Hi there. Stumbled upon this support forum as I was trying to find the miracle cure for my anal fissure (2+ months). I cannot believe there are so many of you that have dealt with this for years. I feel like a wimp complaining at 2+ months but as I'm sure you all know I am just so tired of being in pain every single day. I am hoping that those of you with more experience with this can help guide me or share any tips while my AF is still "fresh." Still trying to understand it all so bear with me as I have many, many questions...

Current situation: I am a 24 y/o female and I have had bloody and dagger-like painful stools for the last two months - with every BM. For a few days while on steroid cream the bleeding and pain stopped but as soon as I went off it came back with a vengeance. Now I am taking fiber 2x daily (Citrucel) and trying to stay hydrated. My doc prescribed nifedipine/lido cream which I use before/after a BM. She said to live life normally, drink coffee and alcohol, but whenever I do this I am so miserable I cry the next day, even sometimes hours after my BM. I believe those are the spasms. I am slowly getting back into exercise and I think this is probably the best opportunity for progress. I saw threads for coconut/olive oil and flax seeds so I think I should start doing that too. My stools are softer now but still quite large so they really aggravate my AF. Should I take less fiber or is that blasphemy... My IBS friend recommended acacia but I don't want to overload. I don't usually get constipated, would it be dumb to cut back or eliminate my fiber all together to make my stools smaller? How long will I feel like this? I don't want to get surgery but from the sounds of it it is the most promising option.

Additionally, I read that AF are caused (more likely correlated) with emotional stress. Since the beginning of this year I have been recovering from an ectopic pregnancy that ended up rupturing leading to the emergent surgery that removed my fallopian tube and rewarded me with this AF. I am really stressed. I am seeing someone for this but it will be some time before I sort out my sources of anxiety... does anyone have any tips on relieving the stress from my AF? I am just really fearful that I will be dealing with this for months (probably a reality) or years to come. I am sitting for a graduate entrance exam in June and it is an 8 hour exam. Studying for it while working full time takes a toll on my bum's endurance but I am freaking out that I won't even be able to take the exam because my bum will be spasming or throbbing in pain. Has anyone taken magnesium for spasms? Not a strong direction of advice on it but I figure its worth a shot. If that doesn't help I may ask for a Valium prescription. Although I really just want to heal entirely, not mask the pain.

End rant. It feels good to let that out to people that understand. Thank you for posting your help and advice.

Buttstuff,

First off I am so sorry you have had to go through so very much. You are one tough lady! I want to write you a longer note in a bit because I can relate on the graduate school stuff. I just completed my program and it definitely caused major anxiety and emotional stress (along of course with other factors in life).
Just know you are already doing a wonderful things for your emotional stress by getting support and reaching out on places like this to ask questions and share your story. It often feels like we are alone trying to get healthier from this bum stuff but know we will always be here to support you!
Will message you more soon.

Thank you Manitourose. Just finding this forum has already made me feel better! I think my flare ups with emotional stress and spasms go hand in hand. So hopefully relieving stress will ease those spasms too. I look forward to hearing about your experience :)

Hi Buttstuff,
You certainly are going through a lot just now.......I remember being at the stage you are now, and I consider myself totally healed, so stay hopeful and know that you can work through this. It will seem like it's taken over your life, and it will seem as though it's taking forever to heal, but be patient. You can and will heal.

You are doing the right things by staying hydrated and getting soft stools. The coffee and alcohol will make it more difficult to stay hydrated, and if they make you feel terrible, cut them out for now. I definitely recommend cutting back your fibre. Citrucel, miralax or another stool softener will keep your stools soft and regular even if you are getting less fibre. I wish I'd realised sooner how much the sheer bulk of fibre was delaying healing for me. You could try cutting back insoluble (bulk) fibre, while still getting soluble fibre. You can google or search this forum to see what foods are rich in which kinds of fibre. You have to experiment and find out what foods help and what hurts. It's a great idea to keep a diary of what you eat, what your stools are like, and how much pain you have.

Nifedipine/lido are fine but if you find they are not helping, don't be afraid to tell your doc you want to try diltiazem or nitroglycerine. As my signature lines say, I had to try all three, and nitro was the one that cured me in the end (that, and time).

Yeah, the whole stress thing - that is major. Even when I was virtually healed, a stressful day could set my anus stinging and aching. I've learned that when I start to feel anxious, I need to "check in" with my bottom to see if I'm clenching it. Usually I am, so then I have to consciously relax it. Have to keep doing that until I've calmed down. I've had to learn to let go of worries before the pain starts. It's easier said than done, but start by being aware of the tension you carry in your body.

Some people meditate, some pray, some take anti-depressants to get them through this bad patch. Try relaxation, and if you are too anxious, try the valium.

And no post of mine is complete without recommending the not-too-hot hot water bottle, which saved my sanity. I sat on mine for hours every day for months. It was soothing and healing and I do not know how I would have coped without it. Don't fill it too full, or it could burst when you sit on it.

Ahh thank you Scientist2516! I tried the hot water bottle and a heated blanket and I am hoping they will help - if anything they are already relaxing me, YAY! I have just started to become more conscious of clenching as well and am trying to keep myself from that. Thank you for the tip on soluble vs. insoluble fiber. I will definitely start paying attention to amounts of insoluble to help de-bulk. Unfortunately due to the conundrum that has been my health the past few months, I have missed a lot of work but do have good benefits and am not completely out of sick/vacation leave just yet. I did schedule a meeting with one of my supervisors this week to fill them in on my most recent issues as it is starting to affect my attendance and performance at work. I was able to tell one of my supervisors the whole deal with my ruptured ectopic, but have not told them about this AF. The person I have in mind is trustworthy and has showed concern for me through all this, however I am still a little nervous they won't fully understand just how difficult an AF is (no idea what their experiences may be). My job is physical on some days so that can make things a little worrisome for me when I have a flare up. Any tips on approaching this with a supervisor at work? Any do's or don'ts?

Thank you X 100000000000000000000000000!

You are so welcome buttstuff!