Hi.
For years I've wanted to come back to say thank you to the people of this forum and to add my two cents as to what helped after my two year battle with anal fissures. I know the pain that you maybe feeling; I know about clenched fist, shot nerves, and involuntary teary eyes as you stand out side of your parked car half way though a long trip. I know just how "seriously" family and even doctors take your condition. I know because I've been there and I've tried some crazy things to get some sort of relief. I've tried to spay countless substance on my rear from aloe to almond/coconut/fairy oil. I took every fiber/laxative I could get my hands on (I over did it with Miralax at one point and nearly hospitalized myself.) I even remember trying to push my screaming butt against the wintery cold concrete of my garage (sanitary I know.) I've done them all it seems like and now after all of these things being tried, weeded through, and refined into a combination that worked not once, but also though the two later flare ups, I've come to pay back my debt to the forum.
In order of importance:
1. Petroleum Jelly.
It seems so simple, I'm ashamed how long it took me to figure this one out. At one point I had a specialist prescribe me some Nitro suspended in petroleum jelly. It was great, but, much to my horror, the fissures came back after a couple of months. Again, I was able to call into the doctor who readily agreed to supply me more via mail rather than have to deal with such a 'small potatos' case again. I started to realize that while the nitro was great and all, it was partially due to the dry climate I live in that I was having this problem. After a third flare up I just tried dabbing a pinky lubed with petroleum jelly about a 1/4" into myself. To my amazement, it worked even better than the Nitro. About two years later I had another flare up coming and a couple of days of this treatment was all it took to fix the issue.
2. Hydrogen Peroxide
. At one point I started to wonder why some people with AF had what they described as mild discomfort while others felt like Pandora's box was shoved up their ass and an army of Illuminati were trying to pry it open. It dawned on me that it might simply come down to infection the same way one's finger hurts like hell if an ingrown nail gets infected. I tried out the same cure for one on the other. My first attempts to put Hydrogen Peroxide on my sphincter were comical at best as I wasted half a bottle on my contorted upside down posterior. Thankfully, some wise soul put Hydrogen Peroxide into a spray bottle and I've never looked back. Now, anyone who knows anything about Hydrogen Peroxide knows that if it hurts that means it's working and the more it hurt the more working it has to do. Yea. Lava. But in the end it saved my ass *smirk*
3. Diet.
Some people are vegetarian types and some people are meat and potato types and then their was me... I was a chilly dog and fast food four times a week kind of guy. And then this thing called my thirties hit me like a ton of bricks. I had this sense that as long as I kept fairly physical and used the energy I took in as junk food that all would be well. Yea, fiber is a thing. My doctor man told me to use Metamucil indefinitely. He also told me to take double the recommended dosage and like an idiot I did for a few days. Yikes. Listen, you don't have to go super vegan if you don't want to, you just have to start eating like an adult; add some green stuff to every meal regardless of what you like to eat. That and the alcohol thing... They said on here never to drink alcohol, but after long painful days of this shit getting me down, I could really use a drink. I realized that red wine was a blood constrictor and the real problem with alcohol was its diuretic dehydration effects. I found that half a glass of red wine with half a glass of water (umm, rinse repeat) made things better and not worse.
So that's it. 1) keep it moist 2) kill the evil within and 3) eat real food. All the other stuff did help more or less, but these simple three actually lead to and end to the most painful couple of years of my life. I would also add two more tip if you're still here; one practical and one existential. Practically speaking, an ice cube wrapped in a paper towel can offer emergency relief. Like all these long baths they recommend (which make it worse in my opinion) it will ultimately make things worse by further drying you out, but the numbing effect of ice directly placed between your cheeks was worth it after many excruciating hours. The existential advice I can offer you is to reduce your stress. We talk about diet and Nitro and this and that, but lets be clear: If you have AF and you don't have a chronic disease (like crones - my heart goes out to you) you are probably a clencher. I worked a stressful job, had a stressful life, and come from a long line of stressful people. We all clench our ass as a matter of sub-conscious habit. Stress is bad for your ass in case you didn't know. In our modern society asking someone to not stress would be like asking a cave man to not hunt; it's a matter of our survival. So, I have learned how to manage the stress in more productive ways. As wussy as it may sound to some, concentration meditation and rethinking how I see the world via Ajahn Brahm's lecture series has done my life a lot of good these last few years. If you're interested in this aspect of the healing I would recommend the following to videos linked below.
Well that's it. My debt is repaid and it is now time for me to move on with my life. So long, and thanks for all the fish.
https://www.youtube.com/watch?v=VD0mave5zZU
https://www.youtube.com/watch?v=mH2sEqrCza4