Hello,
New to the forum here, and relatively new to anal fissures. Mine started a bit more than a month ago after taking antibiotics for about 3 weeks. I'd always had very loose stools in the past. In fact, for the last 15 years of my life, doctors always told me that I had Irritable Bowel Syndrome because my stools were so loose. But they never caused me any problems except some hemmorhoids and the associated itching/burning and occasional minor bleeding. Then I got diagnosed with sinusitis and had to take an extended course of antibiotics. Afterward, I had constipation and hard stools for the first time ever in my life, and that's when the fissure began.
I'm now trying 0.2% nitroglycerin ointment, dibucaine, probiotic pills, Miralax, and a super high fiber diet for the fissure. No improvement yet so far, in fact on a few days I think I've corrected too far in the other direction and have gotten watery diarrhea that's made things even worse. So I'm definitely in the trial and error phase. My doctor doesn't seem to know much about fissures, bowel movements are terrifying, and sometimes it feels like I'm losing all hope of ever having a normal life again. I just wish there were a clear path to resolution; I think it's the indefinite aspect of the condition that bums (pun unintended!) me out the most.
Anyhow, a little about myself, I'm 30 years old, male, and am a computer engineer in the San Francisco Bay Area. I used to be pretty active in different sports like biking and snowboarding, but have had a few minor health issues (hence my forum handle) this year, so I've been a sedentary couch potato recently. None of the health issues compare to the agony of the fissure, though, I've all but forgotten about them until I cann somehow banish this fissure! What complicates things a bit is that my wife is pregnant with twins (one boy and one girl! :D ), and they are due in late September. It'll be our first babies! So it's supposed to be a joyous time, and that it is, but I feel constantly weighed down by the daily worry over my fissure and whether it will ever go away. I know there are worst things that can happen, though, so I'm trying to keep a positive attitude about it, but have to admit that it's pretty hard sometimes.
Well, thanks for reading my novel, hope everyone is doing well, or as well as can be given our condition. This will sound a little bit messed up, but truthfully, I find some comfort in knowing that others out there are going through the same thing and understand the misery a fissure causes. If I can't have a painfree bowel movement, at least I can stumble on forums like this one

Welcome to the board, NG.
If your bowel movements are normally loose, you may not want to use a very strong stool softener. Unfortunately, I have no experience myself with miralax, I took colace which never made my stools loose, just softer.
Congratulations on your impending fatherhood! I can see how the fissure has become the paramount heath concern, and it probably will remain so until it is resolved. Hopefully you can read through the threads on this forum and gain a lot of insight into your condition from the perspective of our various boardies, past and present who have overcome AF, many through surgery.

I just wanted to say welcome, NG. I also have IBS and take Miralax for constipation issues. I would suggest an A/D if you can get on one. My fissure healed and others have healed as well. I feel that one of my purposes in life (besides working at the ARC) is to give hope to other people such as yourself. The nitro cream or diliatzem can heal you. Do not feel hopeless because your situation is NOT hopeless. A year ago I never dreamed I would be making plans to go on a cruise like I am presently doing.

Thanks for the warm welcome! I'm so happy I found this place, I was really headed deep into despair very quickly. To be honest, I'm still kind of there, the bowel movement I had this morning was terrible and today I can barely function -- the drive to work was super painful, and my bum is all swollen and tender right now so sitting on the chair at work is extremely painful too. The only thing that gives me any hope right now is that I know others have overcome this and worse before.
And yep, I too was using Colace before Miralax. Colace didn't seem to to much for me, the stools still came out pretty hard. Miralax worked perfectly, but maybe a little too well. I was taking the full dose, though, so maybe I will try a smaller dose. I'm trying to work up the courage to eat anything at all today, if it were possible I'd just not eat forever so I'd never have to have another bowel movement!
Thanks for the congratulations, having twin babies soon is definitely exciting. I'm hoping and praying that I will be okay by then, because I want to be able to enjoy the process without being terrified of my condition. My wife is pretty small, so carrying twins is hard for her, and I feel like such a wet rag being preoccupied by the fissure when she's going through her own challenges, but I simply can't help it anymore :oops:

If your fissure doesn't get better in a month or two, you should seriously consider surgery. I know the timing isn't right with the kids on the way, but it sounds like you aren't going to be able to endure much more.
Having to work (and drive) with a fissure is hell...I never missed a day of work because of mine but it nearly drove me and my "boss' crazy.
yes, cut back on the miralax...the liquid colace works much better than the gel caps, if that is what you took.
Finally, I think we are all tempted to just not eat when our fissures are at their worst, but it is really the wrong course of action. eating less can be an option. BTW, did you mention you were on a very high fiber diet? make sure you only get the RDA of fiber...don't over do it or it will make your stools larger and you know what that means! OUCH!
And don;t be skipping any BMs, which is about the worst thing you could do (but also tempting) as the older stools in your system will just dry out and get rock hard, and when you do pass them you will pay in double the pain.

