Here's my situation: about 3 months ago I went to see the CRS with burning/itching/bleeding and that feeling of needing to go (without anything being there).
The CRS found that I had internal hemorrhoids and a small anal fissure. He put me on a nifedipine ointment and we set up the appointment to get the hemorrhoids banded.
Had the hemorrhoids done about 5 weeks ago. After the procedure, the CRS said I could stop with the nifedipine. Everything seemed to be going pretty well for the first 3 weeks after the surgery.
However, during the 4th week after the hemorrhoid banding, we had a pretty intense week up at work. There was a lot of standing up, sitting down, walking around, bending down, etc. By the end of the week, basically all of the symptoms were back: burning/itching/bleeding and that feeling of needing to go.
My question is: has anyone had their fissure reopen due to physical activity like that? The bowel movements have been very smooth - nothing's changed there, only the increased amount of physical activity.
I'm just curious since I can't get into the CRS for another 3 weeks or so.

Hey Joseph, before having my surgery I basically laid around and did nothing for fear of making it worse. It didn't matter in my case, things didn't get better. I would imagine any heavy lifting or straining could re-open a fissure.
The problem is they take forever to really heal. I went nearly a month and then it reopened for no reason. I didn't change anything?!! All the info. I found on the ointments showed many people having to use them for 12 weeks. Some on here have needed it much longer to heal.
Fissures suck because you can be doing everything right and they still have a mind of their own!!

My appointment is still 2 weeks away but I wanted to give a quick update. When I talked to the CRS 2 weeks ago, he prescribed a hydrocortisone cream based on the description of my symptoms. That helps with the stinging and itching.
However, after reading several posts on this forum, I decided to also start taking a sitz bath every afternoon. Wow - what a difference it makes! It really seems to calm everything down and get things to relax.
Over the past couple of days, I've had short stretches (like 1 to 4 hours) where things finally felt back to normal. It's only been a few hours here and there, but it's given me hope!
So if you're also suffering and haven't tried one yet, I highly recommend a buying a sitz bath. You can get them really cheaply at most pharmacies or online.

Yep physical activity can aggravate fissures. For me it never actually caused anything to re-tear, but it absolutely did make Senor Fissure angry. Before my fissure, I was very active -- mountain biked, snowboarded, jogged on the elliptical, and rode motorcycles (alright not sure if that last one counts but cut me some slack here :))
I gave it all up basically during my fissure hell, because a lot of it just hurt too damn much or was too annoying to participate in. The only one left that I could still kind of do was use the elliptical, but even after a few minutes on that, I'd feel a dull ache in my ass that sometimes radiated upwards toward my hip and back.
As Dawn says fissures take FOREVER to heal too. When I first got mine, it was around for about 2 weeks, then vanished. I thought I was in the clear and resumed my old eating habits, then about 1 month later, BAM that's when it returned to stay for good (until I finally had surgery). So once you think you're turning the tide, be VERY patient (preferably for 2-3 months minimum if you can) and very careful. And never get overconfident haha :)
P.S. I kind of wonder about the decision to stop the nifedipine and continue with the hydrocortisone though. Nifedipine (compounded at 0.2%) is indicated for fissures, and hydrocortisone is for hemorrhoids. So if you got the hemorrhoids banded, then it seems that the hydrocortisone should be stopped while the nidefipine continues. It might be worth checking with your CRS on that (and of course look it up online on a reputable site first so you don't have to answer "some random dude on the Internet on the anal fissure forum" when he asks you where you got the idea to ask )

P.P.S. Slight clarification: nifedipine (and I think maybe also nitroglycerin) is sometimes used for hemorrhoids too because it increase blood flow to the area. So what's a bit weird to me isn't so much that nifedipine was given for your hemorrhoids, but that it was stopped while the hydrocortisone was continued. Of nifedipine and hydrocortisone, only the former is generally recognized as effective for chronic fissures, which yours would be considered at its current age of ~3 months.

Thanks Neuro. I was surprised about the hydrocortisone/nifedipine thing, too. When I called to make an appointment after the symptoms reappeared, the earliest one available was a month away. When the nurse told me that the doctor wanted me to do hydrocortisone in the meantime, I was surprised and asked her why it wasn't nifedipine. She said that since the CRS wasn't 100% sure it was actually still the fissure, he wanted to prescribe something all-encompassing just to be sure.
Which brings up another point - these CRS are like freaking rock stars - it takes 4 weeks to get in to see one!
So until the CRS actually takes a look, there's no way of knowing for sure what's happening down there. But the more I read of the forum, the more convinced I am that it's the fissure that just never fully healed correctly.
But we'll find out for sure in 2 weeks.

HAHAHAHA I know what you mean about doctors in some specialties being like rock stars. In my area, it's not too hard to get in to see a CRS as there are lots around. But some other specialties are scarce and it can take a looooong time to get in (for example my son's pediatric neurologist).
One last bit I wanted to throw out there: there's no reason you can't get nifedipine and hydrocortisone in one Rx. All the doctor needs to do is write a script for a compound Rx (something like 2% hydrocortisone and 0.2% nifedipine for example, maybe even with a bit of 5% lidocaine thrown in for analgesic properties) and a compounding pharmacy can make it for you. It'll probably cost substantially more than a regular script, but you probably already know this since I'm sure you had the nifedipine compounded before already. Anyway, maybe something to ask about if things are still acting up in two weeks. Hopefully it settles down for you between now and then though!

Just wanted to close out the thread now that I've seen the CRS. Long story short: things finally healed up.
To recap: the CRS prescribed hydrocortisone a month ago and I began taking sitz baths based on recommendations from this forum. Over the month, I noticed things (slowly but surely) began to relax down there. I'd have a good day followed by 3 bad ones, then another good day followed by 2 bad ones, etc. It was frustratingly slow - I'd think I was cured, then something else would happen. Two steps forward, one step back - that kind of thing.
By the 4th week, I was actually feeling well enough to fly again - I wouldn't have imagined it possible a month ago.
The CRS did the full examination yesterday - no open fissures, no issues.
I wouldn't say I'm 100% but it's darned close. I wish I could tell you what specifically got me to this point but my guess is that it was the combination of the hydrocortisone and the sitz baths. The sitz seemed to relax the spasms and the cream worked on the swelling and the itch - and since it wasn't itching, that also cut down on the tightness. And I'll just throw this out there too: I have been consciously reminding myself to relax every time I go - just telling myself to take it easy. Oh, and of course, Benefiber with pretty much every glass of iced tea. But that almost goes without saying at this point!
So not 100% yet, but well on the way to recovery. I hope this helps someone!

Congratulations! I hope you are one of the success stories that heal up totally!
But - just be aware that it can rear it's ugly head again at the slightest provacation! Don't get complacent!
I wish you a very happy, fissure-free life!

Hello
Can anyone tell me whether it's okay to exercise with an AF? I have been a life-long exercise fanatic and I'm so confused about whether it's okay to exercise. This is my second time around with AF torture. I had the surgery 10 years ago and thought I would never have to deal with this again. The websites I've consulted say you SHOULD exercise every day but I seem to feel worse when I do. My CRS says that it's okay as long as I don't do heavy lower body weight lifting. Does anyone know the answer to this? What about weight lifting and/or running? I've had botox, used nifedipine, etc. I'm scheduled for surgery in September when my daughter goes back to school. I'm praying for a miraculous recovery over the summer!!!! So far, no luck!