissure (ie/ skin issues etc) or deeper?

Can using nifedipine after a Lis increase your risk of incontinence? I’ve had a couple of flare ups since mine I’ve used it for but don’t want to risk that.

Do you do or can you do the cauterization of fissure? There is a doctor in NY that does it, but I haven't found one in so cal that does it...

Thanks for your helpful advice. I’m looking for a cream and I have seen something called Pranicura and the website then had a link to your on RU-vid site I live in the U.K. and have a chronic anal fissure and was going to have a operation but rather not Does the pranicura really help or is it something you are not aware of and someone is using your name? Any advice to treat this condition as have had it bad got at least 6 months or more. Great videos so thank you

As much as I appreciate his videos and education, I recommend seeing a Proctologist in person rather than spending $250 for a video consultation. Dr. Chung after seeing a photo taken of my issue recommended a Hemorrhoidectomy via video conference rather than any conservative treatment. That it would not help me...said I had grade 4 from the photo taken after I went to the restroom which I told him. I ended up seeing another proctologist, received Sclerotherapy and am in no more pain and my internal hem does not prolapse after going to the bathroom. Dr. Chung, I recommend you see a patient in person and truly look at other options that may work or give someone needed relief. If I can get needed relief for 6 to 12 months from sclerotherapy, and not have to go through HELL from a hemorrhoidectomy, I choose Sclerotherapy, IMO.

Thanks doctor ❤

Are the pain meds necessary for healing? Or just for pain relief?

Hi Dr. You are the best. One question I want to ask you. I had a Fistulotomy a year ago and have been 99.9% good with avoiding constipation. But unfortunately, 6 weeks ago I didn't drink enough fluids 1 day and passed a tough/ straining stool and now have a anal fissure believed to be from the scar tissue from the fistulotomy. Im keeping my stools soft, but even a slight movement/ even walking for a few minutes seems to reopen it.

Dr chung can we eat watermelon 🍉, almond milk, lentils after polypectomy/ colonoscopy?

Nice video, very informative. I did the same thing. Pain went away for just about everything. Felt great. I race and ride road bikes alot and my first few rides i felt nothing. next few times out the duration in the saddle got longer and i felt my spot again. Your video on scar tissue made sense. Definitely stretch the anus in the saddle. How long would you recommend i not ride. How will know if fully healed. Assume a visit to my doctor? Really missing my bike.

You are a great doctor.

Found out i have one. It SUUUCKS! And my anxiety disorder is not helping either, although now that ik about this stuff im calmer about it. For me it just itches constantly amd it's mildly uncomfortable but sometimes its bad. It also like, has a sharp but slight pain (right now actually too). Went to bathroom today, wiped, blood. Just blood, not TOO much, but a significant amount. I checked later, no blood. So that basically told me, yeah it's a fissure. The thing i hate about it is, it feels like its forever tbh. Like its hard to wait for it to get better. Definitely seeing doctor soon. These vids help though in the meantime! I watched the vid about why the come back and man I feel like the patient described. Was doing good for weeks with 0 issues and then all this stuff suddenly started :(

Shall we use cremaffin daily? Please clarify

Never had fissure until Doc slipped on last 3rd Grade 2 banding (1&2 were great), she kept trying and trying and the instant she got it on I screamed, felt a pulling from the outside in. She put some more numbing on and it got me home. 4 months later she prescribed Nitroglycerin, which makes me super dizzy when I use. A year later and it's like I'm going to pass out in pain regardless how soft the stool is. Now have a ridge of super tight skin interrupting what use to be a circular controlled opening, not this super tiny swollen dreadful that I'm left with. The tiny exterior hemorrhoids are double what they were before the procedure and wish I had never had the banding. My recommendation is space wider the banding procedure then what they tell you. If it's working well after 1 or even 2 stop there. What I wouldn't give to go back to those little unsightly exterior bumps :( Hoping Dr. Chung brings me some relief with a more thorough approach.

Wud vaseline be good to apply around the sentinel pile?

how can a protologist see inside without a scope? Assuming you have a fissure and the scope would bother and be painful?

Hello doctor, thanks for excellent service you are offering through your channel. one question though. if one is allergic to diltiazem cream what is the next course of treatment. surgery?

