So i've been dealing with this whole AF thing since early april. It came to a boil in july and have been to the doc a few times.
i had some internal hemorrhoids taken care of but the itching and burning wasnt going away. Ive been on three different creams. a pink one, a hydrocortisone and a nitrate. none have worked and the area has become more irritated and worse than when it started.
after getting a clean bill of health from my colonoscopy we now are concentrating on the AF(s).
I have one major one and a smaller one. we went over the two types of procedures, botox and the other which i cant spell. I am very torn with what to do. This whole inconsistence(spelling) thing is my biggest fear. I am a 29 y/o male and havent had any issues like this before. i went from normal to not wanting to leave my house and its killing me.
so i just want help. help choosing a procedure...help not choosing one.....help fixing this.

The other procedure is probably a lateral internal sphincterotomy right?
I haven't had a sphincterotomy but have had a Botox injection. That was about a month ago so the jury's still out on efficacy. It didn't make anything worse so I don't think you have much to lose by trying it though.
A lot of folks here have had both and sphincterotomy has made a bigger difference for most folks, but course also carries a bit more risk and is more invasive. I'm sure some of them will chime in soon.
BTW are you taking any stool softeners? They won't cure the problem on their own but they can minimze the pain. I was in supreme pain from my fissure for a while but stool softeners helped me at least get the pain to a manageable level. Interestingly I couldn't tolerate a colonoscopy because it hurt too much during the procedure and they couldn't complete it as a result.

well i was out cold for my colonoscopy so who knows. but since that procedure i have been worse.
the pain of a BM isnt that terrible as of late, but the wiping is torture. i used moist wipes and they sting, as does water. so its just a crappy situation, literally.
i havent take any stool softeners. my stool is fairly soft as usually isnt hard. i have an appointment on 12/7 for the procedure and need to decide if i wanna go botox or LIS. i just want to be done with it ya know? and from what i hear the botox isnt really helping many people.
i also dont want to be laid up for a month like ive read in some of these horror stories. my job isnt the kind i can take it easy....its very active so id need to be at least 80% back to normal to consider going back.

If you want the "surer" shot then I think most folks would say LIS (lateral internal sphincterotomy). I wanted to be done with mine too, but I'm a paranoid dude so I opted for every conservative treatment possible before going to LIS. I'm still in the "trying things out" phase. My fissure's been around for a while but if you're getting bad pain even with soft stools, then it sounds like you're worse off than myself. I also have a job where I just sit on my rear all day in an office without much physical activity...
Anyhow I guess my vote is for LIS given the agony you're in, but take that with a big grain of salt since it's coming from a guy who's never personally had it done.

thanks for the advice. know whats worse out of everything? the itching.....anyone else get that?

Hi, so sorry you're having so much trouble. I had LIS. The surgery itself isn't bad at all. The pain is no worse than the fissure. It's a simple cut and one stitch that dissolves. The incontinence things if it affects you is usually gas and with time that goes away but most people have the surgery with no incontinence. It helped me heal my fissure but I still have some trouble. Apparently I have a narrowing of the area from old scar tissue and that's causes me some trouble. Try not to be so scared of the surgery, honestly it's not that bad. I know if people have other surgery done with the LIS then more pain is involved but I didn't even take the pain pill they gave me after mine. It might not be a bad idea to try some stool softeners too. Even if you think you're stools are pretty soft keeping them soft and easy to pass is really a big help. Good luck Suzy.

Hi - I had LIS last week. It has helped immensely! My pain level is zero now and I haven't had any incontinence problems at all. I posted more info on the "Considering Surgery" part of the website. You can read my story there. I will answer any questions for you too. A lot of people on here have had some good success with LIS. I had some other problems due to childbirths but then, that's not a problem for you! Try taking a stool softener. It helps with the size of the BM too, not just the texture. Sometimes that helps. Itching can be a problem but it can be controlled. Have you tried taking a bath or shower after your BM? That can help control any itching. Good luck! Anna

hey anna
yes i have taken a bath or even showered after a BM and ive found flushable wipes work great....but they sting.
one thing ive found comfort with is Vaseline. gets me through the day. i have used preparation H as well but Vaseline lasts longer.
i really feel if i could control the itching i could heal on my own, but its been 4 months with no luck. i read on a few forums to try tinactin foot cream...might go try it for the hell of it

Has your doctor offered you creams like nifedipine,nitroglycerin or diltilazem?If your doctor is only offering you botox or LIS than your condition maybe more serious.Nitro has helped me to heal in 2 months but I only had one and from a fissure scale mines was about 6-10 bad.If your afraid to get surgery you should try less invasive options first like the 3 creams and see if they work.when I itched I sitz bath it with the hottest water tolerable then I would blow dry my fissure.It would lessen the itch for a couple of hours but it helps to some degree.

afugh....i have tried those creams with no luck. i think im past those types of treatments unfortunately.