I am 20 years old and already have an AF!!! I have had some minor pain within the last 3 months but didn't think anything of it so a 3 weeks ago I went to my primary doctor and she told me to take colace, fiber, water. Pretty standard stuff. Since then, I have really had no relief. I find my self avoiding BM's because I'm so scared. So a week ago I took a few laxatives, which worked, but caused my great pain. It seems like even liquid burns when it's coming out. Two days ago I became constipated, once again, and took 2 laxatives. WHICH DIDN"T WORK! No BM for me. So today, at my wits end, I decided to take an enema that my mom had bought for me. What a mistake. I have never felt so much pain in my life. A 10 is the only way to describe it. Every time any sort of substance would come out I would go crazy. Bawling my eyes out at this point. NOTE: i already have a low tolerance for pain but this was so over the top. So now I"m stuck, the enema is forcing me to go, but I am scared to death to let it out. So finally I did, got a lot out, along with A LOT of blood. I'm really scared now. I took a sitz bath and my parents did some research for me. This is the only site that has made me feel better. Although it makes me sad that some of you have had AF's for 6 years :( I'm 20 and I don't want my life to revolve around this. And now I don't know where to turn. Don't know what medications to use or what to eat. I'm so stressed and sad! Advice please!!!
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Hey Rach, hang in there...
You're in the best place for help and advice.
You've done the right thing by visiting the DR, and the fact that you're taking stool softeners and water is a great start, you will also need to adjust your diet accordingly. Have you asked the DR about creams/ointments that will help with healing and pain? If your fissure is only 3 months old then you have a good shot at healing it with ointments like Nitroglycerine or Diltiazem, they're definitely worth a try at this stage.
You describe the pain as a 10 which we all know too well, we know how you feel and know how much it can impact your life, it's perfectly ok to cry, I know I have plenty of times when my fissure has been at it's worst, YOU are not ALONE.
As mentioned, I would make some changes with food, you will need to cut out all dairy and red meat for a start, go for high fibre foods like boiled or steamed veg, brown rice, wholemeal pasta and bread (without seeds), stay away from sweets and cakes, eat soup every day and drink at least 1-2 litres of water per day, these are just a few suggestions to steer you in the right direction.
Medication: Firstly I would ask your DR for Nitroglycerine or Diltiazem ointment which will help promote blood flow to the area, as for stool softeners, personally I would ditch the colace and try something with clout, Movicol (UK) Miralax (US) just to get things moving a bit.
Good Luck, keep us posted on your progress.

What great advice and I'm so sorry to hear that you are having problems at 20; however, as I look back, I think my problems initially started my junion or senior year in college. I remember going to see the doc who did a rectal exam and said I petechiae (pin-point skin hemorrhages)...small amount of burning and blood - that was my first experience and constipation. I think from there, it's just worsened over my life-time.
I'm now 34 and really been okay with constipation- it would come and go, but I had a bad diet...just ate and drank and did whatever I wanted in college and in the first few years having my first job.
Stevepain gave you great advice. Nip this in the bud right now. No alcohol (not saying u drink now, but if you do, stop)...no junk food, don't switch to all fiber right away, go slow, because if you jump right into tons of fiber, your stomach will pay the price. Go slow with the fiber, spinach, broccoli, lentils, brown rice..and over a week or two, gradually add more and more. Water is so important, regardless of coffee and diet soda that are so dehydrating, drink more water.
I'm in the US and my colon and rectal surgeon (CRS) has always since 2006 prescribed niphedipene cream...it has lidocaine to numb the pain and also a gel to help heal the fissure. If this is your first fissure, you add fiber and water and use that cream, there is a very good chance that you can heal and not live with pain for a long period of time and avoid surgery, but your diet must be assessed I think.
I was your age when my first troubles started... you came to the right place. Hang in there, get into a CRS right away, get the diet changed, and get some cream, hope you feel better soon.

YES! I second the suggestion to find the right type of ointment--some doctors are so dumb about it. The first doctor I complained to sent me home with steroid cream, which isn't going to do anything. You need nitro, nifedipene, or diltiazem. If those don't work, don't hesitate to see a surgeon. People don't need to suffer for years like I (and makem3) have. And try taking Miralax. It works miracles for a lot of people, although I still don't know if I'm 100% in love with it. It keeps fissures at bay but just makes me feel weird in general. But YMMV. Although I'm not the best one to preach about the alcohol thing, having just indulged in an entire bottle of wine myself, it is very important to stay hydrated. Sometimes, though, you just get so sick of the pain and stress, a good drinking binge seems like a good idea (not that it is, YMMV)!

