Hello Everyone,
I'm new to the forum but not to anal fissures. I'll try and keep this brief. I got my first AF after my first son was born in Jan 2011. It was a difficult birth, forceps assisted and 3rd degree tear. I went to my family doc a few weeks after because of the pain during BMs. She actually diagnosed the fissure and gave me diltiazem to apply to the "affect area" and told me to up the fibre and take colace. I didn't understand where the affected area was (since my entire bottom was a mess) and actually applied the cream to the perineal tear instead of the AF. Regardless, the pain during BMs went away in the next few weeks.
When I saw my OB 6 weeks post partum she told me to stop with the diltiazem because I didn't have an AF but my perineal tear wasn't healing so she cauterized the granulation tissue. All seemed fine.
Six months later the AF came back... sharp pain and blood with a BM one morning. This time I could tell the pain was anal and I googled diltiazem. I realized I wasn't taking it properly and I in fact, did have a AF. I started the diltiazem again, 3 times a day. Started back on colace and 3 sitz baths a day. My diet was perfect. I did that for 2 months. Then slowly weaned off colace. I continued a perfect diet with lots of fibre and water and was fissure free for 16 months.
Then I got pregnant again in Nov 2012. I was scared about getting another AF so I tried to eat lots of fibre/water. But unfortunately I got severe morning sickness (hyperemesis) and ended up in the hospital with IVs and medication. I couldn't keep anything but crackers down. I, of course, became constipated and the AF returned.
Since I couldn't take dilitizem while pregnant I took restrolax (miralax) my entire pregnancy. That kept the pain way. My birth was okay except for an episiotomy. But I didn't get constipated. I stayed on mirlax until the episiotomy healed then started weaning off it. Then just before Christmas.. BAM! the AF returned. I started taking the dilitazem again but I fear it might be expired. I'm still taking miralax daily but my BMs are pretty loose. But if I try and decrease the dose it is painful.
Anyway, I have an appt with my doctor this afternoon. I'm so fearful of what's to come. It seems like diltiazem isn't working. Everything is ok while I'm on miralax but I can't take that forever. When the fissure is "active" I only feel pain during the BM. I have read what a lot of you are going through pain-wise and I'm not at that point. But I'm also afraid it will get worse.
I'm thankful I found this forum. It is hard to talk about. Only my husband knows what is going on.