I was sexually assaulted back in January of 09 and subsequently developed an anal fissure, I in fact remember (I think) when it actually tore. It was strange because I had no pain until April 09, after which I became EXTREMELY worried and had a colonoscopy/endoscopy. My doctor never actually saw the fissure, however I was prescribed nitro ointment and it has been very effective as it has an immediate effect on whatever pain I have. I seem to have only mild (in comparison) symptoms and rarely do I bleed or experience a significant amount of pain while defacating. The fissure acts up when I am constipated, when I sit for long periods, when my anus sweats, and during intercourse/masturbation (due in part to some sort of coinciding muscle contraction). I get better, then get worse, better, worse....I am starting to think that while my fissure doesn't seem to be a major one it is time to start thinking about surgery. I don't know what to do as I have read that the body builds up a tolerance for the nitro ointment & without its soothing effects I feel I am hopeless. Sorry about the length of this blahg but this is something that has taken over my life. I know it's negative thinking but I often ponder whether or not I should just end my life as it would certainly be better than dealing with a worsening condition like this one. I have a great life outside of this fissure and it is eating me up both litterally and figuratively, I have no where else to turn....I would really appreciate some feedback from those who share in my experience.

Most of us have been mentally down at some point with this ailment; you are not alone. I would have a couple of suggestions for you:
Try seeing a mental health professional, especially a psychiatrist. AF's are not the end of the world. Many here have healed and you can also. Consider taking an A/D, which has helped some people.
It is important to keep your bm's soft. Miralax, benefiber, and other supplements have worked for many.
Search this board for info. I think Kim has a sticky thread, "What every one needs to know about an AF" or something like that at the beginning of one of the categories.
Keep tuned in here for support and to learn!! Good luck!

I've become a health nut and have been consistently getting enough fiber (20+ g/day) but nothing seems to help, whenever I feel like it's getting better it just ends up tearing again. I worry about my future (I'm 21) and my ability to hold down a steady job which in turn worries me that I won't be able to afford treatment, etc. I think I'm just really bummed out because I shouldn't have this in the first place and it refuses to heal despite my best efforts. Baths, fiber, water (lots), exercise, nitroglycerin ointment should be enough to do the job, right? Well apparently not for me, I think it is because it is a deeper fissure(?)...anyways, this whole process is just so stressful and it is wearing me thin

It sounds as if you have been through a lot and may have to sort out some emotional stuff also, which I think can contribute to healing (or not). Worry can be a vicious circle, and many of us have had some similar worries and feelings. Botox injections and LIS have been helpful to others, resulting in healing. I'm sure you will get some additional responses to your post.

jman11 wrote:... this is something that has taken over my life. ... I have a great life outside of this fissure and it is eating me up both litterally and figuratively

It's hard not to be consumed by something like this, which can cause intense levels of discomfort at any time. You work hard to heal it for months, then one setback happens and you're back to square one. But the risks of surgery are small compared to the effects of stress and other impacts on your life. So, once you're convinced that nonsurgical methods aren't going to work, I wouldn't hesitate. I'm not there yet, but it sounds like you might be.

jman11 wrote:The fissure acts up ... during intercourse/masturbation (due in part to some sort of coinciding muscle contraction).

I'm with you on this one. I feel like I'm going to have to abstain until this issue is resolved. Very depressing...

first of all, i'm so sorry to hear of how you developed the fissure. you're a strong person for coping with the psychological effects of an assault, not to mention the subsequent pain you're in.

Baths, fiber, water (lots), exercise, nitroglycerin ointment should be enough to do the job, right?

No. unfortunately this is not enough for most people. especially after having a fissure for several months like you have. all of those things are helpful but will most likely not solve the problem. before you give up all hope consider trying one of the many options (ie botox, nifedipine, diltiazem, LIS, fissurectomy, or just using softening laxatives like miralax or Milk of magnesia).
in addition, a daily combo of benefiber and miralax has helped so many people on this board and others. try adding a full dose of miralax every night to get your stool to the right consistency. also try eating smaller meals, less meat & dairy, and extra fruits and vegetables.
if you are truly thinking about suicide, please see a dr for antidepressants. i was at that point for quite awhile after my 3rd anal surgery and wellbutrin has helped pull me out of that hole of despair. it's not worth ending your life over. i'm still not better but i have a lot more hope now than i did before.
i hate to say it but you're probably in for a lot of ups and downs over the next few months and/or years. once you have a problem like this it tends to stick around....or come back in your life once you think it's gone. you need to find a routine that works for you and your butt and stick with it as long as possible, even after you think you're better.
good luck.

I appreciate all the responses, I don't know why it took me so long to find this web site. It's good to know that I'm not the only one out there that is suffering from this, and while I wouldn't wish this upon anyone, I'm glad that others know/understand what I'm going through. Thank you!