Hey guys I live in Florida and you would think living somewhere as nice as Florida I would be free of "butt problems" but I guess that's just my luck anyway. I've been in much need of some support and I think I have found my new home . I just get frustrated though. my crs diagnosed me with an AF and gave me some diltiazem but other than that, everything has been left up to me to deal with. boy do I need some advice on this situation. what type of foods to eat? to avoid? also what kind of creams work the best for you guys in dealing or eliminating the pain.

Hi JR! Welcome! Florida is very beautiful. I've been there a few times to escape the Canadian winter, and Dawn is also from Florida. Unfortunately, living in a great state doesn't save people from getting butt problems. :D
I'm glad to hear that you already have a CRS and that your CRS gave you the proper meds. Ointments, like diltiazem, tend to work better on younger fissures. There have been success stories here with the ointments, so follow your doc's directions carefully. Meanwhile, I recommend finding a good stool softener because you really want to keep the BMs soft and easy (no straining!). Many of us here really like Miralax. It's pretty reliable and it comes in a powder, so you can modify your dose to what works best for you. Also, drink LOTS of water, especially since you live in a hot place. Water is critical for keeping stools soft, especially since you will want to go on a high-fiber diet to keep your BMs soft and regular. (Lots of fiber without enough water will constipate you.)
There are lots of good ideas for fissure-friendly meals under 'diet tips', but definitely avoid constipating food, especially red meat, white rice, white bread and alcohol and caffeinated drinks. Generally speaking, those are the kinds of food and drinks to avoid, but we are all different, so you may have to do a little experimenting to figure out the right balance of fiber/stool softener for you.
Warm/hot baths are also really good. They help promote blood flow to the butt, which in turn, promotes healing.
I really hope you beat this dragon! I'm sure others will chime in soon with lots of good advice. The folks here are super friendly and helpful and are happy to answer questions. :D

Hi JR,
Sorry to hear about your pain. I know it can be frustrating when you can't get the relief you are looking for from a Doctor and CRS.
I also took Diltiazem and it was okay. I found that sitz bath really do work wonders. Miralax is fine. I however prefer to take Senna Laxatives with a stool softener, I discovered that when I took the Miralax along with it my stool firmed up a bit. It is not causing me pain, but I notice that after a week the recommended dose is not good anymore.
MY CRS prescribed me HYDROCORTISONE ACETATE 25 MG SUPPOSITORY. I put it in at bed time everynight. It has really helped me. She told me it will melt during the night and the medicine will help heal the fissures. I have been pain free for over a week, when I started using it.
I eat lots of soup, veggies and fruits. I also drink a lot of water.
Good luck JR. I hope you find some relief soon.

hi jr. i agree with the miralaz it has helped me alot also. hope you get to feeling better soon...

Hey Victoria - I'm so glad the dilt is helping you. I'd be very careful with the hydrocortisone, though. Quite a number of us found that it made things much worse over time. Long-term use thins the tissue and makes it more prone to tearing. Lots of GPs give it to patients, but I haven't read about many CRSs prescribing it - actually, it seems that CRSs tend to tell patients not to use it. Anyway, you might want to ask your CRS about that.

Hopetoheal,
Thanks for the advice. This is all new to me. I am just happy to be living again.
I did not know about the thining of the tissue and will ask my CRS about it. I do not think she will have me use it for a long time though. I think once I tell her that I am doing fine she might think the fissures are healed and that is that. I strongly believe that they don't fully heal as I had them for years. I only recently suffered from the severe pain. I only had bleeding and discomfort for years.
I am just happy to have the freedom I do for now. Again thank you for letting me know this info and I will talk to her. :)

Just wanted to say welcome JR. I'm from the sunshine state too, and didn't escape the fissure, Lol. But I had surgery a year ago and things have been brighter since.
Hope has nailed all the info above. I agree 100% with everything she's said!
Victoria, I also second Hope on avoiding prolong(over two weeks) use of hydrocortisone. I was actually told by my GI and two CRS's to throw it out, it could ulcerate the skin.

thanks guys. Just hard to find the right foods so im not in pain for the whole day! but days where there seems to be not to painful. also is it painful because of the actual fissure? or that muscle that's causing the discomfort?

Hey JR - it is really challenging at first to find the right food to eat. I really recommend reading through the 'diet tips' thread carefully because there are some really good meal ideas there. Generally, the idea is to eat as much fiber as possible, but be careful because you can over-do the fiber too (this can be quite frustrating!). Lots of us increased the amount of fruits and veggies we eat. I have a lot of steamed veggies that I put on brown rice. Remember that there are two kinds of fiber: soluble and insoluble. Soluble fiber acts like a sponge and helps to add bulk to stool - rice, potatoes, oatmeal, squash, peas and so on. So have those if your stool gets too loose (watery BMs can also sting like a b*tch when you've got a fissure!). Insoluble fiber acts like a broom, and helps 'sweep' out your system. Spinach, broccoli, green beans, lettuce, and so on are good sources of insoluble fiber. Somtimes the trick is to get the right combination of both forms of fiber. People often get confused because when they are told to eat a lot of fiber, they get constipated; that's usually because nobody told them that a lot of soluble fiber without a lot of water just makes a big block of goo in the gut. I like Asian dishes because they often mixes soluble and insoluble fiber very nicely.
The pain can be coming from the fissure itself and/or the sphincter muscles. Often it's both. When I had sphincter spasms, it really hurt, like a burning, squeezing pain involving the entire anus ('burning ring of fire' is a good description, but I avoid it because I'm a Johnny Cash fan!). The pain was at its worst during a BM (passing shards of glass), but it would also last pretty much all day. I also often felt like I had to have a BM all the time. The fissure itself would usually only give me a sharp pain during a BM. I'd say if you are experiencing pain for hours after a BM, then it's mostly likely the sphincter muscle spasming.
@ Victoria - I'm so glad you are enjoying some freedom from pain. I was one of the poor slobs who was given hydrocortisone by quite a number of butt-headed doctors - they had me using that stuff for seven months!! It really made things A LOT worse.
I'm really sorry you have suffered with this for such a long time. Please don't be afraid of the surgery if it comes to that. I say this because ointments tend to be less successful on older fissures (but it can happen, so let's be hopeful!). If it turns out that the dilt doesn't heal you, I really think you should talk seriously to your CRS about the surgery. It is a scary idea, but it's not as bad as it sounds. I had the surgery in May and it definitely gave me my life back!

thanks guys for the advice.
@ Dawn if you don't mind me asking where do you live?
I have had this fissure since apparently April, I didn't get diagnosed till August. would you consider this a long occurring fissure? Also thanks hope, I wasn't aware of all the technical things about just FIBER!
@vsweeney09 I was eating soups and veggies as well but my weight was dropping.