For months, after a painful year, I've been living with a chronic fissure that was uncomfortable but just about liveable with. Suddenly the other day during a stressful situation something tore, and I think I have a new fissure, or at least a new cut in my anus. It's true that back in April something similar happened, also in a stress situation, but I recovered, up to a point.

At night the pain is bad, with spasms, but during the daytime the pain subsides, and I can almost forget about it. I'm not sure what to do, or how to manage this. A couple of years ago I would go and see my GP almost every week, and was referred to several CRS, all of whom told me the same thing: continue the GTN ointment - they mentioned Botox and LIS, but reluctantly and only as a last resort, they said, because I'm 72. My last GP told me that few surgeons would be prepared to operate on me, because of the anaesthetic risk. My GP has put me on GTN and pregabalin, and think I can manage, but the changing nature of the condition puzzles me - healing seems to be suddenly replaced by tearing, and there's not much I can do about it. It's hard to see my new GP at short notice as she has a waiting list of several weeks, though she will contact me by telephone to discuss my situation if I request it.

A poster here, suzyljank, who has a thorough knowledge of the condition, suggested that the reason for the retearing is probably stenosis (scar tissue, skin tags), and that I might need advancement flap surgery. As far as I know, advancement flap surgery isn't available on the NHS, so I would have to go private. I'm still hesitant to go down that route, partly because I have a fear of the surgery and anaesthetic, and partly because I don't know how I would cope with the recovery, as I live alone and have no backup support. Also, none of the CRS I have seen have even mentioned advancement flap, and that, too, gives me cause for concern (read anxiety).

I think I'm going to try to manage this as best I can for the time being with my resources of ointment, pregabalin, time and rest. And I've left a request for my GP to call me back, though it won't be until Friday, as she is away until then.

I'm thankful for the Anal Fissure board, and all the people here who share their experience, thoughts and support and make one feel less alone.


David

How awful to have to go through this at an age when you would hope to have some peace of mind! I had Botox two days ago and as far as invasive procedures go, it's very very low on the list. If you want to try it, maybe find a doctor who will do it for you without sedation. Also have you had a colonoscopy or other screening to check for background problems?

Thanks for your response. As you can see from my signature, I had a fairly extensive series of tests and scans during the first stage of the fissure - my GP wanted to rule out things like Crohn's, UC, and so on. Nothing malignant was found in the tests - I even had a calprotectin stool test, and while that came in at around 340, relatively high, according to the CRS I saw at the time it wasn't anything to be worried about.

I don't really know what the best thing to do next is. Perhaps Botox is something to try.

One of my main problems is fear - fear of the pain, fear of the condition itself, which seems to change in angry and aggressive ways, and fear of the treatments. some of which seem more like tortures than healing cures. I am seeing a therapist, and trying to overcome the fear, but it's constantly there, and doesn't make dealing with my AF any easier.

I guess they didn't think much of the calprotectin value since your other tests were clear. I agree with you regarding the fear. It's such a sensitive area of the body that the idea of someone messing with it when we're already in pain is anxiety provoking. I'm still amazed that I went through with the botox but I'm glad I didn't back out. Perhaps what you need is to find a doctor who is confident enough to treat you without being too worried by your age. Just an idea.