Hi Exbestfriend,
You've found the best place to be right now but sorry that you have to be here.....
The first thing you MUST do is see a CRS to get this properly diagnosed, even though you say you don't want to see a GP. It is highly likely from everything you've described that you do indeed have a fissure and if conservative methods are so far not helping, you need a little more help. You need to obtain a prescription for Nitro or Diltiazem, creams specially prescribed for the first stages of a fissure. These will assist in relaxing your internal sphincter, which in turn will assist in the healing process and take the pressure off the tear. Ensure you also follow the following, because these are things that have been tried & tested by many of us and have been really helpful:
1) Apply a lot of vaseline pre BM's to lubricate the area well and coat the fissure, "protecting" it as the stools pass through.
2) Start taking warm-hot "Sitz" baths or baths or alternatively use a detachable shower head to shoot water into the area after BM's to clean and encourage blood flow to the area and also for relief
3) Never ever strain (push) during a BM. Squatting might help you also. Just let it fall out naturally - If you keep your diet in check/ up your WATER intake a lot and take a stool softener, these should be sufficient in allowing you to do this.
4) Do not wipe with harsh tissue. Use baby wipes to "dab" the area to clean. Pat dry with a towel.
5) Get hold of the Nitro/ Diltiazem and use after every BM (or at least twice daily)
6) Ensure you are consuming enough fibre in your diet and cut out all fatty/ processed/ spicy/ "white" foods immediately and replace with brown (bread/ rice/ pasta)
Ensure you are eating lots of fruit & veg and fissure friendly foods - Scour this site for dietary ideas and recipes - there are lots!!
7) Cut-out the alcohol and the Energy Drinks (Sorry!) Definitely will not be helping you in any way since alcohol dehydrates...& those Energy Drinks have way too much caffeine.
Drink lots of water/ fruit juices & reduce your caffeine intake to a minimum. Drink water after every meal you eat and lots inbetween too
9) Purchase a stool softener (Miralax/ Lactulose - there are many - again just research the site!)
You are still in the early fissure stages, so act NOW to try and prevent the condition becoming chronic.
No - you will not have to worry about this for life if you start making those all important changes now. Even chronic fissures eventually heal....
Coughing will aggravate a fissure as will sneezing - the best tip here is to hold your buttocks together when you feel the need to do this. It really helps relieve the pressure. It is just a sign it is there but not necessarily worsening.
There is an awful lot you can do to help from home but you also really need to seek professional medical advice.
Some people here have acted immediately and very successfully been able to manage and heal their fissures very quickly, so don't despair, try not to stress - just take a positive & practical approach to dealing with it all by following the above. I'm certain others will drop in to offer you additional support & advice.
All the VERY best to you in the meantime.