Dealing with hemorrhoids – any advice?

Karen Thompson10 said:I had my procedure done in Washington, D.C. at the Butterfly Clinic with Dr. Ivanovic—it was a lateral sphincterotomy (in my case, it was "minimal"). Other clinics perform the exact same thing, and obviously, hospitals do too.
My advice? Don't drag your feet. If you wait, that wound might just keep spreading—or so I was told. Good luck! 🙂

Thanks for the heads-up... I’ve actually heard of that surgery before, but the surgeons I consulted gave me a pretty grim outlook—they advised avoiding it altogether due to potential side effects. Honestly, it’s got me terrified, though it feels like I might not have much of a choice left. This wound is significant; it’s making it incredibly difficult to move around and is seriously interfering with my work. If you wouldn't mind sharing, what did Dr. Ivanovic tell you regarding the risks—how safe is it really? Also, could you clarify what a "minimal" lateral sphincterotomy entails—does that mean your incision was smaller, or is it something else entirely? And, if it's not too much trouble, any idea on the cost? I am desperate to find a top-tier surgeon, so your recommendation carries a lot of weight for me. Thanks in advance!

darkbear14 said:Thanks for sharing... I’ve heard about that surgery before, and honestly, the surgeons I went to for a second opinion told me to steer clear because of the potential side effects, so I’m pretty terrified, even though it feels like I don't have much of a choice left. This wound is massive; it's making it impossible for me to move around properly or even focus on my job. If you could tell me what Dr. Ivanovic said about the procedure—like how safe it actually is—and explain what "minimal lateral sphincterotomy" means (did you say "minimal" because your incision was small or something else?), I'd really appreciate it. Also, if you happen to know the cost, that would be huge. I’m trying to track down a top-tier surgeon, and your recommendation carries a lot of weight for me. Thanks so much!

Well, look, here's my take... I waited a whole month before finally seeing a doctor, and by then things were getting pretty bad since the pain was so intense I couldn't function, though obviously, it wasn't life-threatening or anything. My first stop was Dr. Misir, who wanted to try treating it with botulinum toxin for treating anal fissure injections, but he really spooked me; he insisted I needed to get this sorted immediately and warned me not to end up in a hospital setting where they might just go in and cut me open (which turned out to be the exact procedure I eventually chose).

I had heard great things about Mercury Basketball clinics from several different sources because apparently, they have the best specialists (specifically Ivanovic and Kocman), so I headed up there to get their professional input. Dr. Ivanovic told me it wasn't an emergency and that I could probably wait another two months before getting seen at one of those major centers, but I just couldn't deal with the pain any longer, so I went to see him at his private clinic instead. I was totally blunt with him about both the botox option and the incision above the fissure, and he explained that in many cases, once the effects of those injections wear off, the fissure either returns or a new one develops, though it really depends on the individual case and why the fissure happened in the first place. For instance, I have high sphincter tone, so the issue would have just come right back for me, but your situation might be completely different...

I asked him about the side effects too because I was genuinely scared, but he really put my mind at ease; he promised that he would only perform a minimal version, noting that he’s done it countless times and there was nothing to fear, which is why I ultimately decided to go through with it. When he mentioned performing a minimal sphincterotomy, he meant he was only going to make a tiny incision above the fissure, because in my specific case, that was all that was necessary (to be honest, I never even noticed the incision after it healed).
As for the price, I'm not entirely sure because I saw him for a hemorrhoid removal as well, so he didn't charge me separately for the fissure, but from what I've seen online, prices usually range anywhere from $1,500 to a few thousand dollars. But again, I'm speaking from my own experience—if finances are tight, you can always look into having it done at a public hospital.

Oh, and yeah, there is dilation (another type of procedure) which involves stretching the sphincter, but it felt like a more invasive route to me, though now that I'm reading about it online, some sources say otherwise. It says that both procedures are performed under local anesthesia and that patients are pain-free by the next day with no complications. Honestly, though, please take that with a massive grain of salt because my surgeon warned me I'd be in a lot of pain for a few days, and I was actually under general anesthesia, so...

p.s. I see you've already consulted a couple of surgeons, so what did they suggest to you? There might truly be a better way out there, I'm just speaking from what happened to me. Everything moved so fast in my case, so it's really smart of you to be gathering as much info as possible!

mistybison10 said:So, I stopped by Mercury Basketball today, and from what I could tell, Dr. Poljak was the one on call. I can't be 100% sure if he was actually the one seeing me inside, though. Anyway, the verdict is basically "nothing to do right now." They just handed me this Faktu ointment and told me to come back in three months, so that I have enough time to fix my diet and stop sitting around all day. 😁

The real struggle is that if someone could just give me a clear roadmap of what to cut out of my diet—which is honestly a massive hurdle for me—and what I should actually be eating, I'd be set. I know a lot of you guys have been through this and probably have some great insights.

