I have had my fissure since I gave birth to my daughter 18 months ago this month. I kept being misdiagnosed with piles, eventually got refered, it was decided that I would benefit from botox and a skin tag removal. Had this done in December and felt fine for a couple/few weeks then I had the hardest bm I've ever had (despite living on veg) and bled for 10/20 mins solid, a lot of crying later and I pulled myself together and got on with life, it was uncomfortable for weeks and there was blood, and recently the bleedings subsided but the pain when I go is unreal, its the first little bit of the bm that hurts after that 1st bits out the actual physical pain subsides its still there but bearable its the spasms the hurt next, and wiping hurts so much I've taken to getting rid of most of the mess then jumping in the shower or having a wash in the sink, its embaressing and reduces me to tears cos the initail pain, then the spasms then the awful burning and itching after also I'm not sure if its common but I find my bum is really tight after a bm sitting is uncomfortable and although I get on and do sit back down I sit there trying to stop the tears cos it hurts so much, I don't want to annoy my husband or make my daughters life a pain listening to me moan about bms so I just sit there in pain, my husbands great and listens to me rant about sore bums and itching and how bms hurt but can you really ever understand the pain and the emotional side of it unless you have 1 of these stupid tears I don't want to annoy him by going on and on? Anyway I had a doctors appointment Monday and spoke about it but kinda feel I got fobbed off, he said about treating for piles but I don't think I have piles, it doesn't feel like it and bms despite the pain are soft and I'm eating brown bread and bran flakes everyday to help soften bms, but all he said was piles and didn't look despite me explaining about the botox etc, so how does he know, I know the pain is my tear, bms are soft so when he forgot to give me a perscription due to talking about something else I didn't mention it again cos I know piles aren't the problem, what annoys me is I've had this 18 months and still getting the problems, I know the pain of piles and the pain of the tear and it annoys me he's fobbing me off again. I feel so down about it all and not getting anywhere, I've started eating fibre rich foods to help bms which is a pain cos my family eat normal stuff like white bread and normal cereal, I'm fed up of crying on the toilet and having cream stains in my knickers from applying the cream for the itching/burning and having to boil wash them to get the cream stains out, I'm fed up of being in pain sitting down and generally had enough now :(

Sorry for the rant, I just don't know what to do anymore, I feel down loads and don't feel like me anymore

Firstly... No apologies for the rant... We all need to have a safe and understanding place to let it out... And that is what you have here... People who totally get it and support you and will listen and do all they can to support and help you.
It really sounds like you need another doctor to take a look at you since you seem to banging your head against a wall with the one you are seeing now. Any chance for a second opinion?
Do you feel like your BMs are soft enough on a constant basis? Maybe adding a stool softener or Miralax to your regimen might make stools easier to pass on a more consistent basis. Also, sometimes it can really help to use some sort of lubricant like Vaseline before a BM to protect the area. A hot bath after a BM can help ease the pain and spasms. A heating pad during the day can also help.
But it really seems key that you have a chance to see another doctor. Because with good care, both at home and with a good physician, yes, it will get better.
sending you thoughts of comfort and understanding, and a gentle hug from across the miles.

So sorry that you are in such pain.
If possible, can you get a referral to see a colon and rectal surgeon, as they are far more experienced in diagnosing anal fissures. I have had my tour of GPs and their prescribing all the wrong things for an anal fissure. And a couple who didn't even examine me, and still prescribed things that did nothing.
I can only give what I have done:
-Reduced the amount that I eat.
-Eat soluble fibre - metamucil is what I take, cinnamon flavoured biscuits.
-Drink at least six glasses of water a day.
-Use a Sitz bath. Amazing thing for relaxing the bum, though I only do five minutes at a time, for three or four goes.
-Use something like Miralax (not sure what it's called in the UK). I use MOM, but just about everyone swears by Miralax.
-Don't strain (easier said than done, but I try to let it just come out).
-Never wipe; just dab with wet soft TP. Wipes and that were too much for my bum!
-Use Vaseline - I only use it on the outside, and have stopped using it now, but it helps to relieve like nothing else I have used, and believe me I have used a few things!
-Everything in moderation.
Best to you. Keep coming back. We are here for you.

Hi Louise...... Oh boy, do I hear you!!!!! I am with you all the way! I know that feeling of despair, crying, ongoing agony - actually, I think all of us on this site know that feeling! Which is the great thing here! The support and understanding! I think it is hard for those living with us to understand our pain although I am very lucky to have a wonderful supportive husband. I had botox 8 weeks ago too (early december), and think the fissure is healing (or healed because I can no longer feel the BM's as they pass down the tract) but still getting the agonising cramps/spasms for literally hours afterwards - and yep, mine last ALL day and into the night. So hang in there, I'm sure things will improve soon. I too, leap straight from the toilet into the shower cause wiping was just too sore but also think it is good to clean it all thoroughly away, keeping the area as clean as possible etc. There are no easy answers here, but if possible, get a more sympathetic doctor. Wishing you all the best!

Hey fedup....I have had every symptom you've described exactly! So I know exactly what you're going through. Mine started with the birth of my (third) daughter as well.
Botox tends to be a temporary measure, once it wears off it's really common for people to have a reoccurrence. I know it's harder in the UK, just from what I've seen on this board it seems that across the pond you are sort of pushed to do the botox before getting the surgery. That seems unfair, when the botox results are iffy and the surgery has a high success rate.
I absolutely believe that you're correct about having a new tear, all your symptoms would point to that. I hope you can manage a referral. I really think you need a new doctor to help you get through this. I remember feeling like I was trapped in my body, because it wasn't something I had the power to heal on my own. I needed help, and yet I really didn't want to deal with it, I just wanted it to go away on its own. But it wouldn't!
Finding a doctor to perform the surgery was honestly the best thing I ever did for myself. I was lucky to find a wonderful doctor who was sympathetic and intuitive--he didn't push me to do botox or ointments but agreed to do the surgery right away. I'd been struggling for five years at that point so I was ready.
I wish everyone could see a doctor like that. It makes me so sad to see stories like yours, where the doctor blows the patient off because he thinks all butt problems must be hemorrhoids, or he doesn't think it could possibly be a big deal. It is a huge deal, the emotional and physical toll it takes is overwhelming.
We're all with you here, don't worry about ranting. This board was the reason I kept my sanity through this ordeal. I didn't have many people I could talk to face-to-face. My husband only wanted me to GET IT FIXED. He didn't understand that sometimes it takes time and that what I really needed was a shoulder to cry on.
Take care of yourself, fedup! Do whatever you need to do, I promise it CAN and WILL get better. But it takes effort on your part, to seek out a better doctor who can give you the treatment you need. Hang in there!

Thanks for all the replys I just felt I was banging my head against the wall, the doctor fobbing me off like that when I'm sooo fed up of the pain and discomfort was a big blow, I will try and get an appointment with the original doctor I saw who eventually gave in and refered me for the botox, but at my gp surgery you wait like 3 weeks to see a doctor and its not always who you want and the 1 I want always has an even longer waiting list :(