First of all, I must thank the creator of this forum for doing just that. It has become (in my humble opinion) a source of practical information on coping with with Anal Fissure. I have learnt things here my doctors, pharmacists and other health care providers are simply ignorant of.
I also should thank all members who unselfishly share their experiences here. Reading what works and what doesn't does lead to huge savings in the cost of managing this painful illness (and I dare say, it could be life saving in some cases!)

I live in Nigeria, West Afica and have a stage 3 hemorrhoid plus chronic anal fissure. I have suffered from the painful fissure for approximately 2 years.

Out here, there are no medication readily available for anal fissure. My visits to several hospitals and drugstore shows that anal fissure is routinely misdiagnosed as hemorrhoid (pile) and, quite unfortunately, treatment options are limited to Anusol, Scheriproct, Preparation H, Daflon 500mg or some local herbs along with Sitz baths with table salt. When these fail to provide relief for the anal fissure (as they most certainly will) the doctor suggests a costly surgery.

Perhaps it begins to be clearer why I have found this forum so helpful and I can't say thanks enough to both its creator and its contributors. I have ordered two tubes of Anoheal and here is hoping it works for me as it has for some who have posted here.

Managing BM pains
I hope this helps someone. I have found that taking 150mg of Voltfast (a powdered Diclofenac Potassium NSAID from Novartis) about 15 minutes BEFORE having a BM reduces the post BM pain to a "very bearable" level.

My post BM pain used to last up to 8 hours before reducing to a throbbing and smoldering turture. That was when I took the Voltfast after the BM. But yesterday and today, I had only little pain after the BM, because I took the Voltfast BEFORE having the BM.

But please check first whether your overall health condition can tolerate Potassium Diclofenac. I must also warn that 150mg is a really high dosage of the drug and prolong use can give you gas, which will mount pressure on your internal sphincter leading to more pain. But I counter these side effects with 400mg of Cimetidine taken right after meals. That helps me keep the gas low.


I do hope to get off Voltfast (or any other NSAID) with the Anoheal, a prospect I only first learnt about on this highly informative forum.

Thank you so much for your input...really helpful!

Seems like it doesnt matter where in the world you live...doctors routinely misdiagnose AFs....bizarre.

Keep us posted.

Thank you for your input - sometimes I forget how lucky I am to live in the UK and have access to meds, healthcare and transport to get the two above!! I'm praying you find relief soon.

FF

Thank you both, Canadabum and Fissurefrustration. Indeed, misdiagnosis is very common. That really gets worse when the wrong medications are applied. Over the last few months, I have come to appreciate a basic fact:

A medical treatment for Hemorrhoid would most likely worsen the AF pain.

Most topical preparations for hemorrhoid are meant to generally shrink the inflamed blood vessels forming the hemorrhoid. That is a constricting action.

However, the Anal Fissure won't heal because the internal anal sphincter is tightly constricted (it is in spasm), pulling the anal tear apart while stopping blood from flowing to the fissure (cut or tear) to promote healing. So the right medication to help with AF must act to relax the sphincter muscle and blood vessels so that blood can flow to the fissure and healing can occur. This is what an LIS would eventually do, when all medical intervention fails.

Hence it should be conclusive that medications that work for hemorrhoid (with blood vessel constriction as its goal) would worsen an already constricted internal anal sphinter, as it constricts blood vessels around it.

I have wasted tons of money buying creams claiming to cure hemorrhoids and heal anal fissures together. Today I have such a large stock of such creams, suppositories and tablet that one Doctor joked that I have a Pharmacy in my home.

Again, it was at this forum I first learnt of topical GTN and Diltiazem. Having researched carefully on how they work, I see now what a waste of time and funds those other medications were in my case.

I agree with the point you make - having this forum is extremely helpful. With nobody talking about fissures really, it can be a lonely place. I first showed my fissure to my GP here in the UK who said "I can't see anything". I wish she would have asked me some more questions so she could rule out a fissure, it might have saved me years of struggle and a surgery.

I have seen with three GPs in last 7 months and first two GPs didn't see that I have anal fissure and first GP did wrongly diagnosed with internal ham and second GP didn't see at all, last GP found out that I have fissure. That was really wasted my time and could be better if first GP found out and correctly diagnosed. In Australia, we have bulk billing system and that system let GP to be fast seeing patients, within 5-10 mins, and they see 25 patients and up, per day. Cold or flu is fine with GP but more complicated issue, they don't really look into it. I was stuck with first GP for 4 months with wrong treatment :-(
Now, I am waiting to see with Specialist in next week, in the meant time, I have flash blood once or twice a week, using GTN and Himalaya pilex ointment for a week. I had pain while I have bm but after applied pilex ointment (after bm) no pain at all, no spam feeling at all. And I am sitting on heat pad while I am working, made me feel better.
Good luck to you all and to my self :-)