Hey all!
I just want to quickly share my success story in the hopes that someone who is also suffering can maybe find something new or find assurance in something they're already doing!
Firstly I want to say: I seriously absolutely cannot believe I am healed. From my reading on these forums I am not alone when I say I fully, 100% was convinced my fissure would never heal. I could not imagine a time when this problem would go away - I felt like I had tried everything and then more of everything. I talked with more doctors about my rectum than I thought I ever would. And the amount of them that recommended the same thing was infuriating! I remember I met with a GI who after listening to me detail my symptoms recommended nitroglycerin and sitz baths - which I had already been doing for weeks.
I say all of that because I want whoever is reading this to know that this can be healed. My journey of hell lasted 6 months. I know for many folks on here it's been years and years. I of course do not want to minimize anyone else's fissure especially if they've been caused by something more serious than mine. I don't want to make it seem easy or anything like that - this shit is hard, pun absolutely intended. But I believe there is light at the end of this tunnel! (there's another pun in there I think)

I digress.
I thought I'd just jump straight to the "solution" that worked for me, and include what caused my fissure, etc in the comments if necessary.


So Step 1: and these are going to be in no particular order): Eat fiber. Nothing new there. I found that fiber supplements actually made the problem worse. Because supplements draw water into the colon, they have the tendency to also increase their size. This is no bueno. So what I did, and I really think this is the most important thing, was kept a food journal. I wrote down everything I ate every day and realized how little fiber I was eating. I stuck to a very, very, very basic diet of turkey burgers (I used to be vegan so I wasn't a big meat guy anyway) and enough fiber in each meal to get me to 30g of fiber by the end of the day. This is mostly kale, broccoli, green beans, cauliflower, tomatoes, spinach, asparagus and raspberries and dried apricots. That's literally all I ate for about three weeks. Raspberries by the way have a ton of fiber, they're delicious and they can really get you moving bowel-wise.

It's not very exciting, but that's what it takes to get an adequate amount of fiber. Did I leave meals not feeling 100% full? Yes. Did I go to bed not totally fully or even kinda hungry? You betcha. Could I have eaten maybe a little bit more protein or something filling? Maybe, but I'm glad I didn't because my fissure is healed. Which is why I want to point out - I cut out most grain-based carbs and all gluten entirely. I didn't eat potatoes or anything starchy either. I don't think those were necessarily the key things to eliminate, but I know for me gluten and starch can bind me up. So I recommend cutting those bad boys out and sticking to just protein and just veggies. I'm dead serious I cannot recommend this enough. Count your fiber. Stick to it. Don't cheat.

Step 2: I also had a tendency to eat at night. I'm a proud member of the nervous eater camp, always have been. Except at night that goes away and I can eat anything. So I cut that out. This was hard, but I truly think this was 30% of the battle. I mean think about it; you eat stuff at night, your system has slowed down, it's now sitting there, not moving for 6-8 hours. Forgive me if this is common knowledge, but maybe I'm just not very smart and this was a revelation to a dummy like me. So step 2: dont eat at least 3 hours before bed. I stopped eating like 6 hours before bed. Do not do that. You will be hungry. You will be cranky in the morning. 3 hours should be fine.

Step 3: Nothing new here, but take sitz baths after every bowel movement. This is obviously not novel, and more obviously only possible for some, as I don't know many offices with bath tubs. But if you are able to access a bath after BM, utilize it! With your high-fiber diet you're going to be going more (hopefully). You will have a bunch of awesome veggies and no oil to slow your system down. Sometimes I would BM and be like "eh I probably don't need a sitz". I was wrong. Do not be like me at that phase of my journey. Be like my in the next phase where after every BM - and at times that was 3 times a day at 10AM 3PM and, like, 12AM I drew a bath. Throw some epson salt in there. Embrace self care. I started watching a documentary on the Roosevelts while in the tub so I had something to look forward to. Find your Roosevelts documentary and soak your ass. Do. Not. Skip. Sitz. Baths.

Step 4: This again isn't novel, but after every BM I would put some witch hazel on some toilet paper and dab the area where my fissure was. Now, let me be clear, my fissure was not superficial - it extended into my rectum. So this only works for the external area, but it still works. Again I did this after every BM. Once again, do not skip this ever. You may be noticing a theme here: do not skip or have cheat days or cheat BMs. I tried cheating and it just restarted my journey.

Step 5: This step is smaller, and more fun, and honestly it's not a big deal but I just wanted to include it - I started drinking these probiotic sodas called Obi. They're somewhat hard to find but some Whole Foods or Vons or health food stores have them. They're so GD good, they have very very little sugar, and they're probiotics. Of course you could get this in a capsule, or from kombucha, but I believe in a treat and honestly, probiotic supplements make my stomach upset. Obi did not for me. Get you an Obi. It bears mentioning the oft-used "there's more nerve endings in your gut than your brain." I obviously understood that to be true, but I guess I didn't realllllly believe it. But when you start taking care of your gut with things like probiotics, it really does help ease some tension there. You really notice this when symptoms start to alleviate and it's kind of like a cloud is being lifted and you're like "wait this is what normal feels like..."

