Hello all.
I'm a 28 year old guy from Dallas. I was diagnosed with an Anal Fissure about 5 weeks ago. That was after a month of bleeding, and a week of excruciating pain.
Originally when I walked into my doctors office she did not know what it was, that's when she referred me to a Gastroenterologist(GE). There I received a colonoscopy, which wasn't fun at all.
I was told by the GE that I had an anal fissure, of course i didn't know what that was.
He explained to me that it was a small cut right inside my anus.
I for one didn't thing a small cut was able to produce the kinda pain I felt for that week, but it was.
He gave me some Diltiazem and told me to take some aleve. He also told me to eat more fiber and stay away from nuts and high fatty foods. :( no more hamburgers and pizza..
About a few days passed and I was feeling way better, I was doing everything the GE told me to do, I had no bleeding the spasms had gone away everything was looking great for me. :D
But than something happened, I became constipated and had to strain to push my stool out, well that right there sent me back to bleeding and having a spasm with tons, and tons of pain the following day.
I called the GE and was told to take some Miralax, boy does that stuff work.
This is of course before I found this wonderfull site.
After taking Miralax I still had some pain after having a BM, so I went to go see the GE again, he gave me some Celebrex 200mg tablets to take for the pain and inflamation.
Aleve was doing nothing for the pain, celebrex helped out a little with the pain.
I was searching on the internet around that time to look for more information on what I had and what could alleviate my condition. Thank god I was able to find this website. Thanks for whomever set this forum up. Thanks to the people that have been writing down their personal experiences with their AF. I have been doing a lot of reading on this forum and have learned a lot about our condition, and how to treat it.
I have a follow up appointment with my GE on November 5th, just to see if I will need to have LIS surgery done.
I really do not want to have LIS surgery, and trying everything I can to get better.
It seems that right now I am not getting the dreaded spasm pain, and have not had it for about 2 weeks. I am having 2 BM a day right now, and they are both in the morning around 2 hours apart. (really don't like having the first one, since it makes me bleed and feel an aching pain around my anus for about 2 hours)
Hopefully, all these are signs of me getting better.
Some days I feel worse than others, and some days I have no blood, but I always have some kind of pain after each BM.
There are some days that I feel depressed, I have turned to this website to see how other people dealt with their pain and with their depression and that has helped me out trough some hard times.
Thanks Again to everyone contributing on this board.

You are welcome Raul and I am so happy that you found us - having this forum was a lifesaver for many. You are very smart to read about all of our experiences and how we manage pain, physical and emotional and also about all possible treatments that are available to you.
Some members had LIS immediately because it was just too much pain for them and they wanted to be out of misery, no matter what. Some lived with fissure for 7 years before having LIS (like the maker of this forum), some had enough after 6 or 7 months.
Some healed with Botox or just "out of the blue" - so there are really no rules - it all depends of how much you are willing to wait and how many things you want to try before having LIS.
Since you are dealing with fissure for a short time (speaking relatively -since a single day with a fissure feels like a year :( ), I think that you should try conservative treatments for couple of months at least and see how it goes . You almost healed before you had that constipation episode, so don't rush under the knife.
I hope you found out from this forum what you absolutely must do - keep your BM soft, take 20 min long warm baths 3 times a day, use cream that your doctor gave you 3-5 times a day ( I used it that much), stay away from white bread, cheese, red meat, nuts and such. Your diet just have to be mostly vegetarian now with some small amount of chicken and fish. Drink a ton of liquid - but stay away from alcohol and caffein. You have to be religious about all of this since , as you already saw, just ONE wrong move and your fissure will open again and you will have to start all over :( . Even when you stop bleeding or having pain you will have to continue with healthy diet and fluids for at least a year till your fissure site regain it's original strength.
Good luck Raul

Yes, I think you should stick with conservative treatments for the time being. At least now you know you need to avoid constipation/starining at all costs. Since you haven't had the fissure too terribly long you may be able to heal on your own as you probably haven't developed uneven rough scar tissue around the edges of the fissure. Use the diltiazem religiously and often. Take hot soaking baths and consider using a stool softener like colace, which is safe to use long term. Remember the baths will aid in healing by bringing blood to the area. Just consider yourself lucky pain-wise as many people have excrutiating pain almost all day, and use that thought to try and stay on top of things and in being pro-active in treating it.
And two weeks is a nice long time to go without spasms but it isn't long enough, they can come back and you'll be very depressed at the setback, so this is just a little warning about that. It takes 6-8 weeks for a fissure to heal so never get complacent about your treatment.

