In my experience, when you have an acute ( first time having it, that is, not chronic) AF you really have to stick to the application of the nitroglycerin cream, in my country it's called Retogesic
Yes, it gives you a strong headache. But you can take painkillers for the headache. The headache is nothing compared to the pain around your butt, so do not worry about it too much
The pain will not go away immediately, do not expect instant results. It takes weeks, or even months. Basically the treatment cream's role is not to take away the pain but to allow the muscle to stop contracting so hard. But it will only work in the long run so you really must be patient.
... I know
I was not and now I am paying for my mistake! For me it has been 3 months since the AF nightmare started. I am still doing the cream twice a day and I am still not healed. Because half way through these three months I was feeling better and relented a bit in the application of the cream and taking the stool softeners! A BIG mistake!
One or two hard stools BM and my anal fissure was back!
I have realized the treatments must be continuous until all the pain is gone, and the AF has healed thoroughly
I have realized that hard stools can reopen your AF or make new ones! So it is also extremely important to develop good habits regarding your BM:
- have some fiber every day ( I recommend wholegrain cereal with powdered linseed and soaked chia seeds) to make your bowels work regularly. If you do a bowl of cereal every morning, then it's guaranteed you will become more regular in your BMs
- have fiber at every meal, a bit of vegetables, beans, peas, chickpeas, ( if they make you have gases, use sparingly) or wholegrain pasta or bread, or a salad. You need the fiber to keep you bowels happy and making you have at least one BM a day
- take probiotics. They help your bowels, and a happy bowel makes happy BM
- ideally have at least one BM a day. When you do not have them once a day, the stools harden. The longer they stay inside you, the more they harden as they get dehydrated just before coming out, and therefore a lot harder as they do.
Sometimes they act like a cork, bottling you up inside. So, it's very important to keep them "moving" down and out, if you know what I mean
- you must avoid food that blocks you up: bananas, rice, honey, coffee, tea, chocolate, honey, refined flours
- take stool softeners and drink a LOT of water to help it work
- only go to the toilet for a BM when you feel a real urge. Try to develop a routine, our bowels love routines
- avoid straining at any cost. The natural human position for BM is not sitting so avoid sitting upright, lean your chest against your knees as that helps the stools pass, or you can sit as this image shows - https://qph.ec.quoracdn.net/main-qimg-6 ... aaa100d7-c
- clean with warm water. Soak in warm water or keep the area warm as heat helps the muscle relax. You can sit in warm water or use a heat pack covered with clean smooth cloth. If you manage to relax the muscle, this eases the discomfort as the relentless pain is caused by the permanent contraction of the muscle, which leads to more pain. It's a vicious circle and it's essential to break it ... but it IS POSSIBLE
Don't lose hope
The nitroglycerin cream does give you a headache. It's not pleasant to feel it on top of the other AF pain, but in the long run, it will work. You must persevere, or there will be months of pain, and your fissure can become chronic.
I hope you feel better soon