Is slippery elm and marshmallow root helpful ?

For me i was given deltiazen or something like that, it didn't work and was recommended the surgery. Just got it today, i hate it and wish i knew about u before. It hurts a lot , i hope this works. I was told by my dr NOT to take a bath, just use the sitz bath bowl. Is that right?

So what are those methods?

Hi Dr Albert, I had to go to emergency care because It was very painful and I did not know what can be done. where are you located and how can we reach out to you?

Dr chu how can i purchase your product...iam from Arunachal Pradesh... India

I want a doctor like you and i wanted to take treatment from you. But unfortunately iam not able to .

Can you check bottom area to verify the issue, if yes how

i have had mine for 12 yrs..super fun..!

hi sir, i have gone through Hemorrhoidectomy, it's been 40 days and i have skin tag down there and still i feel pain while pooping and i see a red straight line of blood on my poop, sir i have medicals for military in 1st week of august please help me sir otherwise i would be rejected

Thank you

I get a little red blood on tissue paper from time to time in tissue paper. No pain. Should I get a colonoscopy?

I am a young person, only 16, I used to have such a bad diet because I never really cared about my health since I was in depression. But literally , if I could turn back time I would go back to the day I didn't poop for 2 days and when I did, I cut myself. That cut hasn't healed for 4-5 months. Sometimes it just goes away or doesn't feel like anything but yesterday, I travelled for 15 hours and didn't drink enough water because the bathroom wasn't guaranteed. And here I am, had a very hard poop, reopened my almost healed anal fissure and am in pain. There wasn't any blood but yeah... I really hope I can pass this living hell. I envy everyone who is able to go and poop like it's nothing. While I have to think and reassure myself several times while pooping that I'll be okay.

How can I make an appointment with you

Hi Dr. Thanks for your video . May I ask : can lactulose be taken daily for long term use for soft stool for prevention of anal fissures ? Any side effect of it ? Your advice is much appreciated. Tks .

I.just started this and I'm hoping for help. I've been in constant and daily excruciating pain for 5 MONTHS. I'm so so tired of the pain. I've been suicidal because I felt I could not do this any longer. I've been to 8 doctors and no one is helping me.

Question once you have a chronic fissure and heal, will future flares always be chronic and worse than prior ones? Thank you Dr

Hey doc. Im in this pain now. I don't know, what can do.?

Do you recommend psyllium

Dr. Chung, I want to ask you a question. If only 1 small polyp of 0.4 cm is found during the Colonoscopy of a 50-year old woman with no family history of bowel cancer; do you recommend getting it removed?

How to remove the skin tag which is come from fissure remove it naturely with creams plz help me

If fissure is healed and skin tags are there. Is there sny problem?

Hello doctor Can someone have two or more chronic fissures in sametime?? And if yes, is it cureable??

How much Colace is safe to take a day and for how long? The doctor I have gone to says I have a cronic fissure and gave me 6 wks to get it under control or he wants to talk about surgery. He instructed me to take 2 Colace a day and he wanted my poop like liquid. Before I went to him I was taking fiber twice a day and it was making my poop large but soft but nothing was healing it still hurt to pass. I since was told to stop the fiber and up the Colace to 3 times per day and everything is soft and no more blood for about two weeks now. I just don't want my body to become dependent upon the Colace...

Can a person have an internal hemorrhoid that mimics the pain of a fissure (making it seem like there is a fissure)?

Try Yogurt and banana regular. I am healing

Sir i have trombosed hemmoroids circumferental im in faktu ointment as of now can i ask how long may it take to my rectum to return to its original form...i feel so much discomfort and pain pleasw help thank you

Hi Dr were you located in us.??!!

Can you talk about anoplasty. What is success rate of it.

Hi Dr. Chung, I’ve been suffering from anal fissures for more than 2 years. It does heal with proper diet and creams but the same one reopens again. Recently, I saw blood on my toilet paper and went to see a doctor. The doctor recommended doing a Colonoscopy. Should I get a Colonoscopy? Also, do you recommend a surgery to finally heal it?

You are awesome

I hope you can answer this for me, because google isn't helping. Should I find a proctologist INSTEAD of the colo-rectal surgeon I used to see? I can self-refer with my insurance, and would prefer a doctor who specilalizes in fissures/ fistulas. Thank you.

