I've been dealing with the pain since 2009. My New Year's Resolution was to find a resolution for my problem.
I got an appt with a GI within a week from my Primary Doctor. Within two weeks I had a colonoscopy. She said I did not have hemmroids or AF.
I called back a week later to see when my follow up would be. No appt scheduled. It would SIX WEEKS to get an appointment. I broke down in tears and the nurse got her to prescribe the Nitroglycerin ointment.
I don't only have pain after a BM (at which time there is bright blood when I wipe), I also wake up the middle of the night with pain. I have to sit in the tub with Epsom Salt to make the pain go away. The worse day was three bath visits within 12 hours. It feel like a hot poker under my skin.
I found your forum when I search on side-effects of the ointment.
I am now suffering from lack of sleep, fire below and a massive headache. After reading some of your posts, I'm not even sure the ointment will work for me.

You know I read about GPs and GIs misdiagnosing AFs all the time. I've had two GPs misdiagnose me and one referred me to a GI and it took weeks for the GI to get back to me and say that I should be referred to a CRS and not a GI.
So that's who you should have been referred to. A colon rectal surgeon (CRS). They look at AFs all the time. They would probably have given you the same topical though to start. A lot of people say the headaches die down after a couple weeks. There are different topicals though if it is too much, like nifedipine and diltiazem.
Are you in the states? Can you call a CRS directly? Or do you have to go back to your GP for a referral?
Either way, you should do a search for CRSs in your area and them look up the names on ratemds.com to see which one has the best reviews.
To heal from an AF, it is super important that you have soft BMs! Like toothpaste of soft-serve ice-cream. There are many ways to achieve this, and they all involve at least 25g or fiber per day and lots of water.
Then people will also use stool softeners or prune juice and/or magnesium. I like a couple spoonfuls of olive oil through the day. I like to supplement my fiber with metamucil.
The pain in the night, might be from spasms. Have you searched here for info on that?
Sitz baths do seem to be the best way to relieve spasms. Also electric heating pads. Some have found help with anal dilation.
Please look around the forum and find more answers to your problem.
No question is too embarrassing here :D
Hope you find a way to heal quickly!
-Tanya

Sorry to hear about your pain. All that time sitting in the bath tub sounds familiar. With my latest fissure I don't do that anymore - just use one of those over the toilet sitz baths to get clean then spend hours sitting on a heating pad. That seems to be more effective for me now. I also started using a dilator and had three wonderful pain free days, but today wasn't so good - some spasms again though they didn't last for hours on end as they usually do.

Hi Baba,
Believe me, we understand your pain . I also do the sitz bath routine, though I don't sit for more than five minutes at a time, rinse the water out then go again on the sitz, but it absolutely helps to 'clean up'. You will see that there is a self-dilation post, and also a post by wecc about his Standardized Anal Dilation, which I am hoping to have done if trying it myself does not work.
Welcome! and a big hug