I would really suggest hunting down those posts by Leslie Eldridge, because he has put together some incredibly thorough guides specifically about nutrition on a few different occasions.
Honestly, I feel like you likely already have a gut feeling about what’s good for you and what you need to stay away from. 😁
All that junk food—think greasy pizzas, fast food burgers, or heavy, spicy dishes—along with sodas, excessive sugar, dry foods, and heavy carbs... it's all absolutely terrible for your chemistry.
On the flip side, you really need to lean heavily into fruits, vegetables, soups, nuts, and whole grains... staying hydrated is also absolutely vital, and getting some exercise in helps too. Making the switch to a clean diet can truly be a game-changer for your recovery, even if I have to admit it isn't exactly... a blast. 😁

Since you're still in the early stages, I am crossing my fingers that you catch this before things progress any further, and keeping your diet in check is going to be your absolute best defense! 😉

Karen Thompson10 said:Well, let me lay it out for you... I waited a full month before finally seeing a doctor, and by then, things were getting pretty grim—I was in enough pain to make life miserable, though, granted, it wasn't exactly life-threatening. My first stop was Dr. Misir, who suggested treating it with botulinum toxin for treating anal fissure injections. Honestly, he spooked me a bit; he insisted I deal with this immediately and warned me not to just end up in a hospital setting where they might opt for a surgical excision (which is actually the procedure I eventually decided on).

I had heard glowing recommendations for Mercury Basketball's medical wing from several different sources—apparently, they house the top-tier surgeons like Ivanovic and Kocman—so I headed up there to get a second opinion. Dr. Ivanovic told me it wasn't an emergency and that I could probably wait another two months before being seen for surgery, but I simply couldn't endure the discomfort any longer, so I went straight to his private clinic instead. I asked him point-blank about both the botox option and the surgical incision above the fissure. He explained that in many instances, once the effects of those injections wear off, the fissure either returns or a new one forms—though, of course, it’s highly case-specific depending on what caused the initial issue. For instance, I have high sphincter tone, so for me, everything would have just cycled back to square one; your situation might be entirely different...

I also grilled him about potential side effects because, frankly, I was terrified. He managed to calm me down, explaining that he would perform only a minimal procedure; he’s done it countless times and assured me there was nothing to fear, which gave me the courage to pull the trigger on the surgery. When he mentioned performing a "minimal sphincterotomy," he meant making a tiny incision above the fissure, as that would be sufficient for my case (to be honest, I never even noticed or saw the actual cut).
As for the cost, I can't say for sure since I saw him for hemorrhoid removal as well and he didn't bill me separately for the fissure, but from what I've gathered looking up internet about botox treatment and similar procedures, prices generally range from $1,000 to a few thousand dollars. But again, I’m speaking about private clinics—if finances are a concern, you can always have it done at a public hospital.

Oh, and there is also dilation (another procedure involving stretching the sphincter), which sounded much more invasive to me at first, though now that I'm reading more online, the descriptions seem different. Some sources claim that both types of procedures are performed under local anesthesia and that patients are pain-free by the next day with zero complications. Honestly? Take that with a massive grain of salt. My surgeon warned me I'd be in significant pain for a few days, and I was under general anesthesia, so...

p.s. I see you've already consulted a few different surgeons, so what have they been recommending to you? There might truly be a better way out there; I'm just sharing my own lived experience. Everything moved quite fast in my case, so it's great that you're gathering as much intel as possible!

