Hi all, been battling AF since the last 1.5 years. Started with a painful tear and I made it worse by using piles cream. Ever since I have been aware that it's a fissure, I have been reading a lot about it and using Nitroglycerine cream (only when needed, have never used for more than a week). I go completely pain and sensation free most of the time except that once in every couple of months a flare up happens. The pain during these is very less and bearable, more like a stinging sensation after BM which lasts for a couple of hours. I only have a BM once a day and regularly take Fibre supplement powder and stool softener. The flare ups only happen when I falter in my diet and the pain with each flare up has been reducing. So my question is, should I think about surgery? My main fear is incontinence. How long after surgery does incontinence occur and is it really something I should worry about? I am a healthy 30 year old male.

Wow this sounds like me simplebutt. I just had a recurrence after 3.5 months of being symptom free. (1st fissure was about a yeat ago, but kept re-tearing every 4-6 weeks until the 3.5 month reprieve, which ended this morning unfortunately). My recurrence however is nothing like the original tear which was incredibly painful and bloody, so I am reluctant to get surgery since the pain is not bad and managing it with diet and supplements was working until I got lazy. But I wonder like you if it;s time to seriously consider surgery and hope to read some thoughtful responses. Thanks for asking the question and hope things stay pain free down there :)