*UPDATED 07/11/21

Here is an essential shopping list to help you stock-up on crucial fiber, vitamins, minerals, carbs, protein and other items (to help you "go" and heal):

Mineral water
Apples (soluble)
Oranges (soluble)
Dates (insoluble)
Bran Flakes (insoluble)
Yoghurt
Oatmeal
Peanut butter (always natural & smooth)
Wholemeal bread (insoluble)
Olive oil
Coconut oil
Ibuprofen
Laxatives
Vasaline
Notepad and pen/phone notepad

Important notes:

- Taking notes is one of your best weapons for beating a fissure. Food diaries are a great way to look back and see if certain foods are causing an issue for you (or if you're not eating or drinking anything in particular).

- Water can get pricey (especially as you'll need to sink at least 3L per day). The minerals will help with digestive health and recovery but if you can't do this, get what you can and still drink tap water

- Lack of fruit and fiber (and then being inpatient with straining on the toilet) are main reasons that cause a fissure as you either aren't eating enough or you're eating the wrong fruits (or form of them). Did you know that eating any fruit that isn't fully ripe can cause constipation? (especially bananas due to their high starch content when not fully ripe). I'd personally avoid bananas and pears during the healing process. Mix-up high soluble (oranges, apples, nectarines, kiwi's) with insoluble (bran flakes, wholemeal bread, dates and nuts). The later softens stools and makes it easier to go more often, while soluble keeps your gut healthy.

FIBER TIP: Never overdo fiber and record what you're eating and how it affects you the following day. Ever notice that when you had good soft stools (before your fissure), that you didn't really eat anywhere near your 5-a-day? That's because you don't need it (and everyone reacts differently to fibre). A good start is to eat just one form or soluble and one form of insoluble fruit/veg in one day (always with plenty of water). Record what they were and how your stools were the following morning and go from there. I've heard from multiple doctors that the perfect stool should have the consistency of toothpaste. That's your goal.

- Don't risk pears - These may be the fruit that offer the most insoluble fiber, but they are not the most convenient source, due to the time it takes them to fully ripen (even when buying ready to eat ones!). Due to this, you can possibly store them as backup fiber (while you eat better, ripe and ready to eat fruit) but never fully rely on pears as your fiber source, due to this reason.

- Eggs are fantastic as they'll give you a softer form of protein to heal. Eggs are not actually dairy (they don't contain lactose) and have vitamins and a small amount of natural fat needed for your body to also absorb vitamins and repair.

- Lower fat natural yoghurts are great as they give good bacteria and are easier to digest and pass

- Bran flakes are a great source of insoluble fiber (wheatabix's Crunchy Bran is a version that's even easier to munch and digest), meaning it will help you go more regularly. Just be sure to measure it out and for just one 30g serving per day to start with. You may only need it every other day or may simply need to adjust the gram amount. This will vary depending on how sensitive you are to fiber.

- Peanut/almond butter is good for you as it will contain fibre and protein. Just make sure you don't buy the normal palm oil and sugar injected versions (bad for digestion). Make sure it is smooth and natural, made with 100% nuts and never eat it once it begins to dry out (as you get to the bottom of the jar). Great with oatmeal!

- Ibuprofen can help ease inflammation after you've "gone". Stay away from co codamol (codeine) as this will cause heavy constipation. If you do feel you need ibuprofen, just take one pill after bowel movement with food. Remember that baths, prescribed ointments (short term) and staying off your feet as long as possible are still the best forms of pain relief and healing for fissure, so do talk to your doctor before taking any painkillers.

- Can't stomach fruit? While this really is the best method for recovery, Nestle also make a plant based fiber supplement called OptiFiber. You can also buy other fiber supplements such as Fybogel. Again, test with single and small doses to begin with, test and record the outcome and go from there.

- Olive oil and coconut oil are great for helping the flow of food in your digestive system. I use olive oil drizzled over softer meats like tuna and coconut oil to fry certain foods (like eggs) but others even use coconut oil in hot drinks, with great digestive effects too.

- Laxatives are good depending on your situation. Fruit and softer foods are the best method but if you're still getting issues with constipation (the main enemy of the fissure) laxatives are a life saver and will prevent you tearing your wound again. I personally did not get on with over the counter stool softeners and had to look into stronger prescribed ones such as Lactulose (be warned if like me, you get skin issues with chocolate/high sugar treats, this is pure lactose sugar and won't help your skin), Movicol or Laxido (the last two are my favs and recommended to me on here by many).

