So after a year of itchiness and general uncomfortability, I began to see blood on the toilet paper every time I had a BM, and pretty soon while wiping to relieve the itching (no BM), I was seeing blood every time. I thought I probably had hemorrhoids, or HPV, or some combination of those and other things, but when I went to the gastroenterologist, he took one look at me and said that I definitely had a fissure.
Now, this man is obviously an expert, but I can see a very small (quarter of an inch) dangling piece of flesh with a white tip adjoining to the open "wound" on my anus. The doctor didn't mention HPV, abnormal hemorrhoids of anything besides the fissure.
So now I've been told to quit exercising for a while (I was previously running and doing push-ups, pull-ups, etc 4+ days a week) and take multiple hot baths a day, applying the nitro cream after each and make sure I stand up at work (airline pilot, so not always an option) every so often.
I guess I'm just having a hard time wrapping me head around this. I've never heard of this ailment and now I have to make these seemingly arbitrary lifestyle changes for something that will be so easily aggrevated every single time I have a BM. I'm wondering if not exercising (aside from direct abdominal work) is as critical as the doc would like me to believe. I'm also kind of worried that this thing is more than a fissure and really just hoping that somehow it'll be able to heal despite the fact that it gets seriously bothered and slightly worse everyday
I'm sure glad I found this forum, there seems to be a lot of answers here. What do you guys/gals think?

Hello Duvie,
I'm sorry you are going through this - the symptoms do sound like a fissure, but your doctor is the only who can really tell for sure. The dangling piece of skin might be what is generally called a "sentinel pile" or a "skin tag". It's a piece of skin naturally created by the body to assist with the healing of a chronic fissure, it's very common to be present in cases where the fissure has been around for long.
The first thing I'd say is to visit a Colorectal Surgeon (also referred here as "CRS"), sometimes also called a "Proctologist". Although the name contains "surgeon", he will likely recommend non-surgical options at first. My CRS will only even consider surgery after several months of the so-called "conservative" treatments. I'm sure your Gastro is a good doctor, but fissures aren't really his specialty. A CRS will be the one to recommend the best course of treatment, although your doctor made an excellent call by starting you on nitro.
Most doctors would recommend that you exercise, although they would also recommend against heavy weight lifting. Regular 30min walks, for instance, are excellent in helping with pain and healing because they assist with blood circulation in the area. As most CRS will tell you, poor blood circulation in the anal area is the reason fissures don't heal easily.
Another thing that is pretty important is to keep bowel movements soft and not too bulky. There are many ways to achieve that, but your doctor is the only one who recommend one to you. Common approaches include making sure you eat the right amounts of soluble/insoluble fiber and take stool softeners like Miralax or Colace.
Last, people in this forum feel/felt the same way as you. We don't hear of fissures until we suddenly hear of fissures! Not an easy thing to have, lives get seriously affected by them. However, be sure of one thing: they will heal in time, either with medicine or surgery.

duvie,
not much to add to Dan's great response above except to reiterate what he has advised and also to suggest that you stop wiping with the toilet tissue to relieve the itching. This will only tear at the anal tissue and inflame it even more and create more discomfort. Don't even wipe with dry toilet tissue after a bowel movement. Either use moistened toilet paper to gently dab at the area or jump in the shower or bath to clean up with water.
As Dan has suggested, a visit to a colorectal surgeon will help in a treatment plan in case the nitroglycerin doesn't help you heal, and a surgeon will be better able to assess and diagnose and treat.
good luck!

I can't thank you guys/gals enough for the help. It makes me feel a whole lot better to know how many other people have dealt with this too.
I'll definitely be careful about exercising and try and walk, not run for at least a month. I eat fairly sensibly, but I definitely do have my binge days and drink alcohol sometimes so I'll try to limit that to ensure better regularity and soft stools.
As for the toilet tissue, I bought some baby wipes for home use and I'll have to find some travel packages for work and on the road.
Guess I'll give the nytro cream a go and if it doesn't get better I'll be seeing a surgeon. Thanks again for the advice, I feel much more ready to tackle this problem!

Hey Duvie,
Sorry to bring you bad news, but I highly, HIGHLY advise against alcohol consumption. It's one of those thing that pretty much every doctor advises against in this situation and I've been myself without even a drop of alcohol for almost 4 months now due to my own fissure (although I've never really been a heavy/regular drinker).