Here is my experience.
- Started experiencing burning pain back in March 2020. At first I thought it was hemorrhoids, but after 3 months, the pain wasn’t improving. I saw my primary doctor and OBGYN and was treated for a yeast infection 3 times. No, it wasn’t a yeast infection. I was finally diagnosed with an anal fissure, described by the doctor as ‘pretty severe’.

- This was July of 2020. I was prescribed Nifedipine ointment, 2x day. Doctor warned me that fissures could be very troublesome, that some of his patients would take months before feeling better. So I started treatment, and with very little difference in how I was feeling, he rotated me through nifedipine ointment (2 months), diltiazem (second 2 months) and finally in November 2020 he recommended I switched to diazepam. All through that time I experienced no improvement, but I was dealing with a difficult and stressful family situation so I had to put all that pain aside to focus on what was going on with my family.

- From November 2020 until February 2021 I thought I was experiencing ‘some’ improvement, but most days I still had a lot of pain. I never had any bleeding, but the burning pain was severe and it extended from my anal area towards the front into the vaginal area. Seeing no improvement I saw a CRS who, seeing that the 7 months of treatment with topical creams had not resolved the fissure, recommended botox injections.

- I had two botox injections, starting in March 2021, 4 weeks apart. This was a tough time, because I had hoped to see some pain relief soon after Botox. I thought the Botox had done nothing for me. But it did. It took 6-8 weeks from the initial botox injection until I noticed any improvement. The improvement was very gradual, with many days still as bad as before, but then some days were a little easier and BMs were not as painful anymore. By the time I received the botox injections I had realized the complexity of healing this type of injury. So I tried many things and did everything I could to help it. Drinking water, diet modifications, supplements, stool ‘management’ etc. During this time I continued with the diazepam treatment 2X day and had a warm bath before going to sleep every night.
So, skip forward to July 2021 and upon examination today, the doctor declared the fissure healed. I no longer have any pain from the fissure after bowel movements, although I still worry and fear each time I go to the bathroom. Furthermore, I am not entirely pain-free. The burning pain I had before is gone, but I now am left with residual pain on my left butt and lower back which the doctor attributed to sciatica pain.

This forum helped me understand how long the healing process can be, the difficulty in coping with the pain, and it reassured me that I was not the only one going through this. It helped me understand what was going on and gave me ideas for things to try. I would say that at in my case, there was no silver bullet. I tried a lot of things, more than what is listed here. I did not discover anything new not listed through the forum already. Realizing that two days without pain did not equal a healed fissure was key, but that I had to continue to be extremely careful and keep going for weeks was something I wish I had known in the beginning. In the end, for me, this is what brought me closer to the finish line:

1. Warm baths before going to bed. It was annoying to have to do this. But I do think it made a difference.
2. Diet. This was tricky, and it required a lot of experimentation and frustration before getting dialed in to the foods that would give me easy bowel movements, not too hard, not too soft, not too bulky. I kept a diary which helped me remember and go back and see what I was doing and how things were affecting me.
3. Water. Drinking water without a doubt was necessary for me to ensure the easiest bowel movement possible.
4. A Bidet. It took me months before getting one, but after cleaning myself with wet toilet paper or having showers after going to the bathroom, I finally installed a bidet, which I wish I had done sooner.
5. Ice packs for 15 minutes after going to the bathroom.
6. The pain from the fissure did not respond to pain killers. But I did take ibuprofen after going to the bathroom since it couldn’t hurt and at a minimum it might be keeping inflammation down.
7. Supplements. I had to experiment with the amount of Metamucil that was right for me. Not too much, but a little bit did help making BM easier. Yes, I did try various stool softeners and laxatives, but in the end just some Metamucil and a small amount of Magnesium, along with diet changes, seemed to work best in my case.
8. Also, figuring out how to have a bowel movement in such a way that it would least bother the fissure took some trial and error. I experimented with various positions sitting on the toilet. Also tried various ‘support’ methods and followed someone’s comment about ‘pinching’ your butt cheeks when defecating to keep the fissure closed if you have one in the posterior line, as is my case.

I experimented with other things. I hope something in here helps someone else. In my case, I didn’t wake up one day feeling 100%. The months of pain and tension in the area have caused this ‘new’ challenges that I didn’t have before, like back pain and sciatic pain. And, there’s still some irritation from the fissure. But, that’s nothing compared with what I’ve gone through.

Gratefully.

Thanks for sharing your success story. I hope you will soon have no pain with this at all.