Step 6: Go on walks. For some people reading this, you might be like "I get excersize regardless, I think it's working how I do it". My response is keep doing that. All I know is for me, I used to run every single day, and it didn't help. So I started going on three walks a day. Not long, but enough so I knew I was getting my blood pumping which is, as I'm sure we all know, very important for fissures. Especially if you're in quarantine and you're sitting all day waiting for quarantine to be over. These also help with anxiety and stress (no surprise) which I have in general, but I, as I know we all do, felt soooooooo much stress and anxiety from fissures. I'll get into it more if you're interested in hearing my fissure backstory, but as we know, these things are kind of a self perpetuating cycle, where stress makes fissures worse but fissures cause stress when they don't go away and so now fissure is worse. Additionally, when you walk and walk for long enough you can really feel your lower half relaxing, which brings me to

Step 7: Another not novel tip, but one that really worked for me: actively relaxing your rectum. Like I said, I'm an anxious person, so I'm always noticing a clenched fist, or a hunched over posture while driving, or tense jaw or, more relevantly, a hermetically sealed sphincter. This obviously prevents blood flow from reaching the area which is bad because it prevents oxygen-rich blood from healing the area. So I kind of just developed a system whereby I was constantly checking in with myself asking "hey are you clenching?" and then I'd relax it. Frequently I'd find that literally 60 seconds after I unclenched I was clenching again. That's fine though, just gotta keep unclenching. You may be surprised at just how tight you're clenching and how much checking in can help relax the area and your brain.

Step 8: Have I mentioned I'm anxious? Well that anxiety also led to a bit of paranoia wherein, at one point during this whole journey I was convinced my water was to blame. There's actually some truth to this, because in the part of California where I live, the water is how you say... dog shit. It tastes bad, it's overly-treated, it never helped me feel hydrated. So I bought a big blue 5gallon jug of water and a stand and every week I filled that thing up with alkaline water specifically and drank exclusively from that. Not only did it make my stomach feel better in general, I was noticeably more hydrated. And I will be that guy and say "make sure you're drinking enough water." I was peeing all. The. Time. I brought water everywhere - when a glass or bottle was empty, I refilled it immediately. Do yourself a favor and if you live in an area where water is kinda meh, find a water store and get some alkaline water.

Step 9: This is a quick boring one we all know: get rectiv. Use it externally, I think you can also use it a big internally (I know I sure did). That definitely helped no doubt, though I think at a certain point, my fissure was so deep, medicine couldn't really get in there. My GP also pointed out that our body evolved so that after a few centimeters-ish you don't feel pain in your colon/ intestines if the issue is a fissure. So while you may feel pain in your rectum or sphincter and focus your efforts there, the problem actually might be deeper, which is where all the other non-rectiv steps come in.

Step 10: If you haven't get yourself examined down there. This started for me because I thought I had a hemorrhoid. So I was doing things to treat a hemorrhoid. Now let me be clear - at a number of points during my journey I did develop hemorrhoids as a result of straining etc. But when I went to a doctor who confirmed that this was a fissure and not a hemorrhoid, it made the problem easier to solve. Also, I don't know who needs to hear this, but: yes the experience is odd, yes it is worth the clarification you get.

Step 11: Vary how you sleep. Now you may be thinking: "But OP, I was told to sleep on my side or stomach" and this is true I think. But what I noticed is that some nights, sleeping on my stomach a couple days in a row actually kind of put pressure on my lower back and aggravated the issue. Then I slept exclusively on my sides, and that definitely helped, but for some weird reason it contributed to my having some unsettling sleeps (I think this was because I was kind of holding a fetal position which created some physiological stress). So I recommend varying how you sleep - do a couple nights on your side, a couple on your stomach, and yes even a couple on your back if you can. I am a back-sleeper anyway (we do exist, we are not insane but we do have fissures, just like everyone else) so I was relieved to find myself able to return to my preferred method once or twice a week with no issue. You might be different, so again, do you.

Step 12: Some people use a squatty potty. I didn't BUT what I did do was kind of go on my tip toes while on the toilet, and made sure to sit straight up. This was important for me personally because of where my fissure was located, and the stress that was being put on it based on my posture. This might help you, it might not, but it can't hurt!

Step 13: Another non-original one here, but get yourself some Vasoline, the travel size is fine, and before every BM just lubricate the area. This helps even if your BMs are large and/ or hard. I've been in the clear for some time now, and I still do that once in a while if I suspect a harder BM.

Step 13: IF these steps work for you do them until you start having pain-free BMs. It will be some of the most relieving moments you will ever have. I no-joke congratulated myself and may have almost cried when my BMs started to be pain-free. But a mistake I made was after one or two days of painless BMs, reverted into my old ways. Do. Not. Do. This. I recommend marking the day your first pain free (or noticeably less-pained BM is) and continuing what you're doing for no less than one week. Honestly, go as long as you can. As I write this, I've been in the clear for around 3 weeks, maybe more, and I still eat all of that fiber, don't eat grains and drink water and go on my walks.

So, that's all. It's alot. I cannot reiterate enough how blown away I am as I'm writing this that this problem has resolved. Again, I really didn't think I would ever feel "normal" again. But these steps really really really worked for me. And if you're wondering how long I did them for, for me it was about 3 weeks, maybe. But like I said, I kept doing them even after my symptoms where gone.

Be well, folks. Don’t give up the fight. Don’t forget to be kind to yourself. Don’t doubt that this, unlike our hard poops, will pass. You can do this!!!!!

Congrats! So happy that you were able to heal your fissure and it looks like you also picked up some good new habits in the process.

Other forum members though, should first check with their doctors before making treatment changes.