I am a 48 year old male who is new to this forum. I also happen to be a physician, but my specialty is radiology. I developed an anal fissure July 11, 2006 ( I remember the date well. . . ) Since that time, I have tried NUMEROUS different therapies including various creams and mixtures which I will list below. I saw a colorectal surgeon and also had a botox injection last March. Here is a summary of what worked - and didnt work - for me:
1) I first thought I had a recurrence of my hemmorhoids; ythat was a big mistake as I started using Preperation H creams and wipes (witch hazel) which aggravated my problem at first. I tried several other steroid type creams (prescription and non-prescription types) as well.
2) Still thinking hemorrhoids, I tried various sprays and suppositories next. These worsened the pain and did nothing to help the fissure heal.
3) After diagnosing myself with a fissure, I tried the nitro and nifedipine creams. No help; the nitro gave me headaches that I could tolerate, but 6 months of use did nothing for me. I even went so far as to try the 2% nitro used for cardiac issues. Still no help.
4) I experimented with treatments suggested on various forums like Tinactin, lip balms and menthol-containing gels like Vicks Vapo-Rub. No help at all.
5) I tried softening my stools with homemade and medical concoctions including olive oils, metamucil, colace and mineral oil. These helped soften the stool, but some must have altered the quality of the stools significantly as lots of burning and pain accompanied my bowel movements.
6) The botox injection made absolutely no difference at all. I couldnt even tell anything was different afterwards. Whether the surgeon missed the spot or whether it just didnt work, I dont know.
Now, for what seems to be helping for the last week:
1) I take 2 Aleve before going to sleep around 11pm. I am very regular, and have bowel movements each morning at 7 when I get up. I think the Aleve helps to reduce pain levels and lets the sphincter relax.
2) I spray a small anount of Solarcaine on my anus when getting up; this has a good concentration of Benzocaine anesthetic and helps the sphincter to relax upon defacating ( usually 10-15 minutes later).
3) I am lucky to have a bidet in my home that I use after gentle wiping after my BM's. I use it on an all-cold setting. I think this further numbs the sphincter and prevents spasms.
4) After showering, I use Palmers cocoa butter skin treatment around the anal area. I believe this helps heal the dried, injured skin. I also spray a small amount of Walgreens aloe sunburn spray around my anal area once or twice a day if needed to reduce lingering pain.
5) I now take 2-1000 mg fish-oil supplements at night; I believe this has helped to lubricate the stools and facilitate voiding. Thanks to all of you on this forum for that idea!
6) Finally, I apply some Gold Bond Medicated powder to my anal area with a makeup brush before going to sleep. I believe this has helped healing as well.
I have now gone 7 days with nearly NO pain and NO bleeding for the first time in nearly a year. I truly think I have turned a corner in this arduous, painful process.
The items I note above are inexpensive, do not require a prescription, are unlikely to worsen things, and - at least for me - seem to be working!
I'd be happy to answer any questions that might help any of you. Thanks for all the great comments and advice that I have gotten from all of you, too.