My doctor once told me "If you got a cut on your finger, you don't go and get it cut up some more and hope it heals." Anal fissure is basically a 'cut'...LET IT HEAL by knowing your diet, your lifestyle, bowel habits and then, make the necessary adjustments. And give yourself time to work through these things. The pain SHOULD NOT force you to seek drastic treatment. It sucks but work through the less drastic options. I literally had to lose 80 pounds, take stool softener pills initially and then transition to things like Metamucil and then drinking bottles of water, eating way more fiber aka dark green veggies and foods loaded with fiber. I took walks after eating. Aside from my morning coffee, I avoided foods that used to constipate me. I wiped my butt LESS HARSHLY. I remember I used to wipe my butt until the toilet paper was free of poop or had small amounts of blood. I realized that caused problems. Now I wipe gently and I used a spray bottle as sort of like a bidet. Squirt some water up there and wipe with toilet paper. WOW, instant clean bum feeling. And the cooleness of the water helps. Heat the bottle if you don't like the cold water. LOL. Oh, my job requires me to sit all day in front of a computer...well, I asked my boss if I can use a standing desk and voila, less bum problems. Sit, stand, sit, stand...no more sore bum. ALL THIS HELPED, after suffering for many years. Be nice to your bum, or else, it'll be a pain in the ass to you.

Doctor, can anal fissures be caused by hypertonic pelvic floor dysfunction?

While you seem to have it all figured out I am over here dealing with 20 years of this and it has ruined soooo many aspects of my life!!! Healing seems hopeless!!!

You're speaking so much sense , I have chronic anal fissure, it's been a year and a month, the pain I experience when excreting,I even bleed😩

I'm feeling better laxative ,stool softener and shower hose after pooping instead of wiping is key

One of the things that's frustrating about having a chronic anal fissure is the waiting in-between seeing one's specialist to check it. Mine is acting up a bit extra at the moment but I'm not seeing my doctor until August. There's always the concern that it'll develop into something more nasty. The stool tests they offer free for over 50s (here in Australia) only check for blood in the samples provided, but if you suffer with anal fissures, blood is a common thing to find. So, it is not that effective a test for people suffering with fissures. It makes it frustrating and worrisome. I've lived with this condition for decades but it doesn't get any easier. And the idea of having surgery in that area terrifies me. But nothing I've tried helps cure the condition.

My doctor says she can’t see anything but see says might be anal fissure or hemmoroids and gave me creams and Botox and surgery for anal fissure (sphincterotomy) and it’s been 6 months and I feel absolutely no difference and still in so much discomfort everyday and my doctor said she took little hemorrhoid out but still no change…. Now she send me to dermatologist but can anyone give me advice as to what to do to fix my discomfort for good

I tried diet and ointments sitz bath, its in control , much much lesser pain but its not healing. The Cut is open after 1 month

Great Doctor Chang. Please how I can contact you by email or Whats app to get an advice from you. Thanks a lot.

Hi doctor,I am from india,have 2 anal fissures I was prescribed with diltaitzem but I was feeling dizzy with that ointment so my doctor suggested to stop using it now he is suggesting surgery can u please provide me with options where I can heal my fissures without surgery, that will be a great help

hello doctor... I have a chronic anal fissure for 10 years.. it comes and goes after some time. normally after a hard stool. can chronic anal fissure turn to cancer if it is not treated? mine is chronic and has indurating edges.

Sugar! Please do a video on the effectiveness of applying granular sugar on prolapsed/external hemorrhoids.

Hi! My husband has painful chronic anal fissure. How may we seek your treatment? We are in Spore.

My surgeon says to give it more time to heal, but I don't know if it will. Im praying to God and trusting in Him that it will heal and I don't have to have another surgery (LIS, etc). Any suggestions? Thank you.

Hi Dr. Chung, I just love your content please keep it up. I have one question. Due to anal fissure i have a sentinel skin tag. The problem is may be the skin tag is infected/inflamed and leaking pus with some pain sometimes. My doctor has prescribed me Fusicutan anti bacterial cream and he suggests further to go with fissurectomy. I only have problem with the infected skin tag. What do you think would be the best treatment option?

I've had this going on for 2-3 years... I just want it to end...