Welcome Raul :hi:
So glad that you found this world of information here !
The Diltiazem cream is a godsend, I know it has helped me and others here in healing fissure, it is important you use the cream atleast twice a day, I used it 3 times daily and before BMs too , also if you can get the cream about one inch inside that will help too !
Absolutely stick with miralax everyday while you are healing , no spasms are a great sign but do not let your guard down !
Keep up a strict regime and hopefully this could be enough to heal you …
Goodluck Raul !

Hi Raul,

Yes, healing fissures and other anal conditions has become my religion. You have to be vigilant about what you eat, getting warm soaks, using the cream, and managing the pain as best as you can. I tried celebrex too but found that 800 mg of ibuprofen worked better.

If you can get in the tub right after a bm it can help with the pain. Keeping your stools soft but not so soft that it leaves debris behind in the fissure is important. If you have read on here a lot you know I recommend All Bran Buds cereal and some kind of oil supplement like flax seed or fish oil to help coat the stool.

Good luck on your healing journey and may it be a short one!

Welcome Raul,

It sounds like you are on the right track. So glad to hear you don't have any spasms, that is a good sign.
The miralax works wonderfully for me, I have been using it for many months now. It really helps from retearing and bleeding and pain. The dosage can be tricky though, after several days I need to lower the dose occasionally. Adding some fiber is really helpful also.
Hope this site can give you some good encouragement. It really helps!
Jo

Raul,
I use Miralax also and used the Diliatzem ointment which was helpful.
Cheryl

Hi,
I am also new to the forum and understand what you are going through. A colonoscopy to find a fissure sounds odd since the fissure is found way before your colon. I would go to a colon rectal surgeon, not a GE. I am using Nipedefine cream for my fissure, along with alot of water and fiber. If you feel a hard stool coming on, I would suggest inserting some vasoline with a gloved finger to help lubricate the canal. Let us know how you are doing.

Hi Raul,
I am sorry to hear that you have a fissure, but the fact that you have had it only for 5 weeks means that there is hope for you, in terms of healing without the surgery.
I had the surgery, but it was only because I had the fissure for so long. Originally, I thought I was dealing with hemorrhoids and so I wasn't taking care of myself like I should've been, which led to my big bad chronic fissure.
What I recommend is taking 100 mg of magnesium every night before you sleep. Make sure you take a multi-vitamin so that you can balance all your vitamins. Magnesium can make your stools too loose, so start with 100 and experiment. But, magnesium helps you sleep and it keeps things moving comfortably. It is my godsend.
Also, since I can totally relate to not wanting to give up junky foods completely (I'm 24) I try to slide some yummy things into my diet that have fiber in them. Fiber one makes great pop tarts in a couple of different flavors, as well as muffins. If I am going to have any alcohol, I make sure that I hydrate myself throughout the day before hand, and that usually seems to do the trick.
As far as your pain goes, getting in the tub will really help! I had horrible spasms myself, and the tub was a life saver. The more you stay on your diet and do your "fissure routine" the less and less your spasms will be. I rarely have them at all anymore.
Make sure you get a great CRS who is supportive and willing to let you try your options. Some surgeons are quick to get you under the knife for whatever reason. I had that happen to me, so I went to a second doctor and got better care.
Good luck to you, my friend, and happy healing. If you ever need to vent, don't be afraid to let it rip! People here are AWESOME.

Kate

I just want to thank everyone that shares their experiences here on this board, I think it's awesome!!!
Everyone is being so candid with their progressions or regressions.
This is going to be my 9th week with my Anal Fissure.
I think at this point I know its a chronic one!!!!
I have left my GE, and gone to a surgeon.
But before leaving my GE, he gave me a prescription of 60 24mcg Amitiza capsules,to take twice a day.
I have been on them for about 2 weeks now, and am noticing that my BM's are coming out super soft, and more frequent, which it has stop me from bleeding all the time.
I do notice a little bleeding whenever I sit down in the toilet for over 8 minutes and only pass gas. (no pushing or straining on my part) Has anyone else also noticed this?
The dull pain after BM's has been lasting for a shorter period of time, maybe 20 - 40 minutes after my BM's, the pain is subsiding.
The spasms have also lasted for a shorter period of time.
Hopefully, all this means that the fissure is healing, slow, but healing nonetheless.