I have suffered from a chronic fissue. Clearly I have experienced severe pain and bleeding, especially after BMs, but my predominant symptom was itching-all day, all night (often waking me). I used the recommened sitz baths, wet wipes after BMs, every cream I could think of, nitro cream with some success, then needed a hip replacement and narcotics for several months pre and post op....so you can imagine that progress went backwards. I do not suffer from constipation, rather I had frequest BMs (10-12 per day). I have Celiac Disease so have been strictly gluten free for about 5 years.
Things that seem to be working:
1. Grain free, dairy free diet. I eat lots of protein and veggies. This is very similar to the "Paleo diet". I see a nutritionist who recommended this. This reduced the BM frequency and made my BMs more solid. The itching improved quite dramatically. I also lost 23# after only 3 months. I am also taking a number of digestive supplements recommended by the nutritiont (but the diet made the biggest difference).
2. Probiotics taken once daily. I use Florajen3. This improved gastric motility.
3. Just this past week I stumbled upon a really important comfort measure that seems to be healing the fissure. I made my own essential oil suppositories. Not only did these lubricate my BMs, but it improved/removed my itching and appears to be finally healing the fissue (in only about 5 days of use so far). I searched on the internet and found a site that showed how to make these and made my own receipe.
My receipe: Essential Oil Suppositiories
Get a really small ice cube tray-I used one from a recently purchased minfridge. If not, use a regular size and you can cut each suppository into 1/2 or 1/4 size.
1. Melt some coconut oil and pour into the ice cube tray. Even with the very small tray I used, I only filled each compartment about 1/2 with coconut oil.
2. I used Young Living Diagize essential oil. 1-2 drops in each "cube." You can also use Diagize topically for GI disturbances. It is a great blend to have on hand! (I have no relationship with this company-I am just a happy consumer of their products)
3. I added one capsule of vitamin E oil and one capsule of Flaxseed oil to each cube. I just broke the capsules and squeezed them in.
4. Stir around to mix. I used the tip of a table knief.
5. Refrigerate. They harden really fast.
6. I cut one half of each "cube" with a butter knief and inserted it as a suppository.
7. So far I have done this for about 5 nights. The impact has been so huge that I wanted to share my success. It lubricates my BMs and has really removed the itching! Warning, the first one I inserted, increased the itching, but stick with it.....after that it has really resulted in improvement. You could do these more than once a day also. The nice thing is the suppositories are not messy following insertion!
Let me know if you try this and it works for you. Best wishes for healing and comfort! LH