Hey this is Prince, I need help. It is affecting my life badly.
So my story starts on 1st week of April 2013 I had a hard stool and it as little painful, no bleeding though. I am bad in taking fibers so it was understood, and used to happen sometime so I moved on, but it remains burning after BM for hours (12 hours), and then daily after BM I had similar routine, so have been to general surgeon, he checked it and said it is Anal Fissure (Phew). I was thinking of piles, but anyways he gave me nitroglycerine and Ispaghol husk (Natural Fibre) to take two times daily, I did so for about two weeks and found that no more hard stool, since I was using all fibers, vegetables, fruits and lot of water. but no change in pain :(. Pain and hell burning starts after few hours of daily BM and extreme by the 12-14 hours and then burning decline to zero at the time of next BM.
So have been to another more senior general surgeon (In my country, Pakistan general surgeons do piles and anal fissure surgeries) and he checked thoroughly and said it is Anal Fissure, while checking using gloves he touched it and pain was like a hell, he said if this is the pain you better go for LIS surgery in a day or two. I said I need a time to discuss with family and some research he said sure if you can bear it then fine. I came back and discussed with family and we decided that I should try Homeopathic way, I went to one very famous Hakeem(Doctor in local language) on 26th May 2013. he gave some tablets and cream to use and asked me to continue nitroglycerine and natural fiber with it. after like 4-5 days burning remain the same even I found intensity was little increased so I stopped Homeopathic.
I thought it is more of stool thing, if somehow I can make my stool more softer it might heal, so I tried Delax (Bisacodyl) 5mg tablet, one in a day. I felt some wired pain in stomach etc.. until the BM. but BM was very soft, and I used it for a week, and all was good. not much burning nothing, and I Thought it is healing, but I heard on internet that I cannot use Bisacodyl more then a week so I stopped and next day was okay, but after 2 days the stool was average and pain/burning came back, another day burning increased again and now after like 4 days I think it is same as it was before :( Unfortunately. Can I use Bisacodyl for months or more?
During these all exercise there were few things which were different from any other case I found on the internet, those are as follows
1) delayed pain and burning, not at the time of BM but after BM it starts after few hours.
2) No bleeding at all so far I noticed.
3) sitting on warm water not helping much. (Temporary though)
Now what should I do? should I go for LIS? because I cannot concentrate on my work, and have to get rid of it but safely.

hey prince, first of all very sorry, but join the club. give us some more information...How old are you? have you has this before and how long did it fix itself. I Personally think you should give it some more time. You said you have had it before? but it healed? Also is this a common surgery in pakistan? Is it safe over there? Ask around family and friends so if anyone else has had this. Also

Just wanted to let you know, I am just like you. 1-2 hours after BM pain starts. Never any blood, and sitzbaths only gives slight relief.
I think its pretty typical for a fissure to act this way.
Not sure what advice to give, but mind you, fissures heal slow, and nitro usually needs 6 weeks to work its magic.
Hope you heal soon!

Hey thank you guys for your prompt responses!
I had constipation before but not anal fissure (I never went to surgeon for this so not sure). I am 100% sure it never last more then weeks. but this time it is already more than two months and intensity is increasing.
About me:
I am male, 32 years 8 months old, married with one kid. Never smoke, never drink, 150lbs weight.
I don't think it is common surgery here in Pakistan, because never heard from any friends, relatives or colleges. But my surgeon told me that he do one per week. I tried to search on internet but didn't find any Pakistan based case study either.
Can i take Delax (Bisacodyl) for life long? I am taking Miralax(Ispaghol) but it is not giving stool as soft as Delax is giving. thoughts? LIS is the only solution left?

Hey prince, I am also from pk from lahore, but living here in the usa. i am 29. I a m suppose to go see my surgeon this wednesday and i am going to get me some nitro. But I would recommend you wait a little bit more because i have had headled 2 fissures in the past...took me like 6 months. Try Mirilax---i think ispaghol is different.isaghol is fiber which bulks the stool, you need miralax, also no spices and also what helps me the most is Magnesium.(safe to take forever)it softens the stool and also relaxes the muscle. Anyway i am also thinking of surgery if the nitro cream does not work out. it takes at least 6-7 weeks. good luck i know this is the worst thing i have had in my life...i havent talked to anybody in my family yet but i think i am the only one but again people dont talk about his stuff often. good luck PM me if you need anything.

Thank you Splinterboy! Nice to me you, I am from Karachi.
Miralax is not available here in Pakistan, is there is any other name for it? I might able to find imported somewhere it would be quite expensive, is that worth enough? Should I go to medical store and ask "Magnesium" as well, any brand name or anything?

Help??? it is burning like hell.

hey prince try looking for movicol the uk name or magracol.
magnesium tablets should give you softer stools

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