by NeuropathicGuy » 07 Jul 2010, 11:16
Yup you can still have pain after 4 months. A lot of us here -- I'd say most in fact -- have had fissure problems for much longer than even that, unfortunately. I think there are two possibilities: either your fissure is slowly healing, or the pain level has decreased as it's become chronic (which is not unusual).
What have you been doing to manage your fissure so far? Any creams, stool softeners, etc.?
The likelihood that surgery is needed does increase as time goes by, but I don't think it's necessarily a must-have just yet. It all depends on how much pain the fissure is causing (and therefore how long you can tolerate trying other treatments) and also what other remedies you've already tried.
If you haven't tried any of the creams (nitroglycerin, nifedine, diltiazem) yet and the pain is tolerable, then I'd give those a go first, along with a stool softener that works for you. But if you've already tried the creams then I'd have a CRS (colorectal surgeon) take a look to see if it's healing. If it is, then give it more time. If it's not, then consider more aggressive treatment like Botox or surgery.
By the way I used the creams for about 6 months, then tried Botox, and then finally had surgery 1 year after I got my fissure. Some others have gotten surgery immediately after getting their fissure. Some folks have had more than 1 surgery too. So everyone is different and it really depends on what's going on in your particular case.