Hi Johnny91 - Thank you for all the advice. : ) I will give the mineral oil a try, although I might start with a little Miralax first and see how it goes. I agree, all of this requires so much experimenting. It's really quite stressful. : ( But I'm trying to hang in there and not give up hope. Some days are really tough. : (

My issue is that my stools are loose in my second movement, which sometimes irritates and stings the fissure even more than harder stools and I don't want to make those loose stools even worse with supplements or medication. So, I don't really want really loose/near-diarrhea stools, either, since those also can cause me pain afterward. It's so difficult trying to get the "perfect stool." Sometimes it just happens for me (no clue why, since I eat the same food basically every day), then it just goes away and I continue to have the hard stools first thing in the morning and looser stools after that. Ugh, it's so frustrating!

My fissure being internal doesn't help, either, like with yours. I can't really put ointment on it, since it's deeper inside. Every CRS I've been to can't see it without a scope (which I refuse to have in me without any kind of sedation), which is incredibly frustrating. I know it's there and I can feel it. It stings and burns and throbs sometimes after BMs and then those awful spasms happen for hours afterward that make everything worse. : ( It's awful.

Anyway, thank you for hearing me out. Just venting a bit here. Part of me just really wants to get the LIS surgery done to heal the fissure since my original CRS said that (along with exam under general anesthesia) was the next step. I just don't have the money or insurance for it right now. : ( If I did, I think I would just get the surgery done as soon as possible. So tired of all this.

Hi Luka,
Those loose stools are probably due to IBS, i'm not sure if i have it but until now i've never managed to get loose stools except when i had diarrhea for a couple of days. In my case though, i'm fairly sure that the diarrhea pain/irritation was better than hard stools.
In case you are planning to use mineral oil, use it without previously drinking miralax because in my case the effect of macrogol 3350 i've tried which is similar to miralax would take over and it was like i never drunk mineral oil.
So make sure to drink only mineral oil for 2-3 days to actually see its true effect.
I cant figure out why osmotics lead to more pain but it has to do with the type of bulk they produce and the stretch of the area.

Don't put all your hopes in LIS. If you read the forum on LIS topics, its kind of rolling the dice.
If you are lucky then it might help you a lot on healing but its not guaranteed and you might also be in great pain for 1-2 months after the surgery.

So long all the personal records i have from friends who undergone LIS were terrible, based on after surgery pain, bleeding and chances to wound infection and have yet to see results.

I've been through the same as you on bad days. I would do anything to get rid of the pain and get back to the normal life i had. This thing messes with your mind and you can't think clearly when you are in pain.
I'm not talking about incontinence, i'm talking about pain and quality of life.

Try some GTN along with mineral oil and let it calm down.
After all LIS does exactly what GTN does in a more permanent level.

Johnny91 - Thanks again for the advice regarding the mineral oil and Miralax. I will give either a try and update this thread in time. Hopefully, I can get those harder stools in the morning softer. The loose stools are troubling, too, though, because they sting and spasms happen soon afterward. Ugh, so frustrating.

Yes, I'm pretty sure I have IBS. I'm a very stressed out person (runs in my family, unfortunately) and it's pretty obvious it greatly affects my digestive system. Having the fissure and pain has only made things worse for me.

I've researched LIS a LOT and I agree that it can be iffy. The majority of people do heal completely from it, though (doesn't it have a 95% or so success rate?), so it's something I really need to consider. The recovery scares me the most, though. I worry about having a very painful recovery (worse than the fissure pain) like I've read from some people on this forum. You just never know how it will work out, so it is taking a big chance. I'm so tired of being in pain, though. : ( I'm out of other options at this point and the only thing holding me back is money/lack of good insurance, as well as fear.

I do have some GTN which was prescribed by a CRS I saw in San Francisco a couple months ago (which unfortunately didn't work out... she only wanted to do LIS without any kind of anesthesia and there's no way I'd agree to that). I've been afraid to use it since I heard it can cause awful headaches, which I'm prone to.

Have you tried GTN? How did it work for you, if you did? I've used Diltiazem for a long time, but eventually got a rash from it and had to stop using it. I wanted to get Niphedipine prescribed more than the Nitro, but unfortunately none of the CRS's I saw would prescribe it.

Hi Luka,
I was prescribed GTN in the first month of my fissure but i was reluctant to try it due to side effects i was hearing about as well.
I finally talked with a doctor friend of mine regarding this and she easily talked me into getting it.
Side effects are always there with all the meds out there but only some people experience them.
Also most of the people actually don't pay attention on the doctor's words on GTN because everyone is insisting on putting a very small dose of it. The packaging actually had 2.5CM dosage instruction and i ended up putting less than 1CM at first and gradually upping the dose.
The headache i had was a lightheadedness like the headache you get from too much sun exposure or dehydration, nothing that couldnt handle and much better than the fissure pain of course.
The only thing i regret is not buying it from the very beginning.

In any way, in order to get fully recovered you have to address the problem to its root.
LIS is not a magic way to get yourself relieved from pain, after all today i saw in the forum a rather unlucky case of recurrence. Keep that in mind and if you manage to afford it in the end, search for the best and definitely not someone who is willing to do it without anesthesia.

You have to manage your stool form first because nothing is more crucial than an inevitable everyday habit.
All the times i've re-ripped, its been due to wrong bms in terms of stool form and technique.
Check out this video it helps you understand how the mechanics on this region work.
You need to find the combination of all these first and then you will be closer to actual healing.

Thanks for the advice again, Johnny91. You've been a big help. : )

I had a looser BM this morning, but didn't do anything differently, so I'm not sure what that is all about. It stung and hurt afterward. : ( Sometimes it seems like the harder stool is easier on the area. I definitely have IBS, so that's why it's so difficult getting the stool issue under control. I just want to get the fissure fixed once and for all since I just cannot seem to get my BMs under control lately, no matter how much water and fiber I take. It's too hard or too loose and almost never in-between. : ( So frustrated right now.

I am going to give the GTN a try. I just have to get over my initial apprehension about the headache. My CRS also said to apply a very small amount at first and work my way up, so that's what I'm going to do. I just get prone to headaches for other reasons, thus my apprehension. Thanks for the advice!

Don't worry about the headaches. I'm not having any effects any more even if i overdose a bit. I'm very happy about buying it even after so long. I keep it in the fridge and use if i get irritated.
Go buy it and use a very small amount to see how you will react. Its not like a normal headache, for me it was a very low level passive pain in the lower back of the head which didn't interfere with my life at all. I also had 10% faster heartbeat at the first few days.
It works fast and relieves the sphincter from the spasms in minutes.
Its not like a miracle cure that will fix your fissure next week but it really helps with pain and discomfort.
I'm also planning to use another 2month therapy next month, maybe i will finally heal, who knows...
Anyway good luck i'm waiting for your news

Johnny91 - Thanks again for the advice regarding GTN. I will definitely try it out and report back.

I wish you luck with everything and hope you finally heal with this next round of therapy. Good luck and take care!