I have been viewing the messages of this community at a distance for a while as registration wasn't permitted. I've leafed through alot of the wealth of information and am very excited at the idea of sharing ideas on management of this irritating condition.
My story is a relatively new one, in that I've only really been suffering for about 5 months (only :roll: ), but management of this problem has becoming an annoyance on a daily basis. I was getting the classic characteristic 'glass-cutting' like pain when the time of evacuation came and followed by the obligatory blood stains. I went to my GP and received a ghastly digital rectal examination and then a diagnosis of a fissure.
I was prescribed Fybogel, which is just psyllium husk which i believe to be Metamucil in the US, and I started to eat All-bran (the basic kind, like eating shreds of cardboard) for breakfast. My stools became regular as clockwork and soft in nature which started me on the right path.
I went to a wedding and strayed from the path of bran-like virtue and then that was it - I haven't been able to restore my regularity properly since. I'm a small guy and I try to eat at least 25g of fibre a day and I cannot regulate myself to at least once a day. I don't really have that much room for experimentation given that the fissure wants to rear its ugly head whenever the error bound is exceeded.
I stopped taking the psyllium, it was either doing nothing at all or making the stools somewhat drier. It just didnt seem to work.
I tried initially using 0.4% GTN ointment which yielded the effect of being beaten around the head with a baseball bat very shortly after application. The doctor tried to convince me to give it another go, even if in a smaller dosage at a time, which I have done and have managed to keep that up.
I really am not sure of what is the norm here, so I'll be glad to talk and get some more information on this worry-some issue.
One thing that does concern me is that my anus (to the touch) is always quite tense, and that is without having to insert a finger. The tension is always palpable just by inspection around the area and I can feel the uniform tense ring that is my butthole on a consistent basis. Is this normal for sufferers or should I be more concerned. My doctor didn't express any explicit fears after administration of a digital rectal examination.
Sorry to ramble on, but I eagerly await trying to get this under control and I wish to conference about it with much zeal!
Kudos to the creator(s) of this board!!
With regard.....
Brendan

Welcome dear Gone_Fissuring :) (Fantastic username !)
Brendan :)
Sorry to hear you are suffering too
I am glad you have preserved with the ointment from what i have learnt here the headaches do get better with use, Someone correct me if i am wrong ! :roll:
You could try the Anoheal: Diltiazem ? I never got any headaches with this and Diltiazem seems to be more tolerable i think, i am from the UK too , and was given the anoheal and movicol, maybe the movicol would work better for you as it makes the stools softer, whereas the fybogel adds bulk and if this is not consumed by plenty of water it can cause problems, i didn’t like the fybogel , i use Regucol- psyllium from holland and barrett, has the prebitocs too :)
You will find heaps of really good information here, i am sure it will help, the search function at the top is a great tool too :D
I wish you well

How long have you been on the GTN? You should be able to tolerate it more and more with the passage of time and it will take a few weeks to begin to reap benefits, as would the two BP creams.
Yes, the anal tightness is absolutely par for the course, it's one reason your fissure won't heal...the blood flow to the fissure site is constricted. The GTN should help correct that, to some degree.

Welcome to the Tight Ass Luck Club Brendan!
i think you will be okay with a tight butt and nothing to be concerned about.
it may be an indicator though that you need to work on destressing and if you are familiar with yogic breathing, to practice that while going to release your BM into the wilderness of the sewage pipes via the toilet.
read up on my link below (well it's not my weblink but a resource in the UK that has some great basic information) about macrobiotics.
combining macrobiotics with some yoga and keeping your stress levels low and body very flexible, will go a long way in helping you heal.
welcome again.....
happyass

Welcome Brendan! Sorry to hear you are a fellow sufferer. It is like one day you are going along your merry way not even knowing there is a world of anal pain and then the next you have entered and the door shuts behind you with a bang.

But it will get better. I had a fissure that I treated with anoheal and 3-4 sitzbaths a day. Diet is pretty important as you are finding out. I am on a steady diet of all bran buds and take a glucomannan and probiotic supplement that seens to help. Also, stool softeners can be very helpful. I take a little miralax and MOM every day. I also recommend omega oils like fish or flaxseed oils which help to lube the stool for easier passage. If you can pinpoint the fissure you could try to put some petroleum jelly or A&D ointment to cover it up before you go to occlude it so it doesn't open up so much.

Welcome again!

Thanks for all your input guys! I'll keep an earnest community diary to tabulate the events as the epochs of significance occur.
I thought I made a response post to your comments before but I guess it didnt make it past the review stage before I switched off my computer.
I've been on the GTN ointment for about 2 weeks and the side-effects are becoming less severe; the drop in blood pressure is noticeable but the headache is becoming less throbbing. I am very diligent in this regimen so I hope it'll pay off.
I actually got the call [euphemism for a BM] (hooray!!) as I was writing this message and it was good! I notice that after a BM my sphincter is definitely tighter and I can feel the entire ring more so than ever. Does anyone else experience this phenomenon?
I'll be headed to the US soon; can anyone recommend something I can pickup at CVS or Walgreens or something whilst I'm out there that might not be available here in the UK. Anything I can take to aid a more predictive and successful supplement would be great.
I'm very, very glad this community exists, although I wish there were no need for it by the same token.
-Brendan
Edit: I am also introducing docusate tablets into the mix. They seemed to have done some good so far. 2 (good) BM in 2 days - that can't be bad.

Lecia wrote: I am on a steady diet of all bran buds

How are these in terms of taste and texture. When I started eating 'regular' All-Bran (the shreds of bran) I was full of a zeal and enthusiasm in hope for positive things; my stools softened and regularity increased, albeit short-lived. However, by the end of my relationship with allbran I suffered severe morning despair, in that the idea of eating what seemed like a piece of shredded shoe was too foreboding.
Are the 'buds' any better? I'd like to give them a shot, they're very rich in fiber.
Thank-ye
Brendan

for your CVS or Walgreens visits in the US, pick up some Magnesium Citrate fluid - it comes in cherry or lime flavor - and about 12 oz....
tasty when cold and helps to keep you regular in case if you need it.

If Docusate works - stick with it since it is a stool softener and not laxative like Milk of Magnesia. I use Metamucil 2 times a day - orange flavor. If you drink it immediately it has a texture of a water LOL, but if you wait it will start to form a gel. ALWAYS make sure to drink a LOT of water with any fiber - only that way it can work properly.
I guess that most things that you can find here you have in UK but under different brand name. The only thing that they offer here and not at your side of the pond is Botox, I think, and that unfortunately you can not buy in a drugstore
Don't forget to eat a ton of fruits and veggies and avoid meat, milk and cheese as much as you can.
Best of luck !

Thanks for the info guys.
I will quote you what one of my GP's said to me, which left me a little awestruck but here goes. He said that it was okay for me to take up to 6 or 7 sachets of Fybogel (Metamucil, psyllium husk) per day, with each sachet being 3.5g in content I believe (a standard 'hit') followed by plenty of water.
I took 4 in a day after gradually building it up and I usually drink about 3 liters of water per day; I'm constantly going for a leak. I didnt want to try 6!!
Any thoughts on this? This is word of mouth from my GP.
-Brendan