Hi, I feel suicidal. I have had AF for a few years. In fact I think it has been many years (I am 40 years old) and can remember saying "mum it won't come out" when I was a child and also taking a laxative on occasion. As a rule after a couple of days of pain with BM it eases and I relax a bit. I have a wide tear on my left (is that 9 o'clock or 3 o'clock?!). I don't know when it originally tore but it did tear in September but I reduced the pain within a couple of days. Then almost 4 weeks ago it re-tore again, badly, but again after a couple of days I could cope with a pain free BM. I did see my GP who didn't even want to look at it, he said "what would that achieve", and I said "peace of mind", so he looked and said it was a "normal" fissure. I don't think he looked properly. He then issued me with some 0.2% GTN, which I admit I used for a week but then I used it after a morning BM and I felt really unwell with it, so I stopped using it. I also have some Lactulose which I take 10mg/ml and take it about 4:45am every morning so soften things up for my morning BM. However on Monday it re-tore, and I have no idea why. It was sore all day and I have a desk job which I think doesn't help. Tuesday afternoon the pain was so bad I didn't know what to do with myself. It was ridiculous. I went home and decided to take a look and strangely the pain subsided. Tuesday evening I did have to take a painkiller just to get some sleep as on Monday I couldn't get to sleep because the pain was bad. I have been eating fruit and veg, sloppy foods, drinking more, taken a spoon full of olive oil (yuck), a glass of prune juice which I have every evening and the Lactulose, just trying to keep everything soft. I have sitz baths and use anusol suppositories and cream of which I put plenty on last night thinking it would ease the passage in the morning. So BM this morning was very fast and caused even more pain. Usually it eases after a couple of days but this morning it was bad again. I was surprised because I can usually ease the pain, why not this time? So now I am in a very deep depression (I suffer from anxiety/depression anyway). It's all I can think about. It's putting a strain on my marriage, I don't want to do my job, I can't speak to anybody because I can't think about anything else. And I just don't know what to do. I have lost weight, I am 5ft 5 and weigh about 7 stone. I just feel like it's taken over my whole life, I can't eat normally and I can see no end to it. I've read the boards about LIS and I just don't know if I can get through that. I just wish I wasn't here anymore and I don't know how to make it better.

Hi Carolineandy,
Firstly, I'm sending you a really big soothing cyber hug. I know exactly how you are feeling right now... Been there too, and it's not the kind of place I would wish on anyone.
It sounds like you have been suffering from fissures for a very long time... And you already have a good routine to cope with a flare up. May I suggest swapping the lactulose for mirilax (movicol). I did, and noticed such an improvement it was the best change I have made.
Could you ask your gp to refer you to a proper colorectal specialist... You may get some better creams such as diltiazem or nifedipine.
Look after yourself.... Make sure you get lots of rest.. Try not to get overly anxious.... You WILL manage to get your pain level down. Anti anxiety pills were a life saver for me, as I was becoming all consumed with my pain, routines, what went in my mouth (by then, very little!)I was literally a complete wreck.

OMB x

Thank you OMB, you made me cry (it's ok) because of your kind words and I didn't think anybody was going to reply to me so hugs back.
The dr previously gave me Laxido, and I was consuming a tiny amount, literally half a tea spoon a day and even that I couldn't tolerate. It gave me terrible stomach cramps and indigestion. Is the Movicol the same as Laxido?
I am a wreck at the moment, I look terrible and feel hopeless, I don't know what people see when they look at me. I have a drs appt on Thursday to discuss my anxiety (I was on meds before but got well and came off them), but I think if I can manage this God awful thing, then perhaps I will become less depressed. It's a vicious cycle, I don't know what to eat and I am not eating anything more solid than potato and other veg. I had about 12 weeks of no fissures, it was heaven, then I ate some chips which were as dry as anything and the next day - wham - big tear.
I have read the posts on the forum and just think it's so awful the routines people have to go through to try to heal and keep it to a point of just managing everything.
I will ask the dr to see if she can refer me and I should try harder with the nitro. It's such a pain with the routine ALL the time.
My pain seems to get worse during the course of the day, not better. Is that normal? Is it because the wound is drying out and becoming sore?
Thank you for your advice and kind words, it means a lot x

Hello Caroline Andy,
I am sorry you are suffering with this. Please don't give up hope. I was in a big black hole a few months ago, I just didn't want to wake up, it was that bad, the pain, burning and control the Fissures were having over my life. Thanks to lots of support from family, this Forum (thanks OMB) I got on Anxiety meds and started to sort myself out. I had Botox at the start of April, still keeping up with the softeners, diet and sitz baths. I am feeling a hell of a lot better. My weight has plummeted from 9 stone to 7.5 stone, I am also 5.5 in height. I didn't want to eat anything, was so scared and anxious about the pain on BM and the pain all day. I just turned into a jibbering wreck! Nowadays I am being more positive and trying not to let it rule me. Please keep us posted on how you are doing, you are not alone in all of this.

