For the past 3 weeks, it’s been pure hell...I haven’t been able to have a BM without pain. No matter what I eat, I get a very hard tip every day or every other day. Miralax keeps the second half smooth but the first bit tears the fissure so it’s always painful. I truly believe my condition is pretty bad and I need to get surgery as soon as I can.

My surgeon is quite a reserved one as ell. She doesn’t like performing LIS on women either, but I think that’s my only option...

Botox is worth trying, some get a repeat soon after the first one wears off giving it more time to heal and I think that’s what I would’ve done if I didn’t fall pregnant.

Strangely enough there was a lady on our Facebook page that got the lis done at 14 wks. She had to wait to the 2nd trimester but all went well

Yea my CRS said she’s done one before as well - 1 in 15 years as a CRS. I don’t want to risk it.

Does the diltiazem cream help you at all? It would at least give me temporary relief when nothing else would. I know some doctors will prescribe to pregnant patients while others won't. It's a hard decision to make since there's not a lot of data with pregnant women and diltiazem, but I've know a few women who have used it without issues.

Hopefully they can think of something you can try while pregnant. I know how terrible that pain is and with pregnancy it's even worse.

The only other thing that slightly helped me was to try and use some sort of lubricant before you use the bathroom. I tried literally everything when I was pregnant because it was so awful. I hope you can find something that will bring you at least temporary relief.

I asked my doc about diltiazem and she said I can’t use it while pregnant. I’m using nifedipine + ligocaine atm.
I tried lubricant as well...even made my own coconut oil suppository...but when it retears, nothing really helped except for rabbit diet and more miralax and warm sitz bath all day :-(
My OB is worried about my weight, I only have a BMI=16 and haven’t put a single kg since being pregnant(now 19 wks), I’m even 1kg lighter due to morning sickness earlier. I need to eat more...honestly I love food, especially unhealthy ones but I just can’t at this stage...I’m sure you guys can all relate to that.
Sorry for sounding so miserable, at least I have a very supportive husband and my mums helping whenever she can. So still grateful of what I have right now.

It sounds like you've tried every possible conservative measure to treat it. I'd honestly look into getting the surgery while in your second trimester. If you're current doctor doesn't feel confident doing it, I'd look into finding another one. Surgeries during the second trimester are typically considered safe, and the actual surgery itself is minor (although still very painful!). You might even be able to look into different types of anesthesia instead of the general. I'm not sure if they ever do it under just a local or a spinal, but those both might be possibilities.

With your current weight and difficulties eating, I think it'd probably be risky to NOT have the surgery and struggle in pain. Obviously you should go over all the options with your doctors, but in my opinion, I think I'd probably go for the surgery. I know how painful these can be, so good luck with whatever you choose!

Also, if you decide against the surgery, maybe you could try increasing the miralax a bit? I typically eat whatever I want and don't have the issues with the stool being to firm at the edge.

I am pregnant as well and had an anal fissure off and on. Now mine is gone and I'm 25 weeks pregnant. Personally, I feel like it is a miracle that it is gone (lot's of prayer). Also, I wash down there always with Aveeno natural skin relief. I feel like it really helps. I hope mine stays away for the rest of my pregnancy and after. I know they are so painful and can consume you. Also, it's so hard to know what to do when pregnant out of concern on how it will affect your baby. I hope you find relief.

Also, I just looked up Nifedipine while pregnant and found this: https://www.drugs.com/pregnancy/nifedipine.html

What does your doctor say about Nitroglycerin while pregnant? May be an option. I was using it up until a few days I found out I was pregnant. I stopped when I was 4 weeks pregnant and haven't used it since. Then, found out I was pregnant at a around 4 weeks and 3 days. However, from what I've researched it doesn't seem to have teratogenicity.

Hi help please, I’ve used nitro before but didn’t work so CRS gave me nifedipine during pregnancy. Nifedipine has risks if taken orally (tablet form), however it is one of common medication to treat severe hypertension in pregnancy. We are using a cream form so that should be fine.

Does yours disappear magically after week 24 or it was already improving? My CRS said it usually starts to improve after week 24 due to high progesterone (it has a property of muscle relaxant) our body secretes to prepare for labour.

Mine was somewhat (not completely gone though) better at 4 weeks pregnancy but I stopped incase I was pregnant and ended up being pregnant. It came back at 5 weeks but improved (been gone) since 9/10 weeks. I am 25 weeks now and it has not bothered me. A few times I have felt stressed it may come back since I may feel a little twinge going the bathroom but it hasn't. I have been using the Aveeno Natural Skin Relief when I shower and I feel like that has helped as well. Also, I always squat (put my feet up on something) when going the restroom and use wet wipes.

I had a miscarriage with our first baby and after that I got the fissure. It was so painful for months but I didn't want the surgery since I knew we wanted kids and the risk of inconsistency. However, it sometimes was at the point I would do anything to not be in pain all day. I was hoping to have it cleared up before I got pregnant again but didn't want to put getting pregnant on hold because of it. For a few months I used Nitro and Dulcosoft (Miralax) but slowly weaned off of it since I knew I was hoping to get pregnant. Also, my doctor said it wasn't good to make your anus think that's the normal poop- the muscle needs to stretch. However, at the time I do think it was important to use at the beginning to start the healing. It did hurt some when I weaned off but I am very grateful it never came back full fledge. I feel very blessed that it's gone and so hoping it stays that way. I do think pregnancy should help though since we have more blood flow down there and more blood flow helps things heal. Also, I will say I prayed about it a lot as well and my mother was praying for me too. From what I read online there was little hope once it became chronic but I hope this gives you a little. I take nothing now to help me go the restroom and have not altered my diet and do not use any ointments and it is gone. I never strain either even if I feel a little constipated. I just sit there and relax.