- Reintroducing meat. Once you start to pass stools easier and begin to feel as if you're recovering, slowly reintroduce meat (as your body will need more protein to heal). Start with fish or other softer meats (remember that olive oil can help here). Go from there and record and adjust to how your body reacts.

Ointments/GTN are prescribed to help ease pain and relax the anal sphincter. However, this should be used short term as many have had headaches, dizzy spells and even passing out with such ointments. I have been told by several doctors that I was possibly the only patient to have used Rectogesic ointment for 8+ weeks on end! Due to this, I believe this may have caused extra and possibly quite prolonging affects with the fissure. **UPDATE** Please check my latest update to this thread (07/11/21) as using Rectogesic for 8+ weeks with pile cream had caused major irritation. This won't happen with everyone but if your healing starts to take a U-turn (even when your BM's are on-point) and you're getting intense burning, itching and pulsating pain throughout the day - it's worth checking that post on this thread (as it's quite detailed and can really help).

- Vasaline (yup, the protrolium jelly you get in those blue pots) I really do have this forum to thank for this beaut. Vasaline is a godsend for fissures. It will help protect the fissure while keeping it moist for healing. Highly recommended and even more than GTN ointments if you've tried everything but it doesn't seem like your fissure is healing. I apply it by adding a small blob on the end of a cling-film finger (as with anything, clean the area with sensitive and flushable wipes first) and gently ease the vasaline inside, massage and then remove (you should then have none or very little remaining on the finger). Don't worry if any gets around the outer part as this will only sooth that area as well. Start with one application after every BM and increase if needed.

Hope this helps!

Also good fats olive oil ripe avocados coconut oil. I put 1 tablespoon of coconut oil in my morning coffee. Keeps things hydrated and moving.

Updated 29/08 with the following:

- The importance of note taking

- Better tips on fibre management

- Olive and coconut oil (shout-out to missymoo for the hot drink tips)

- Vasaline (shout-out to Bottomgun and missymoo)

- Ointments/GTN (I will also be updating this with some important findings soon!)

A shout-out to Conifer for the advice on Laxido. Seems to be very similar to Movicol but with a much cheaper price tag.

I agree with everything you point out.
Avocado and olive oil are a must. Greasy fishes like salmon work like a charm too. I have to increase my egg intake, thank you for this list (and for the vaseline to you and the girls!)

Waiting for your findings on GTN! High five, I've been with 0.2 nitro twice a day for 5 weeks now and no headaches anymore. Doc reduced the amount to just once a day, and I'm not sure if it's enough. I would really like to hear your experience! My fissure is closed (I reteared at week 2 but it closed fully at week 4) but it still hurts if I dont use GTN after my bm.

Hey Worstyear,

Thanks. Yeah, I'll need to add more salmon to my diet. I used to eat that as a pre workout meal and I miss it! lol

Same with the ointment. I no longer get the usual side effects anymore...but I'm close to finding if chronic constipation is a new one with long-term use. Of course, there are many types I believe, but all my docs keep prescribing Retrogesic.

I've been off it for 4 days now and no more constipation and after easy BM there is no pain while going or even sitting now (even after eating foods I thought that caused issues while I was working with baffled docs to find the cause). Very interesting but just allowing enough digestive time to test fairly.

Bathboi you also started movical and to be honest it will likely be that magic stuff taking away your constipation. Worstyear i would use the rectogesic like many doctors have told me to in the past 3x a day for 6wks

Missymoo please don't get me wrong here, I wouldn't recommend against the ointments as I've had good results over short term use. The issues that I've had with constipation have not just been recently. They have have baffled doctors while on all forms of fiber variants and other powerful laxatives.

At the moment I have to take the following into consideration:

- Fiber worked and softened stools for around 1.5 weeks but then constant chronic constipation kicked in (even on healthy diets, eliminating intolerance and testing a balance of both fibers, eating just one form fibre and even focusing on calorie ratio with fiber intake - 12-14g per 1000 cals). This totally baffled 3 doctors btw.

Yeah, the Movicol is more powerful stuff but that's why I'm still testing this and can't rule that out. All I know here is that you can't suddenly develop intolerance to a food with chronic constipation over the course of a fissure lol. Something wasn't right and while Rectogesic is good short term, I've been taking it for 8+ weeks, twice a day (could easily be longer tbh).

While the ointment is 100% recommended short term, I can't yet rule out such side effects long term due to the above.

Just in case, I just wanted to add that the above is NOT questioning the ointments capabilities to relax the sphincter/heal and ease pain. It's purely focused on the issues I had above, with severe constipation (so if you are not experiencing that, there is no need to stop using it).

Yeah thats cool as maybe rectogesic was causing your constipation but i just cant see how it could thats all.