Great, thanks for such a thorough response. It’s good to have that insight regarding Dr. Ivanovic, though for now, I think I'm going to go with Dr. File. He uses a radiofrequency device to cauterize the fissure while simultaneously performing an anal dilation... I'm really hoping this method holds up, but it's good to have an ace up my sleeve knowing about Dr. Ivanovic if things change. To be honest, I'm a bit worried because my fissure is pretty far from "normal"—it's quite large—and I spent all this time thinking I just had hemorrhoids, but they weren't the source of this level of agony. During my exam, Dr. File mentioned he could handle both the hemorrhoids and the fissure at once, so I'll give it a shot with him. I suspect I have high sphincter tone just like you, though mine was primarily triggered by the fissure itself. From what I've gathered, the increased muscle tone is actually a reaction to the fissure—basically, the body's way of spasming due to the intense pain.

Karen Thompson10 said:Well, here’s my take... I waited an entire month before finally seeing a doctor, and by then, things were pretty bad—I was in enough pain to make life miserable—but it wasn't exactly life-threatening, if you catch my drift. Initially, I saw Dr. Misir, who wanted to try treating it with botulinum toxin for treating anal fissure injections. Honestly, he spooked me a bit; he insisted I deal with this immediately and warned me not to end up in a hospital setting, implying they might just opt for surgery (which, in the end, was the very procedure I decided to go through).

I had heard several recommendations online for Mercury because they supposedly have the top-tier surgeons (Ivanovic and Kocman), so I headed up there to get a second opinion. Dr. Ivanovic told me it wasn't an absolute emergency and that I could probably wait another two months before being seen at the main facility, but since I was at my breaking point, I just went straight to his private clinic instead. I asked him quite bluntly about both the botox option and the surgical incision above the fissure. He explained that in many cases, once the effects of those injections wear off, the fissure either returns or a new one develops—though, of course, it really depends on the individual case (specifically what caused the fissure in the first place). For instance, I have high sphincter tone, so everything would have just cycled back to square one for me; your situation might be entirely different...

I also grilled him about potential side effects because, frankly, I was terrified. He managed to calm me down, assuring me that he would perform only a minimal incision—something he’s done countless times—and that there was nothing to fear, so I pulled the trigger on the surgery. When he mentioned performing a "minimal sphincterotomy," he meant making a tiny incision above the fissure, as he felt that would be sufficient for my specific case (to be honest, I never even noticed the incision myself).
As for the cost, I can't give you an exact figure since I saw him for hemorrhoid removal as well and he didn't bill me separately for the fissure, but from what I've gathered browsing the web, prices usually range from roughly $1,500 to a few thousand dollars. But again, I’m speaking from experience; those prices typically apply to private clinics, whereas if finances are a major concern, everything can be handled through the hospital system.

Oh, right—there’s also dilation (another procedure involving stretching the sphincter), which sounded much more invasive to me at the time, though now I'm reading conflicting things online. Some sources claim both procedures are done under local anesthesia and that patients are pain-free by the next day with zero complications. Honestly? Take that with a massive grain of salt. My surgeon warned me I’d be in significant pain for a few days, and I was actually under general anesthesia, so...

p.s. I see you’ve already consulted a few surgeons, so what have they been suggesting to you? Maybe there truly is a better way out; I’m just sharing my own personal journey here. Things moved incredibly fast for me, so it’s great that you’re gathering as much intel as possible!

I should also mention an article I found on the internet about botox treatment authored by Nebojša Stanković and Darak Mirković from the VA Hospital. It’s titled "Botulinum toxin for treating anal fissure," where the authors present their research on using botox as a potential alternative to surgical intervention. Based on their findings, they concluded that it can indeed serve as an adequate substitute for surgery.

darkbear14 said:That’s awesome, thank you so much for such a detailed reply; it’s really helpful to have that info about Dr. Ivanovic in my back pocket, though I think for right now I'm going to go with Dr. File, who uses a radiofrequency device to cauterize the fissure while performing anal dilation at the same time... honestly, I'm crossing my fingers that this method is just as effective, but it feels good to have an ace up my sleeve by knowing about Dr. Ivanovic too. To be honest, I'm pretty terrified because my fissure is way beyond what I'd consider "normal"—it's huge—and I spent the whole time thinking I just had hemorrhoids, but they weren't actually the root cause of this level of pain. During my exam, Dr. File mentioned he could take care of both the hemorrhoids and the fissure at once, so I'm going to give him a shot, and I suspect I have that high sphincter tone just like you do, though my fissure was primarily triggered by the hemorrhoids. I finally realized that the increased muscle tone is actually a reaction to the fissure itself, basically the body's way of reacting to the intense pain by causing the sphincter to spasm.

