Need some help here, but a little backstory first.
My fissures came about by my own doing. Crappy diet as a kid, lots of non-fibrous food, little water, long periods of time on the john, sitting a lot, weight lifting all led to the day when blood started coming out every time I used the bathroom (in addition to hemorrhoids). About 1tblsp or more came out each time I used the toilet, this didn't bother me that much as it only came up when I used the bathroom and never caused me pain.
I went to the Dr. about it and he prescribed me docusate, it began to heal (I assume) as the bleeding stopped and the pain started. It became really really bad a few months after that. As in, I'd use the bathroom and would be immobilized in bed for hours afterwards until the pain subsided and I could walk/sit down again. At this point I was still not staying on a strict diet or anything, just using the bathroom less.
I finally got fed up and after an attempt at curing it with a 0.1% nitro and 2% dibucaine I went to a surgeon and had a lateral sphincterotomy. It took a good week for the major pain to subside. What I noticed was that the fissure (at 6 o'clock if you think of a cross-section of your rectum with 12 being forward) pain was basically gone, but I had pain at the point of the incision, a constant dull pain.
I vowed to get this over with and stuck to a strict diet of high fiber foods, lots of water (over 100oz a day), and 24g of acacia fiber daily spread across 4 doses. I did/do not sit except to drive places and on rare occasions at restaurants and movies.
That was nearly a year ago, the dull pain is still there and I seemed to have developed 2 or 3 new small fissures. They not nearly as painful as it was the one I had in the beginning but it is still painful enough to keep me from sitting unless needs be.
Needless to say I'm growing tired of this limiting condition as I'm in my early 20s now and it has eaten up 2 years of my life. What else can I do?
Could I have Crohn's (the thought of a colonoscopy makes me wince)?
Could my hemorrhoids be complicating things?
Why new fissures after so much effort to eat/drink right?
Could the kneeling be aggravating things?
What gives with the incision constantly hurting? My surgeon said he can't see anything and to just "give it time"
I still maintain the same diet, lots of water and tea and fiber.
I aim to use the bathroom only once daily, twice if I eat too much.
I use an OTC prep h cream.
I kneel a lot at the computer and sit little at all. I do not do much physical exercise as it all seems to aggravate the fissures.
I have a botox appointment scheduled for a month from now.
OTC and Rx painkillers only do so much.
Any suggestions would be great, thanks.