How can I tell if a fissure is infected please? Ive got pain most of the time now, instead of “just” 5-10 mins after using the toilet, its now constant. Only thing thay helps is being in a bath or lying down - neither of which I can do and hold down a fulltime job...

I think only a doctor can tell.

I'm wondering about infection as well. My pain has decreased from a 9 to about a 4 (plant-based diet, no alcohol, no nightshades, no processed food, nifedapine and calendula compound), but there is some pink-tinged, slightly thickened, yellowish fluid coming from the fissure site. Does anyone know if this could be a sign of wound healing as opposed to an infection...or maybe that's just wishful thinking? I'm trying to avoid going back to the CRS prior to my follow-up at the end of next month because I'm running out of money for co-payments!

I have never heard of a healing fissure doing that, maybe if you had LIS the wound would do that. I would get it checked out by a doctor ASAP, if it is an infection and you wait, it will be much worse. Fissures can get infected but it is not common.

Thanks Thorgrim. I was afraid of that. Maybe the draining is indicative of something more insidious, like an abscess?

It could be- that is why you need to have it looked at, if it is an abscess and you do not get it looked at right away it could turn into a fistula, which you do not want. I am not trying to scare you, just do not want you to go down that road.

Thanks again, Thorgrim. I plan on scheduling an appointment with my CRS on Monday and will report back following the appointment in case anyone else is following this thread.

Good luck!

Thanks for the well wishes, Okaybum! Just returned from the CRS. Doc says the fissure is "looking good" and is almost healed, which is great news! He was able to do both an internal and external exam (ouch!) and determined I have a small "infection, probably an abscess" right inside the anal opening which is causing the pus. And P.S. the CRS confirmed what others on this forum have previously stated: ANAL FISSURES DO NOT COMMONLY BECOME INFECTED AND ANY SIGN OF INFECTION IS NOT LIKELY TO BE ATTRIBUTED TO THE FISSURE(S). New plan is to continue the topical nifedapine (to prevent re-tear of fissure) and treat the infection/abcess with a by-mouth, 7-day cycle of Cipro. In his words, "If [I] run a fever, experience increased discharge or the infection fails to resolve within 7 days, the jig is up and we're going to the OR." Fingers crossed! Ok, I'm off to the pharmacy to grab the antibiotics and purchase a thermometer. Will continue to update this thread. Hope everyone out there is having a manageable day!

So, I went to the pharmacy to pick up the Cipro and the doc had added Flagyl as well. I'm now on 500 mg Cipro BID and 500 mg Flagyl TID. The Flagyl made me moderately nauseous with the first dosing (I took it with some unsweetened almond milk yogurt and fresh pineapple pureed in the Vitamix), but nothing ungodly. First dose of Cipro was right before bed last night and I didn't notice any side effects.