In the previous section, we focused on what is leaving our bodies. In order to truly be pain free we must not just look at what comes out, but also regulate what goes in.
There are two areas to focus on regarding diet: what we can eat to promote smooth and easy bowel movements, and what to avoid to prevent constipation and painful, hard bowel movements.
In order for us to have smooth bowel movements, we must make sure that everything that goes into our body will provide moisture and lubrication to the gastrointestinal tract. Anything that does not contribute to this goal should and must be removed until all symptoms and pain no longer exist.
The objective is to put an end to constipation.
The first item to supplement to your diet is psyllium husk. I have tried various brands, but have gotten the best results with Konsyl, which you can find at your local drugstore. Get the original formula.
Drinking psyllium husk adds necessary fiber to your system, and the way it works is by growing and bulking up into a very hydrated mass that pushes all the digestive material forward. As it moves along the GI tract, it essentially cleans and clears your system while providing moisture and lubrication along the way.
Here are some suggestions on how to drink the fiber.
First, make sure the powder is completely dissolved in the liquid. I use a glass tumbler with a lid instead of stirring with a spoon. Fill the cup with a decent amount of liquid. Then add a heaping tablespoon of powder. Put the lid on and shake vigorously until completely dissolved. Take the lid off, gulp down the mixture, add some more liquid on its own to get the remaining bits that are stuck to the glass, put on the lid and shake, drink some more. Here is a link to the set of cups that I use in case you are looking for some, although any cup with lid will do.
Second, if you are dissolving in water, you may find the texture and flavor difficult to manage. Make sure that the water is very cold and you will have a better experience. Personally, I like to drink mine with some fresh apple cider, which is also good for the digestive tract and your gallbladder and liver (more on this later). If possible, use apple cider that is cold pressed and only lightly pasteurized, if at all.
You are welcome to drink the Konsyl as many times as you want throughout the day, but I prefer to drink it at the end of the day, preferably at least thirty minutes after your last meal. This ensures that the psyllium is the last thing to enter your digestive tract, and it will push the entire contents of what you ate that day, which will aid in the goal of having one bowel movement the next morning.
We mentioned that the goal is to have a smooth bowel movement, not a constipated dry one that will cause you to push and cause further damage to the anal tissue. Towards that end, take a dose of magnesium citrate after meals. It will soften your stool and make bowel movements much easier to pass. It is a natural mineral supplement that aids the digestion of food, so you don’t have to worry about negative side effects or overdosing.
It is tempting to take stool softeners to soften up your stool, and they do work, but I would not take them regularly since they will negatively affect your digestive tract in the long run. I have taken stool softeners before, but once I learned that there was a natural solution that also benefited my overall health, it was an obvious decision.
What to Eat
Drinking psyllium husk and taking magnesium citrate as a supplement every day is incredibly beneficial, but in the long run they alone will not get you out of this mess. You need to significantly change your diet in order to get your rectal health back in order and put an end to the pain for good. You must eat foods that will benefit you and eliminate foods that will cause the anal fissure to worsen.
Towards that end, eat water-rich foods that hydrate and soften the stool, and eliminate foods that cause constipation.
In a lot of articles related to hemorrhoids and anal fissure they will tell you to drink a lot of water in order to prevent constipation. This advice, however, can be misleading. I used to drink copious amounts of water for months and didn’t notice any improvement in my situation. The problem is that any water you drink is directly absorbed by the stomach, processed by the kidneys and exits your body through the bladder. It never really makes its way inside the colon, which is what you need to hydrate and lubricate.
In order for the water to make it to the large intestine, you need to eat water-rich foods that inherently contain large quantities of water. This means fruits and vegetables. The water must be contained by a cell wall in order for it to not be immediately absorbed before reaching your large intestine. As the water is bundled up with fiber and other nutrients, it will keep the stool loose and easy to manage, resulting in smoother bowel movements, which will allow the fissure to heal more than it tears every day. The aim is incremental improvement every day.
Following this process will eventually lead to the fissure completely sealing, the skin tag drying up and falling off, and then a lot of itching as the pain begins to subside. Itching, in this case, is a good thing because it means your body is in the process of healing itself, as itchiness is a mild form of pain. Think about getting a bad cut – in the beginning it is just pure pain and any movement or touch will cause a great amount of suffering. But as the wound heals, it develops a thick scab and will start to itch, and you will be tempted to scratch around the area. We will get to methods of how to deal with itchiness later in the book as we discuss exercises you can do to get better.
What to Avoid
It is just as important to remove harmful foods from your diet as it is to eat foods that promote health. Unfortunately, they may be food or beverages that you enjoy eating/drinking. I understand how difficult it may be to give up certain types of food, but think about the long term comfort knowing that you will not have to suffer from excruciating, menacing pain every day of your life.
Most important, alcohol. You must eliminate this from your diet as much as possible. This was the most difficult thing for me, as I relied on having a couple drinks at various points throughout the week, whether it was at home or out with friends. The social pressure is tremendous, but when you realize what alcohol is doing to your system, you will figure out a good excuse to give when you refuse a drink. Just removing alcohol from your diet will be tremendously helpful towards healing yourself from the pains linked with anal fissure and internal hemorrhoids.
In my own experience, I realized that I had an incredibly tough time in the bathroom two days after drinking alcohol. Removing it from my diet was a critical step in the healing process.
Coffee or Caffeine
Coffee or other caffeinated beverages such as soda or caffeinated teas. Coffee is the main culprit here, and I understand this can be nearly impossible to give up for some, but drinking coffee will result in irregular bowel movements that are hard to sit through, literally. Even certain types of tea in large quantities will cause constipation. I remember early on when my anal fissure was starting to get pretty bad, I thought it would be a good idea to drink green tea, so I drank it constantly throughout the day. After a week, my pain levels shot up due to the constipation and hard stools. Later in the book, we will discuss some teas that will benefit the healing process.
Chocolate is another culprit that we must eliminate. Even eating just a little will cause digestion problems. Just don’t leave it around the house and you will not miss it as much.
The same goes for spicy food as well. We will go further into ideas of Chinese medicine, but the basic idea is that spicy foods generate internal “heat,” and since anal fissure is a symptom of excess heat in the body, eating spicy foods will be akin to adding gasoline to the flame.
In general, you want to avoid as much processed food as possible and focus on vegetables, fruits and other foods that are naturally full of water and fiber. Also, try things out for yourself to see what works and what doesn’t work. I would try eliminating all the foods I mentioned above for at least a month. If you still really miss them after a month, then add them back in one at a time. Make sure you wait a couple days before arriving at any conclusion, as I noticed that it was usually two days after eating something that I would notice its effects on my rectum.
For me, after living pain free for several years now, I do eat the above foods and drink alcohol occasionally. They still have the same effect that they did before, but since my condition is no longer acute, I have no problem eating and drinking in moderation. When I was in critical condition, however, I completely cut them out because the difference was significant.