One of the best tips I got here was vaseline. But wasn't sure how to apply. I just threw it in with the syringe, but still got pain. Today though I had a perfect BM, didn't even feel the fissure and here's what made the difference.
I tore pretty badly on my last BM 4 days ago, even though my stool was Bristol 5. I probably let it out too fast and the vaseline must have missed the fissure. Afterwards I felt the whole fissure burning all the way up. But the last 4 days allowed some healing and I think the Manuka Honey I started using since then helped some.
So today it was BM time, was preparing to lube, but a good chunk slipped out, since I'm on botox. Since I was contracting hard to hold back, what I noticed is that the stool doesn't quite get in contact with the fissure, it barely touched it a little and I felt just a little stinging. The piece that came out was very flat with with clear cut edges. I managed to stop the flood and then it all came together.
Sorry if it's totally stupid and trivial, but I just realized my asshole is not really a hole, but more like a straight line from back to front. I always thought the anal tissue closes in like the head of a drilling machine, but mine at least, it just folds in. I realized that from the very flat shape of that piece of stool, which was confirmed when I analyzed myself in the mirror. Didn't pay attention so far.
OK, so now I know my fissure is in the back fold of my anal canal. That explains why I just wasn't able to find it sometimes. It also explains why doc insists on massaging the area, so the fissure won't fold into itself.
And then it occurred to me, what if I just fill in that fold with vaseline, completely hiding the fissure? So that's what I did. So as I'm laying on my back, the back fold is like a valley with the fissure at the very bottom. Fill that up, so now my fissure is covered in a river of vaseline.
Additionally, I'm gonna keep my anal muscle slightly contracted when pooping, like I was trying to hold back and reduce evacuation speed (I was already practicing this for a while). That is not to open the anus completely to a full circle, cause that will make the vaseline layer very thin, allowing the stool to wash it off.
OK, so the result was amazing. My BM was like back in the old days, I really didn't feel any pain at all during BM. Like my fissure has disappeared. I think there was no contact at all between stool and fissure. I did swell a lot though, but it went away couple of minutes later. Some slight stinging after I got out of the bath tub, but 3h after my BM no spasm yet, it would usually kick in by now. Just mild discomfort.
Damn, never thought pooping will become a science. Sorry if it's all trivial for you guys but for me it was like a big discovery.

bgd, that is a great post on your fissure experience, I use vaseline before a BM, I can also see the way the stools comes out that it have an area that kind of have the track of the fissure.
I also insert vitamin A carlson suppositories before going to bed, Baby desitin helps also because it sticks to the fissure, creating a water prof barrier, that works for irritation.
Nice post.

bgd wrote:Additionally, I'm gonna keep my anal muscle slightly contracted when pooping, like I was trying to hold back and reduce evacuation speed (I was already practicing this for a while). That is not to open the anus completely to a full circle, cause that will make the vaseline layer very thin, allowing the stool to wash it off.
OK, so the result was amazing. My BM was like back in the old days, I really didn't feel any pain at all during BM. Like my fissure has disappeared. I think there was no contact at all between stool and fissure. I did swell a lot though, but it went away couple of minutes later. Some slight stinging after I got out of the bath tub, but 3h after my BM no spasm yet, it would usually kick in by now. Just mild discomfort.
Damn, never thought pooping will become a science. Sorry if it's all trivial for you guys but for me it was like a big discovery.

LOL I discovered this last year when my fissure was really acting up. I realize that by doing fast and short contraction, it is less painful. It is almost like a workout because I tighten my ab and push fast/short...and just "squeeze" that stool little by little out.
I've also noticed that by using deep breath, your diaphragm pushes downward, which opens up your anus without using your muscle to push out. This method is best with squatting.

yup, same here. It is like developing a yoga routine for the anus with specialized precise breathing and very precise muscle control. : )