Kim you asked about the pain, well like others it starts after a BM but not always, sometimes it just starts when it feels like it. Sometimes the pain is throbbing sometimes it is just constant stinging and it lasts for about 12 hours, some days I'm lucky and it only lasts for 4-5 hours, ocassionally it wakes me early morning at bout 4 and then that's me !
Also Kim I don't have cheese omelette every day, I'd never get away with that! Hehe tonight I'm making toad in the hole with veg. I have always had tummy/ constipation bother since I started my eating problems so for about 17 years I guess but never had this before and when the AF started I can't recall any particular difficult time, not even sure when the pain started. And I think I'm pretty sure I get the spasms but maybe not much since the Botox .
Corsi, the difficult thing about all the fruit is as it is low calorie I would need to eat alot of it to make up my daily calories which is very difficult for me, I know I am my own worst enemy at times. Do you think that as my BMI is only 15.8 I am preventing the fissure from healing quickly? Would weight gain speed up the process?

Forgot to add thanks Cheryl it's nice to be liked hehe xx

Yes, I would go easy on the cheese!
It's possible that being drastically underweight can affect your AF healing rate, but more likely it is how tight your anal region is. Since it does appear you have spasms ( you said the pain can start at any time and also the botox seems to have helped -- and the spasms is what the botox is most likely to help with :) ) then you may be a candidate for LIS surgery if the botox treatment(s) don't work.
We have several boardies who have had the botox, maybe they will ring in here and give you their take on how well it helped them.
I will have to research to find out how below-average your BMI is; most of us get pretty darned skinny while having an AF!

Jackie,
I wear the Scottish flag and Scottish emblem when I golf!!
I drank Ensure about a year ago to gain weight when I got too thin because of the AF. I am no longer underweight and it is difficult for me to believe that I was trying to GAIN weight a year ago. Maybe try an A/D to help your mood.
xx

Your diet does sound Ok Jackie but your BMI is well under, that’s makes you very underweight unless you are very petite ??
I do understand your anorexia :( I had similar issues in my teenage years, I think now that is probley the cause of my IBS and maybe even fissures !
That’s why I say food is your medicine now ! For me being seriously underweight and ill frightened me, now I would never ever miss a meal or such !
Please take care of your body ..
Hang in there with the botox, I found it sometimes made bowel movements a little slow moving , I think because the muscle is paralysed, so very good idea to cut out the fybogel ! I would also ditch white breads, pasta, rice, switch to wholewheat.
I hope the botox helps you

Tabby I'm 5 foot 4 so not that small really, I get weighed tomorrow and I'm scared, scared I've put on weight but equally scared I've not, I hate battling the ED aswell as the fissure! I have now stopped the Fybogel and White bread and have been to the loo the past three days so that's good but in still experiencing the pain after and throughout the day, it seems to help if I'm lying flat on my back which is bit really practical me thinks! Lol
anyway fingers crossed for the Botox but I'm not holding my breathe xxxx

Jackie, don't forget to take as many hot soaking baths as you can each day! They not only soothe, but bring blood to the fissure site for healing!

Thanks Kim, it is difficult though with a two year old , every time I mention bath she wants to join me! Lol, a bit tiring!! Haha

Ha ha, I could see how that might be a hindrance!