I'm so sorry you are dealing with this! You will get some really good advice here.
As already said diet is really important for managing pain and healing. I agree with Steve on ditching the colace and getting the miralax, movicol. Drink plenty of water and avoid sharp foods such as chips, nuts, popcorn as they can scratch coming out. Also as mentioned dairy, red meat anything that can make stools firmer or constipate. I know it's scary to have a bm when it's going to hurt but it's really important not to hold your bm's and become constipated. If you can get one of the ointments from a CRS , they will help to promote blood flow... Take warm baths for at least 20 minutes to get the blood flowing down there and hopefully help with the spasms.

psss....
Don't use anything for hems down there. It's useless and can thin the skin. Maybe try some vaseline or A/D ointment until you can see a crs and get the diltiazem or nitroglycerin, etc....
I'm so sorry, I have a 20 year old daughter. Unfortunately fissures don't pick a certain age group. Even babies can get them. I wish we were better educated on them and maybe could prevent it from happening to some. I know mine was caused by poor eating habits and getting constipated. If I had known what I know now, I would have ate my veggies although everyone who gets a fissure isn't always bad eaters.
I hope you get this taken care of soon. It sucks and I know how scary it is. I had no idea what was going on when I first got mine....

Thank you so much for all of the advice!! I can't tell you how nice it is to have all of you reply!! I'm so glad I saw this site. I laughed when I started reading some of the posts because my mom kept asking me "what does it feel like?" and I could not pin point it! But "shards of glass" as you all say is DEAD ON! haha! I've literally taken notes on everything you've all said and my sweetheart mom just came back with miralax, vasaline, baby wipes, and an actually sitz bath that attaches to the toilet!! Never thought I'd be so excited for a sitz bath! Today was very scary for me, by far my worst day, and I have to say the whole thing is a bit disheartening. My friends can eat whatever they want and now I have to constantly be aware of my diet. It stinks :( BUT, in 20 years I'll be healthy and ahead of the game right?? I'm a nursing student and I work in an oncology unit and it makes me feel lucky every day that I am so healthy. I feel like we should all feel lucky it's not worse.
...But I'm certainly glad I have this site to complain on
Thanks again! I will certainly keep posting the progress and hope your all feeling well <3

Hi Rach,
I don't have anything to add to the advice already given, as it's all excellent advice. Just wanted to say WELCOME!
& HANG IN THERE!
By the way, you're probably right ... having a young body will likely help a great deal!
sphinc

Hi everyone!
No change here really but I have new questions. I called me doctor for some pain medications and an LPN called me back and told me she didn't want me to go on pain medications. She wants me to try an over the counter cream called anusol? Have any of you heard of it? I don't know if I want to waste my time with it.
Also, I haven't gone since Saturday. Not because I haven't tried but I have absolutely no urge. And the longer it goes on like this the worse it will be when I finally do go. I hate this.
Does this happen to anyone else? I want to go to see a gastroenterologist but I'm not sure what else he is going to tell me. Advice please :(

Hey there,
Anusol is for hems, not for fissures. I really don't understand why so many doctors prescribe or tell us to use them. Both a GI and CRS told me not to use it at all for a fissure. Even a CRS has told me not to use it for hems. It can ulcerate the skin if used as long as two weeks.
I would call your doctor back and tell them you want one of the creams for a fissure like dlitiazem or nitroglycerin, nifedipine and you don't want creams for hems!
You may want to see someone who specializes in fissures- a colorectal surgeon. Most other doctors are clueless on how to take care of fissures.
Have you been taking a stool softener/ eating plenty of fiber with water?
Try not to sweat the bm coming slow... Maybe you haven't ate enough to get the bowels moving. It's really important to get your fiber through food/ supplements or whatever works for you, so your bm's will become regular. It can be a challenge to figure out what works ,and hard to advise on since we're all different, but this will be the key to healing and minimizing your discomfort with your fissure.
I personally wouldn't use the anusol or anything else that's for hems.
Take care:)