I understand the pain and despair when dealing with an anal fissure. Especially when it seems nothing seems to help. Like they say, some things work well for others and not for some.

So let me tell you what seems to have given me relief in the past couple of weeks. After trying different creams and ointments( lidocaine ointment, Nifedipine, Proctofoam) i finally settled for this routine. First and most importantly, you have to get the stool under control. And i found that changing my diet, plus a daily dose of Miralax achieved that. I only eat fruit, oatmeal, bran cereal, vegetables and drink plenty of water and juice. No meat or any processed foods or anything spicy and heavily seasoned. Think about it, all you eat comes out and comes in contact with the area down there and its hard to say whats going to irritate it.

So first thing in the morning, I take my daily dose of Miralax and right after I drink that down, I am usually due for a bowel movement. Not because of the Miralax, but because thats my routine now. First week, bowel movements were very painful, but I knew that not going when i felt the urge would only make it worse, so i just clamped down and got it over with. Once the stools were soft, the pain was still there, but that was the first hurdle. Then after BM, I would immediately have a sitz bath with a spoonful of coconut oil in the warm water. While sitting on the sitz, i would take a baby wipe and gently clean the anal area while i was sitting there. That provided relief from some of the pain. Then I would get ready to prepare myself for the internal anal sphincter spasms that came after and could be so bad, I could hardly walk!

My doctor prescribed another ointment, Rectiv (nitroglycerin) and let me tell you, it works. Headaches are supposed to be a common side effect when using this, but thankfully, I've done fine so far. I started it on a Monday and was actually feeling relief from the spasms by the end of Tuesday evening using it once every 12 hours. Only the dosage it calls for, which is a line an inch long, and inserting it anally at about half an inch. At first I was thinking there was no way I'm going to be able to get this ointment any where close to my anus, let alone INSIDE it. But I was able to use the applicator that came with the proctofoam and use that to insert it in my anus. The spasms are a big part of the pain cycle and the reason why the fissure doesn't heal. I have noticed a huge difference from the painful bms, once the spasms decreased. Apparently the spasms make everything so tight and tense its what causes the pain and bleeding because it keeps re-tearing! Im starting week 3 and thank God, this routine seems to be working. I get a stray pain or a mild sting here and there, but for the most part, there is about a 75-80% difference so far! I can sneeze and cough now without sending pain through my whole body.

So, just wanted to share in hopes that I could point someone in a direction that could offer them some sort of relief. Make sure that the Doc verifies that its just a fissure before taking any ones advice or trying to handle it on your own. Sometimes thats why treatments don't work for everyone, because there could be other underlying conditions that aren't being addressed! Hope this helps someone relieve their suffering :)

Great post and glad things are going well for you. I split your post from one you wrote on dated 2013, so that you have your own "space". Also removed the second identical one from another early post :)

to the forum, and keep on doing what you're doing as Rectiv is excellent, especially for fissures still in the acute stage!