Writing this in the hope it may help others suffering similar problems.

I developed a fissure sometime in 2004. I didn't really seek treatment for it as it seemed to come and go. I believe it developed due to a number of reasons : not drinking enough water, excessive straining during BMs, constipation. Of course, these are all connected. When it got worse and BMs started to become noticeably painful I sought advice from the Dr. He recommended tri nitrate ointment. I hated using this treatment and didn't really apply it properly, indeed without giving it a real chance convinced myself that it isn't really working.

Over the next few years the condition became worse. Luckily I realised that eating food containing any kind of chilli always triggered a flare up. This would spiral as it seemed that as soon as my body detected any chilli the muscles around the fissure would tighten making BMs difficult, this would eventually cause me to strain as the constipation caused headaches and general muscle ache. Straining tore the fissure and the surrounding muscles would tighten further. A flare up would last about 2 weeks during which I used to dread going to the toilet, I had never felt pain like that before. Sometimes after a bowel movement my body was in minor shock and I had to lie down as I felt dizzy from the pain and the shock of seeing the blood in the bowl. I sometimes used the aneasthatising spray used for hemorrhoids which provided temporary relief.

Eventually after about a year, I saw a consultant who recommended botox treatment. This was under general anesthetic and included a proper examination and a botox injection to relax the muscles and give the fissure a chance to heal. Before the operation I was offered Lactulose but only took a spoonful as I didn't understand what it was for. The operation was apparently successful and confirmed the presence of a fissure. Unfortunately, the general anesthetic caused constipation and I couldn't go for 2 days so when I eventually went there was some straining and it felt like the fissure became worse. So for the next few years I managed to control this condition by giving up chilli of any kind and taking Lactulose twice a day without fail. The fissure would still flare up a few times a year and I was generally miserable for a couple of weeks because I could always feel some pain all day. Having lived with this condition for a few years I was resigned to dealing with it permanently, always ensuring I had a good supply of Lactulose, even on holiday.

Then in December 2014 I developed IBS (first time for me). Either condition is bad enough but both together were beginning to get me down. I went to a different Dr at my surgery and she prescribed Mebeverine for the IBS and insisted I stop taking Lactulose as this increases bloating. I was so reluctant to stop Lactulose as this was my saviour. However I did what she suggested and swapped Lactulose for Movicol. The IBS disappeared after a few weeks, but miraculously it seems that the fissure is either dormant or healed! I haven't had anything like a flare up for 7 months and I can once again enjoy mildly spicy food. I still take Movicol twice a day and will start to reduce the dosage. I always drink plenty of water and get lots of roughage in my diet and have finally learnt not to strain during bowel movements. I am always aware that both conditions could reappear but am thankful everyday to have relief from them. I don't know whether it was the Mebeverine, Movicol or just coincidence that relieved the symptoms but hopefully this may give some of you ideas, especially if you have suffered from fissures for years as I did. Would like to know if anyone has a similar experience.

Lessons to learn.
1. Drink lots of water and get some roughage in your diet to avoid constipation.
2. Avoid straining during BMs.
3. Use the ointments a soon as you develop a fissure and use them a directed.
4. If you have any ops under general anesthetic take precautions to prevent constipation.