See, I didn't even realize there was an option to treat a fissure with a radiofrequency device! It honestly feels like everyone is just pushing their own specific methods because it's better for their bottom line, of course. Based on what you said, plus a few articles I dug up online, it seems like anal dilation might actually be the better route. Back when I was making my decision, I thought it was going to be way more invasive because Dr. Misir did everything in his power to convince me how intense it would be, even drawing out the procedure for me. 🙄
He probably assumed I wouldn't even ask about surgery since I was so intimidated that it wasn't even on my radar, and I didn't ask Dr. Ivanovic anything about dilation because I had already crossed it off my list, though he did mention it and I just shut it down immediately. Anyway, this whole ordeal has taught me that you should ALWAYS seek out multiple opinions...

I also went through that phase of thinking it was all just hemorrhoids, so it was a total shock when they told me I actually had a fissure caused by them.
And the fissure is what causes that high sphincter tone, not the other way around. In fact, I actually think (though I can't say for sure) that my doctor suggested surgery because it's a more permanent fix, since the high muscle tone could just keep coming back otherwise.

Anyway, good luck and please let us know how it goes (I'm saying that to everyone 😁), just so people can have a bit more information to work with!

darkbear14 said:I also wanted to mention this article from an internet about botox treatment search, written by Nebojša Stanković and Darak Mirković from the VA Hospital titled Botulinum Toxin for Treating Anal Fissure. In it, the authors present their research on using botox as a potential alternative to surgery, ultimately concluding that it can serve as a viable substitute for surgical intervention.

I’ve spent quite a bit of time digging through English-language articles and even some clinical studies on the subject. From what I gather, the success rate hovers around 85%, but you have to endure multiple injections that are honestly pretty painful—I ended up needing twelve myself, though I might have been a particularly difficult case. Plus, there’s always that nagging possibility that the fissure might resurface after six months or just never fully heal. I actually spoke with a lady who found everything came right back after about nine months, and she had dropped a significant amount of money on it. For my situation, they quoted me around $3,200 when combined with hemorrhoid treatment.
I'm just not sure... the whole thing didn't really appeal to me because I was hoping for a "one and done" solution, and then my doctor told me that my muscle tone is too high, making the chances of the fissure staying away after injections very slim. On top of that, he didn't even include the fissure treatment in the initial quote, and since he could have easily performed it at the hospital without any reason to be shady, I felt it was better to be cautious.

If you ask me, those injections might be fantastic if you catch it early enough and the tissue isn't overly sensitive, but in my case... it felt way too risky. Honestly, this dilation option you mentioned sounds like a much more solid path forward, and I am genuinely curious to see how that turns out for you. It makes me so happy to see all this information becoming available nowadays, because back when I was first looking into this, it was so hard to find reliable firsthand info. Wishing you the best of luck!

Has anyone here actually tried using those Quest Diagnostics magnets before?

Casey Rogers47 said:Has anyone actually tried those Quest Diagnostics magnets?

Magnets? Please. Just don't bother...

Greetings to my fellow travelers!

I live just twenty minutes outside of downtown Boston, yet somehow I was completely unaware of the clinic > keeps recommending. I really owe him a thanks—for once, there’s actually some hope that I might return to my old lifestyle. My surgery is officially on the calendar for three days from now.

That whole "cleansing" process before the procedure has me a bit uneasy. Is it... well, disgusting?

Thomas King28 said:Hello to all my fellow travelers on this journey!

I live about 20 minutes outside of downtown Boston, but honestly, I had no clue that clinic existed until Michael Diaz4 mentioned it. I really want to thank him. For the first time in a long while, I feel like there’s actual hope that I can get back to my old self. I actually have my surgery scheduled in just three days.

I am a little nervous about this whole "cleansing" process they have to do before the procedure. Is it as unpleasant as people make it out to be?

It can definitely be painful, especially if you're dealing with Stage 4...

