Hi I'm new; first time with AF, and it's incredibly painful. I can only sympathize with those who go through it much longer.

I'd like to ask, how does the healing process work exactly? I feel as though, dispensing everyday only re-tears the fissure, even with soft toothpasty and small stools. Sometimes I feel like not even eating to lessen stool, though I know that's not good. And at one point, I had accidentally eaten too many beans, and formulated so much gas; it was excruciating to release gas, and at the same time, excruciating to keep it in.

I just feel like it almost seems impossible for the fissure to heal when we have to dispense stool at least once a day.

I had the same question. All I can say is, with time and soft stools, it should eventually heal. It does take time - maybe a few weeks. Don't despair though, because once healing is under way, the pain gets less.

Healing can work when 1) the stools are soft and not too big. 2) the anal sphincter can relax, which allows 3) the anus to get enough blood flow to allow healing. And 4) you stop the spasms, which are painful contractions of the anus, which prevent healing.

How to relax the anal sphincter? Medications such as nifedipine, diltiazem or nitroglycerine relax the anal sphincter muscle. This helps to reduce those harmful and painful anal spasms, and helps blood flow. Also these drugs act directly on the blood vessels, expanding their walls and increasing blood flow that way too.

Heat applied to the anus has a similar effect, so warm baths, sitz baths, heat pad or hot water bottle will help.

You are right, the daily trauma of BMs make it very difficult, but keep those stools soft and eventually you will see an improvement.

Good luck!

Thanks for the answer it's encouraging and helps.

For me, I recently went on a road trip, and became constipated due to it, which fared horribly once I got home and finally dispensed. Even though most of my stool is watery, it burned like hell. But after 2 days of washing and using neosporin the pain has settled. Today, spasms have not occurred, though I'm sure if I dispense, I would feel pain. Not sure if the neosporin does a thing, but I used it anyways.

Hi guys

This may sound like a dumb question, but how do you know when you're healing or starting to heal? I have had a big improvement in the past week in terms of pain (no spasms in a week) and in finally getting soft BMs but I have bled a few times. Does this mean I am starting to heal or am I being too optimistic? Even when I have bled I have not had the painful afterpains that often would last for hours, but I have started to experience slight itching...

Thanks :)

I measure my healing based on the pain I feel throughout the day and when I have BMs. At the worst part, BMs were extremely painful, and quite traumatic, leaving me sore and in pain for the rest of the day. Also making it extremely difficult to do much, such as walking and sitting. But as it healed, I no longer felt pain walking too fast, or sitting. Sometimes, there's a prickling or stinging sensation, I take it to be part of the healing process.

I'm not sure about why you keep bleeding though. I say try to only have 1 BM a day. That might mean reducing how much you eat.