After many years of having a lot of problems with mainly itching and burning after defecation, and wrong treatments like nitro-glycerine creame; then - I forgot the name of the method, but it included 4 injections / every 3 weeks directly into what the doctor thought were mildly enlarged hemorrhoids - later on I learned that this only made the things worse; then I was supposed to have a surgical intervention - one Dutch specialst wanted to do a dilatation of the sphincter, then another (very famous) specialist in another country promissed total cure by doing the classical sphincterotomy (I did not accept any of the latter two), finally another Dutch doctor (who unfortunately passed away few years ago) was the only one who was: 1) capable of doing an examination without hurting me (on every examination done earlier there used to be lot of bleeding and, in fact, the worst problems I always had after an examination,
2) explained to me that what I have is probably some kind of a problem with blood vessels in that area, which in combination with all the preavious treatments and creams that I have used, plus possible wrong communication of the sphincter and the vegetative nervous system that partly commands its work, plus skin problems - my problems were in the area before the sphincter, but also a bit deeper - was causing what I have, and that was described as superfficial, fine fissures that occur ever time the sphincter is engaged and then due to contamination of the area with fecal remnants, there is itching or pain. Such a condition is a contra-indication for a surgical intervention - it could have made things worse, especially after some time in the future (that doctor was also a surgeon, but his policy was to avoid an intervention with a knife as long as it is more beneficial for the patient not to have it. The doctor in that other country simply wanted to take money from me, to do an intervention that might cause other problems (like fecal incontinency, sooner or later), and I would have paid for that a lot of money. Most likely, I would be happy in some time after the operation - the 'final' doctor explained to me, but on the long run that could have been disastrous. The dilatation method should be even worse and he told me that he was pursuing its ban from surgical practice, for same reasons (over 20% of patients would develop incontinency).
3) I was advised to undertake the physiotherapy of my pelvis musculature - which I never did because at the time there was only one therapist that had been recommended, and it was simply impossible to get to him, and the other reason is that the same Dutch doctor advised as an immediate remedy washing of my rectum after defecation with lukewarm water injected via the pear-like rubber baloon (don't know the name for the thing).
I cannot explain the feeling that I had when literally after first use of that method I was able to have a normal day. After many years of every day having pain or itching, not knowing what to eat (I was eating too much things like plums etc, which is also not good for this situation) I was also given one cream that did not have any active ingredients to apply after washing - I was told that surgeons use that cream to apply between different tissues in final steps of a surgery that cuts through different organs / types of tissue, and it is only a desinfectant; have to check for the name - I am not using it for years.
It is important to say that the examination by the Dutch proctologist came only after 10 days since the previous examination where I had been badly hurt, and when the other proctologist prescribed sphincteroctomy - and the Dutch doctor was very determined that there was nothing that would suggest that there had been a recurring anal fissure, or hemorrhoids that should need attention. He immediately recognised the area that had been treated by those injections, and put a comment that this has probably not been necessary either, but should not be considered as critical for the present condition. Also, he explained to me that to a certain extent, lower grade hemorrhoids that are not inflamed are good and help the situations in which possibly the incontinency could occur i.e that they help sphincters to do their work. I fogot to mention that after that 4th injection (see above) I developed a big problem in the form of a huge outside hemorrhoid and was totally devastated after in two weeks, and with the use of certain french medication it finally went away - I was just told that "this sometimes happens when this method is applied, and should be considered as an accute probelm that will leave no harm behind it when it is gone..." When I say that to receive those injections I hade to travel over 200 km to Belgium, and then see no improvement (I was always told, it will be better when the whole therapy, i.e. after 4 injections, is done...) one can imagine my state of mind when finally after the last injection I was in the worst condition ever... Fortunately, that thing never broke, I was eating bird's food and my stool was extremely soft (which is not good for such conditions...) until it finally went away
All this was 6 years ago. I am 49 now. I never had problems like constipation or the opposite, so I can say that I had a normal work of my bowels. My problems started more or less 30 years ago - with eating bad food i.e. a lot of meat, chocolate, etc, having hard stool, blood after defecation and itching - but it would come and go when I was younger, and in between I would have no problems. Now, (because nobody in my family has or had such problems) I think that those problems and the situation as a whole is the product of my rowing - I used to practice rowing, which is extremely heavy and demanding sport, and especially that area (rectum) is under stress under heavy rowing practice load (and my constitution was more of astenic type - I never had too many muscles, but had high level of endurance and was in good condition). I had a surgery of varicocoele on my left side when I was 29 (and I had another, major surgery, 10 years ago when one kidney was removed due to tumor. After that, varicocoele developed on the right testicle, but doctors say it is nothing to be worried about.
Another, skin doctor, advised me to stop using the rubber pear baloon thing and instead, whenever possible, to wash myself with water, but then to avoid having the area stay wet. He advised drying the area whenever possible with a hair dryer. At work I have a plastic bottle with that nozzle-type of cap, and I use it to wash myself (without injecting anything inside). So, since that time I combine both methods - at home still I mainly use the more radical washing, which is 100% efficient and I will never have any problem, even if the consistency of my stool is harder, when there may be few drops of blood ocassionally also. I use no creams or any other thing (well, only on few occasions in these last 5-6 years I have used hydrocortison cream around the anus and 1-2 mm inside), soemtimes I can survive without problems without any kind of washing, but in most situations there will be certain itching or burning if I don't wash myself immediately after. Eating too much dairy products, especially butter, or olive oil - which I like and could drink in small quantities, chips - could provoke eccema i.e. seborrheical reaction on my skin and in that rectal area - when I am disciplined and do not consume those articles, the situation is definitely much better. The need to use the cream i.e. the problems would become stronger, after eating few days in a row a lot of dairy things (I like milk, for example, and could dring 1 liter of it very easily, with some cake or whatever, and due to my constitution, I have no visible problems like fat etc). If I use the cream it is only as a remedy to itching, 2-3 days in a row, then I stop, because cortisons are not good for that area and should be avoided by all means.
Anyway, since the discovery of that possibility to wash that area after defecation I can say that the quality of my life improved 100%. Later on I had an examination by another Dutch proctologist who advised no special change in my habits - the washing cannot harm, eating flakes is also only good. I keep the preferred consistency of my stool by consuming a soup spoon of raw flakes more or less 2 - 3 times a day, after meals, and can eat anything without fear that hard stool will hurt my rectal area.
Are there any other opinions about this i.e. reasons why I should avoid the use of pearlike baloon and washing in the described manner too often, as well as eating raw flakes. Is there any suggestion on how to improve the quality of the skin/rectal tissue and prevent microfissures that create basically the whole problem? Unfortunately, I sit too much at work and in a car, so this needs to change first... Sorry for the long post, but I thought it is good to know more details for people who can possibly recognise this problem with themselves and compare it. Thanks.