Kim,
You definitely are a guy who's walked this road before :D You got it right, it was indeed the Colace gel caps that I was taking. I will try the liquid version to see if it does any better for me. Miralax softened the stools for sure but it seems to also make my large intestine go into "contractions" that I can actually feel as a series of tightening.
And yeah I was on a supremely high fiber diet for a while. I was having a big salad for lunch everyday along with Fiber One bran cereal as snacks, plus a little bit of fruit at night. That combined with the Miralax turned "the desert" into "waterworld" right away. I've since cut back, and now get most of the fiber from cereal, as it doesn't irritate my stomach as much as fruits and vegetables do.
You're definitely right that I'm getting close to the end of my rope. In fact I don't know if I can even do trial and error for another month. I think if nothing changes in the next week or two, as in no improvement at all, I'm going to jump at the chance for LIS. Ideally I'd like to give the nitro a go, and if that doesn't help, then maybe give botox a try, but I don't know if I can deal with the pain for that much longer. I shall see, though, as today is the first day I'm actually applying the nitro inside the anus, so fingers crossed! If the pain were only during a bowel movement, then I could deal with that, but the fact that it hurts so much for so longer afterward is what kills me.

Botox is as iffy as the nitro (or the BP cream, Nefedipine and Diltazem). They all have only a 50-67% rate of healing (depending on which source you read). The thing is, Botox is costly and often insurance won't pay for it. So you need to question that option.
Still, if you have only had the fissure a month, a CRS may not be willing to do LIS so quickly. I think they are considered chronic after three months.
Dano, a boardie we had here, did heal with nitro and used to write about how he'd "cake" it up pretty high into the rectum. I used a syringe type thingy to apply my nefedipine up higher, though many CRS will insist that you only need to apply these treatment near the outside.. I agree with Cheryl, at least a centimeter or so sounds better than just the outside.
You seem to feel like I did, I often thought if I could only get a week off and rest and lie around, my fissure would heal. But really, I wonder. We have had Canadians and Europeans who, due to NHS (I guess) were able to take *months* off and I never so that not working was a real benefit, but I am sure it helped a lot in managing the pain levels.

Thanks, Kim, the syringe thing is a good idea. It's a slowish day at work so I'm going to pop out and see if I can find a suitable one (capable of sucking up gel) at the store along with some liquid Colace to try.
Sometimes I think time off would be nice, other times I think it would just make me sit around and worry even more. Today it would definitely be nice because my rear is so tender that sitting on a chair is pure torture.
The price consideration of botox is a good one, I hadn't considered that.
I'm actually not entirely sure just how long I've had this fissure. I know that for years, I've had some itching and burning after watery stools, along with occasional bleeding. I had a sigmoidoscopy done about 6 months ago and at that time, the doctor told me I had internal hemorrhoids that were bleeding. He recommended a colonoscopy but I never had it done.
Then in early May of this year, I started having extreme pain during bowel movements. The doctor did an anuscopy and told me there was a fissure. I took Colace for about a week and the pain went away, although some occasional bleeding remained (usually after repeated bowel movements). About a month ago, the pain came back, and this time it was here to stay, which leads me to now. So it's unclear as to whether I had the fissure for years but it wasn't causing me any real pain, or if the fissure appeared in May and was aggravated again in July, or if the May and July occurences are separate fissures altogether (I couldn't tolerate an anuscopy during my most recent doctor's visit so he couldn't look around inside).
Anyhow I'm off to the drug store for today's ray of hope, thanks so much for your feedback! One of these days I'll have to ask what you do for a living, I thought only software engineers were online this much during the workday :-)

Some of us are just "budding" software engineers!
I think you *can* have a fissure for a long time and not really have any pain. I had some blood on the stool from time to time for about a year leading up to my agony, and since I haven't had any since the fissure healed, i assume that's what it was. it just took an awful case of diarrhea to tear it enough to create the living nightmare...
Get a referral to see a CRS. Tell him/her everything and they can work out a plan of action for you. And good luck with the liquid colace!