Hi everyone,

A little bit about my story below:

-First had blood after bm in July 2018. I went to a doc and she just gave me stool softener, said it was probably a tiny cut, and told me to eat lots of fiber. Didn't give me any other details about the fissure and really wishing she had told me to take it more seriously then.. I took stool softeners for a very short time (under 2 weeks probably) and didn't have any other issues with bleeding or pain for probably a year or so.
-Some point in 2019 I started feeling more pain and smaller traces of blood. By the end of 2019 I knew something was very wrong. I was also alternating between constipation and loose bm's, which I'm sure aggravated the whole situation.
-Feb 2020, I was on vacation and saw more blood than ever (still relatively small compared to some of the stories I've heard but it was alarming.) It seemed to heal for a few weeks and then came back with a vengeance.

Finally in April I sought help from my PCP. She prescribed nitro cream 2x day, sitz bath, high fiber diet. I inspected the area and saw a cut that looks like it might be 1/3 inch, but I didn't see scar tissue or anything else around it that others say is indicative of a chronic AF. I also saw a second, smaller cut nearby.

The plan was to do nitro cream for 4 weeks, if the fissure healed, to stop. If it came back, to continue nitro for 4 weeks while getting a referral to a surgeon.
So..4 weeks went by relatively pain free. No blood since probably early april. I did notice that the nitro started burning last 2 weeks or so. I stopped the nitro this week and then.. had one hard BM and it either re-tore or it never fully healed. The stinging of the nitro may have been a clue that it was not healed.

I've been eating basically the same way for weeks if not months now, no idea what caused this. I've been pretty restrictive about my diet and it would be nice to eat like a normal person again, vs worrying about my fiber intake, whether I will have an incredibly hard stool, etc. Trying to get some exercise but difficult since I have a pretty intense WFH job that keeps me sitting as well but looking into getting a standing desk.

Anyway, thank you all for reading this. Right now I guess the next plan of action is to see a surgeon (for some reason my PCP said it has to be a general surgeon not a CRS?). If anyone has any recommendations for CRS surgeons/specializing in AF or LIS in Northern California, please let me know. Bay Area preferable. I don't need a referral for my insurance so I can see whoever I need.

I've been depressed/anxious and its so hard to think about anything other than a BM and my fiber intake for these last few months It has been really hard to remain hopeful and optimistic that things will get significantly better, but I'm hoping to find a little support in these forums. Thanks everyone.

My experience is very similar to yours progressing over the last couple years with a tipping point in the last few months.
I totally get how your whole life revolves around a BM and whether you will be in pain for hours after. It's a total mind breaker after months. I feel like I lost months to anxiety, pain and depression and irritability with my work and family from just being in pain all the time or worried all the time. I am 9 days out of surgery and feel like I've turned a corner after a very tough first week. I can see the light I think.

Hey Joanna- how are you doing now that it's been a few months post-op?

I'm still suffering on and off. I went to see a new PCP and she also mentioned me possibly seeing a surgeon as a last resort. Strangely just like the last doc she suggested possibly a general surgeon not a CRS. I've been using Rectiv (Nitroglycerin) again and it seems to be helping a little, I haven't seen blood since I began using it but I've had some pain. Because things aren't horrible pain-wise, it seems like the new doc wants to hold off on any further interventions. She's really pushing the diet, stool softeners and not straining during BMs. I'm really not sure if that's going to solve my problem and I'm getting anxious that it's been almost a year and I still don't know how many fissures I have, if it's healing and reopening or just never healing, etc. I would love to see a specialist but it seems really hard to get an appt during Covid The impression I'm also getting is that doctors don't want you to see a specialist until things escalate but it sounds like fissures have a better chance at healing if you address it early on!