Hi to this community. I’ve been lurking for quite some time and finally decided to post. I’m a 27F that has been dealing with fissures on and off for the last ~4 years. I’m on a high fiber vegetarian diet, take 2tbsp of psyllium husks every morning, and drink about a gallon of water each day.My typical cycle is an irregular BM (too lumpy, too big) that will result in a tear. I’ll use my nifedipine gel and stay vigilant which will heal everything for a few months. But it’s one imperfect BM and I’m back at the beginning (blood and pain).

My CRS has been monitoring the area and has noted in the past that it looks completely healed, only for a new cut to appear in a month's time. They’ve also noted that the fissure is NOT CHRONIC - I’m able to heal, but a new one crops up eventually. I’ve also had superficial ‘skin cuts’ in the area that seemed to be fixed with a topical steroid.

The CRS is suggesting Botox, a colonoscopy once it’s not as inflamed, and an appointment with a Gastro to talk about diet. LIS isn’t recommended due to my age and gender.

Does anyone with a similar experience have advice on how to proceed? I’m beginning to lose hope that this will ever heal for good.

Hi there, from what you're describing you have way too much insoluble fiber in your diet. Reduce fiber, stop the psyllium and start miralax/magnesium and see if your BM cycle improves. Steroids are not a good idea for superficial cuts because they thin out the skin and make it more prone to tearing. Also try using a bidet to clean and minimize wiping the sensitive area. Take care and I hope you find a solution soon.

Hi, this is exactly what happens to me!
However, my doctor suggested surgery may be the way forward. I am going to see a specialist soon! Keep us updated. Hope you solve the issue soon.

Botox is a band-aid solution. It will wear off within a year and you'll be right back where you are.

Botox may be just what you need. If you are able to heal *almost* fully then it may give you the extra time you need for the last bit of fissure to heal. Plus it's much less invasive than surgery. It worked for me in conjunction with a fissurectomy, no lateral sphincterotomy was performed. Had a chronic fissure for 4 years, now I'm 3 years healed.

AcrobaticBerry8203, did you get the Botox?