Does anyone actually know at what point hemorrhoids go from being a nuisance to a legitimate medical emergency? Like, what are the actual stages?
I’m dealing with both external and internal ones right now, and honestly, the pain is just unbearable. It feels like the external one is the main culprit because it hurts every single time I try to walk.
I've dealt with internal ones before, but nothing has ever been this excruciating. In the past, things seemed to clear up eventually, but this time? I have a feeling my usual over-the-counter creams aren't going to cut it.
Ugh, god, it hurts so much.😁

It’s entirely possible you’re dealing with an anal fissure, and perhaps a particularly stubborn one at that. Tell me, does it actually hurt when you're walking?

I’ve been frantically scouring the internet trying to figure out what on earth this is, but honestly, everything looks exactly the same online.
And I just don't know. Is it actually a sore? Because looking at the photos, it doesn't look anything like them, even though the descriptions match.
The pictures definitely show something like a skin lesion or an ulcer, but mine is more like a little lump, and part of it has turned purple. The cream has started working somewhat, which is a relief because I couldn't even move this morning, but it still feels incredibly tight whenever I try to walk.

And while we're at it, can someone tell me how one actually goes about scheduling an appointment with a proctologist? Do I just call them directly, or am I forced to go through my primary care physician to get a referral first?

My advice? Head straight to a proctologist. If you can swing it, go private—it's worth every penny... I’d personally recommend Dr. Miller or maybe the City Health Clinic over in downtown Chicago! Assuming, of course, you actually live in the area.

Michael Diaz4 said:Magnets? Give me a break, just forget about it...

Look, when your doctor tells you that your hemorrhoids are only Stage I or II—meaning they aren't even worth surgery—and then hands you a prescription for ointments, creams, some cheap pills, some expensive ones, chamomile baths, tells you to stick to soft foods, avoid spicy stuff, and basically gives you a whole list of "lifestyle changes" that don't actually work... well, you start looking for other options. It's only human.
Now this guy with those Quest Diagnostics magnets is out there on TV claiming they'll give you your money back if they don't work.

Michael Diaz4 said:It can be incredibly painful—especially if you're dealing with stage 4...

Up to this point, I haven't felt any pain or seen any bleeding at all—the only thing I've noticed is some lumps during bowel movements. Does that sound like stage 4? Thanks!

Thomas King28 said:I haven't had any pain or bleeding so far. The only thing I've noticed is some lumps during bowel movements. Could that be stage 4? Thanks!

It’s a good sign that there isn't any pain. From what I understand, stage 4 means they don't retract at all. Stage 3 also involves issues with them not going back in. If you're seeing lumps during a bowel movement and then they eventually settle back down, it likely isn't stage 4. In my view, it shouldn't be stage 4 if that's the case. If you end up going to the same clinic where I finally got my issues sorted out, don't worry—you'll be in great hands. Honestly, if you've already had an exam and surgery is scheduled for three days from now, the doctor would have definitely explained exactly what's going on.

Casey Rogers47 said:When a doctor tells you that your hemorrhoids are only Stage I or II—meaning surgery isn't necessary yet—they just hand you a prescription for ointments, creams, some cheap pills, maybe some expensive ones, chamomile baths, a bland diet, no spicy food, and a whole laundry list of other stuff. When none of that actually works, you start looking for other ways to fix it.
This guy talking about those HemoBalans magnets even claims on national TV that they’ll give you your money back if they don't work.

Look, it's obvious you don't always need surgery right away. But over time, things just get worse. Usually, people drag it out until they hit Stage 4, and then they're facing massive problems. That's why I keep saying surgery is really the only permanent, total solution. I remember reading an article by the surgeon who operated on me; he mentioned that women often develop them during pregnancy, and the doctor decides when to operate based on the exam. If it's not urgent, they usually wait until after the baby is born. As for those magnets? It's definitely nonsense. There is zero scientific basis for believing in that kind of thing. We know what hemorrhoids are, and magnets aren't going to do anything for them. People just get desperate and try anything. I was in that exact same spot myself. I even let someone talk me into seeing a "bioenergy healer." 🤦 Of course, it didn't work. I was in such a state of confusion and unbearable, agonizing pain that I ended up seeing a quack. Nothing helped. I actually had to laugh at myself—here I am, a man of science and engineering, sitting there with a bioenergy healer. These alternative methods are useless for acute conditions. Honestly, most alternatives are garbage because they lack any shred of science or logic. But again, I'll say it: when people are in despair and constant pain, and it feels like there's no hope, they reach for anything and everything... even things they know probably won't work.