Hi CarolineAndy...
Just read your post and thought I would drop you a short note.
Like others who have replied to you, we have all been there before.
You probably have not read any of my posts, as they are older. I had a fissure that totally consumed my life. I suffered with it for about a year trying all sorts of creams and laxatives. Nothing worked, or at least nothing worked for very long.
I could not function properly any more...job...wife...all were being compromised terribly.
I decided to talk to my Dr. after I had done some on-line research of my own. I located a clinic in Toronto, Canada called the "Rudd Clinic" that specializes in rectal problems.
He set up an appointment with them for me and off I went.
I was willing to do whatever it took to get my life back.
After a consultation...returned to have an LIS.
...didn't work.
Returned after about 6 weeks...was put under again to have a second LIS surgery, but while under, the Dr. decided that I should have the operation in a proper operating theatre, and not at a clinic.
...Sent me to the Chief Surgeon at the North York General Hospital who was also an CRS specialist.
Step #1 with him was Botox...didn't work.
Step #2...second LIS surgery.
And, my life is back!!
That was about 5 months ago.
I am not always 100%...but...I am very happy with things and hold both the Rudd Clinic and the Dr. at the hospital close to deity status.
Re: laxatives...I talked to the Dr. at the hospital about laxatives, as I have been on them all. He said to stick with Metamucil.
I take about a tablespoon each night before bed and after a few days...everything is as it should be.
I asked him about diet...booze...meat...veggies...etc., etc...and he said to eat what I want.
Reading your story, I would suggest that you at least get to a proper CLS and talk with him/her, bite the bullet and get it done and over with.
There is light at the end of the tunnel.
It is actually something, once my mind was made up, that I was looking forward to getting done.
The pain after surgery and through the healing process, is at least, only going to get better every day. Without LIS...the pain may subside for a day or two, but it will return.
Good luck to you...keep me posted!
All the best,
Bajan

Carolineandy sorry to hear that you are suffering with fissures, you are not alone. Most of us are here because we have also suffering from either fissures, fistulas or hems.
I know that anxiety and the worry that you feel while wondering why you are in so much pain and suffering from this affliction.
But like I say you are not alone, we all been there, are working on getting better or have been healed.
Sadly pain is part of most chronic fissure suffering.
Irritation after BM, blood in the stools and water and the spams they all go hand in hand.
If you are having problems with the cream tell your doctor to give you an alternative or to refer you to a proper CRS.
Also, if you do not have hems, you do not need to use anusol, any creams that are for hems will hinder the healing of a fissure because you need blood in the anal area to heal and hem creams reduce the swelling suppresing blood flow.
Use vaseline to make the BM easier to pass, lubricate and avoid irritation.
Pain killers helps with the pain when became unbearable.
Is light at the end of the tunnel, either you can find a routine that will help for you along with the proper prescribed cream.
Fissures can be very painful but you can make your life more comfortable.
Is plenty of information here that shows you how many of us has found ways to deal with fissures, it helped me and I still have my fissure but It's not as painful as before even occasional re tear.
Many other people also post about their experiences with surgery, while others post of how they have healed on their own.
When I felt like it was the end of the world for me I used to come to the forums and read about all the wonderful stories about healing, that gave me hope.
I wish you the best and that you find a way to cope with this condition.

Carolineandy,
This forum is fantastic for support.... I think no one could possibly understand the soul destroying pain an anal fissure causes. It's such a deep routed pain, it causes extreme anxiety... I mean... It's an area that just has to be used.. It's un avoidable. The folk on here know the pain and the angst all to well.
It's great that you have a drs appt next week. I personally wouldn't hesitate to go back on your meds for the short term... It will just give you that bit of clarity in your head to be able to think more clearly and cope that bit better until things calm down again for you. While you are there you could ask for a referral to see a proper crs.
I hope you are feeling a little better today.

OMB x

Carolineandy
As we are deeply sorry and it pains us to know yet another person is experiencing this, but yes, this is the place to let it all out my dear.
you expressed

I was surprised because I can usually ease the pain, why not this time?

This is the bane that makes AF so insidious to all of us. I distinctly remember in my battles sitting on the toilet trying to pass razorblade laden rocks.........I ate perfectly, I exercised drank plenty of water, why the hell am I constipated!!!!!!!
Carolineandy I think our AFs along with the digestive system works in cycles and goes through progressions that perhaps we have little control over once certain things take place. Plus it sound like your pain may be spasm which are totally unpredictable.
Those certain things may be something we ate or a certain irritant our body is dealing with or even a stressful situation which is manifested phisically.
Hence even though we are sure we may have done everything right, our body (our AF and digestion) may be responding to traces of irritants or foodstuff from days ago combined with stress and perhaps lack of exercise of that day. And spasm due to overworked muscles+++.
Alas, who knows why these things happen, but I sure understand your frustration and even depression over the matter. many a days I wanted to throw in the towel and say ok, I will have to deal with Af for the rest of my life.
But re-tear after re-tear just made me more determined to beat them. And I finally did, with diet alone.
Strap up your bootstraps and take these fissure by the horn, attack them like they are attacking you and ultimately you will win.
Stay strong

Hang in there, Carolineandy! It's great that you're meeting with your CRS. As someone who suffers from depression and AF, I can tell you I know exactly what you're going through- for what it's worth. Sometimes this board is the only thing keeping me from throwing in the miserable towel. I'd suggest getting back on some anti-depressants or anti-anxiety meds just to get you over this bump- and know that you WILL get over this bump! Have you explored the possibility of LIS? I'm five days post-op, and so the memory of the immediate recovery is very fresh in my mind. It's not so bad, certainly nothing to be afraid of. I'm not sure yet if the LIS worked for me, but I don't regret it for a second. If the LIS isn't something you want to consider, perhaps Botox would be a better route. All this, of course, is only if you're fed up with trying to manage the AF on your own.
Just know that you are NOT alone. I feel like a ring wraith half the time (nerdy Lord of the Rings reference), but chatting with the folks on this board makes me feel a little more human again.