Hello all
Thought I'd introduce myself. I'm 25 and have been suffering with an AF for over a year now. It started from one large stool that wreaked havoc and it's been crappy ever since. I take Mirolax everyday to relieve the pain. It's been my savior, however, I'm concerned about the longterm effects of taking this for so long. Every now and then I'll stop taking it wishfully thinking it's magically healed. Nope. Pain and blood.
I went to a "CRS" doctor about 9 months ago and he told me to take Mirolax and prescribed me Nitro ointment. I tried to stick with the ointment but the headaches were very bad and very distracting at my job. Anyways, fast forward to today and no change. I finally sucked it up and started taking my ointment again for a week now. I haven't seen blood and things seem okay but I'm worried a) the ointment is expired and no longer effective or b) I'm building a tolerance already. I really don't want to go back to the doctor. He was a bit rough when looking at my AF and it was painful to say the least. I know it's his job but still.
I know a lot of you have it much worse but this thing really sucks especially since I try to stay active and I'm relatively young. I just want to take a poop without worrying.
Any tips or advice would be great (especially about my ointment). Is it still good you think?

If the nitro is giving you headaches, I reckon its still good. If not, get some new.
Stick with the nitro for at least 6 weeks, even if you see improvements. The headaches are bad, but they passed after 14 days for me, and thats what other ppl also experience.
You could also get diltiazem if you cant live with the headaches.
Good luck!

So in the long run, you may want to try to find whats causing the hard stools in your diet.
This will allow you to be weaned off any artificial products to keep your stools soft.
For some, I think our fissures is our bodies way of protesting what we are shoving in our mouths.
Like a computer, garbage in-garbage out.
Many of us here have to give up certain foods for a while or at last cut back.(Processed foods, breads, spicy stuff)
Or simply increase some foods we may have been neglecting.("Insoluble" fiber, plenty of water, fruits and veggies)
At 25 this may be a challenge for you, but if your fissures stick around long enough, you'll take the challenge square on.
Oh yeah, in fact it was at around 25 that my fissures started attacking me. And only years later did I finally beat them for good, through diet.
HTH

Thanks for the responses guys. Not sure what originally caused my hard stools but I'm sure it was my diet. I also steadily gained weight (went to 160lbs to 195lbs) over the course of about 2 years, so that played a role as well too I'm sure. I eat much better now and my stools are always soft from the Miralax. I've tried to hit the gym and lose some weight but its tough with this constant pain. I've heard intense exercise could be harmful to my AF too?
It's been about 2 weeks now since I started taking my nitro again with no significant change so far. I still feel that distinctive sting like there's a cut down there. I only apply my nitro once at night as I am pretty regular about going in the morning when I wake up so it's the best time to take it to avoid headaches and my bowels will be loose. I want to perhaps apply more often but I'm not sure it will even be effective if I don't really go anymore throughout the day. I do notice I'm straining less and it sort of just falls out so that's good I guess?
Fingers crossed for another few weeks.

Fissure, the nitro is usually two times a day as doctors instructions, when my fissure was the worst I used it three times a day.
Now you will feel the fissure when putting the cream but the discomfort goes away.
It takes several weeks for the cream to work so give it time, remember that you fissure is considered chronic after such a long time.
Now as for exercises I am into fitness so even in my worst days I still went to the gym and did what I could.
You may have to do some changes like doing your Free weights standing rather than sitting, I had to stop doing sit ups because I could feel the pressure on the anal area, also could not sit on any incline bench or exercise machine until I was better, as that was very irritating to the fissure.
Beside that I had not problem with exercises, occurs if you are in a lot of pain and is too uncomfortable for you then by any means keep yourself from anything that will make you feel worst.
I was a hard head and even with pain I kept my exercises routine.
I hope the fissure heal soon for you or at least it gets under control for you to feel more comfortable.
It took me 10 months to be able to deal with mine and while is not gone I can have a normal life again with mild flare ups once in while.