Hi everyone!! I was soooooooo relieved to see that I am not the only person in the world suffering with this problem. Not that I am happy that anyone else has it, because it's absolute torture, but it makes me feel so not alone with this since my entire family just don't get it when I try to explain the pain to them.
I still remember the day/moment (March 10, 2010 approx 5:00 PM while at work) of the excrutiating pain when I received that wonderful thing called a fissure. At the time it really scared the crap out of me, no pun intended. I just felt some horrible pain and then there was a ton of blood, which of course in turn made me so nervous to poop so then I became constipated for about a 1-2 weeks. I waited for about a week to see my PCP because I thought things would get better, because I wasn't sure what was wrong with me, but things just kept going downhill. My PCP gave me Anusol suppositories to use, but I had such a hard time using them and it would just pop back out. Not to sound so gross, but I think that they kept popping out because I was so constipated at the time. One day I finally had a few cups of coffee and some stool softeners in me and was able to get some relief. After my first round of trying to use the suppositories for 2 weeks and not having much success my PCP gave me another Rx for them. By that time I was no longer constipated so it was able to stay put. The pain that I was in was just unbearable so I called a CRS. I thought that I was going to die after the exam. He did not do an internal, but I never knew a butt could be stretched soooooooooooo far. I'm pretty sure that he could see the light at the other end because the whole exam, which was only a minute but it felt alot longer, I was screaming...well not really screaming loud, but screaming ouch, ouch, ouch, and of course calling him names in my head. Anyway, he prescribed me Diltiazem/lidocane for 3 weeks. The 3rd week of using the med. I ended up with diaherra, which was my fault because I decided to have several cups of coffee before eating anything, and ended up bleeding. I didn't have much pain just alot of blood that day and a few days following. So I went back to the CRS last week and told him what had happened and he said that he thinks that I may need surgery, which I disagree with since the bleeding was of my fault. He told me to keep using the Diltiazem for another 6 weeks and if that doesn't help then I will most likely need surgery. I am just not ready to put myself through that surgery though.
So now everyone waking moment of my life I sit here in a panic of when the next BM will be and worry over what the pain is going to be like. I don't eat much anymore...just some chicken noodle soup and crackers, chicken, turkey breast lunch meat and mashed potatoes. I try to switch the foods around so that I don't get tired of them. I just don't know what to do anymore. I don't have the constant pain that I used to have. I mainly get some pain when my body lets me know that I have to use the restroom or just at the beginning of the BM. I think that sometimes I am causing some of the pain because I tense up so much right before and during the BM. I just wish that I would wake up from this nightmare.
Well that's my story...thanks for taking the time to read this journal. Any pointers would be great!!! Oh...and yes...I do take sitz baths at least 3x a day if not more, and I have recently found out that an ice pack helps to relieve some of the discomfort also.
Thanks again!

Hello Firecracker, glad you found us!
If you have only had your fissure since March 10, then *just maybe* there is a chance it can heal on it's on, and be an "acute," rather than "chronic," fissure -- once they go chronic, around the third or fourth month, then it gets more and more unlikely it is going to heal on it's on (without non-conservative intervention, i.e. surgery, botox, etc..)
But after 3-4 months of suffering, most people are READY for the surgery or whatever option is available...
just some chicken noodle soup and crackers, chicken, turkey breast lunch meat and mashed potatoes. Your diet needs to consist of soft, cooked foods, especially fruits and vegetables. Less meats, and certainly less junk food as they can create lumpy hard stools which will hurt and re-tear your fissure. The goal is for you to have soft stools, but not runny, loose stools. And use the diltiazem, if it doesn't heal you it may at least keep the worst of the pian away by keeping your anal canal less tight.
As for tips, you can learn a LOT by reading the threads on this site, here is a good starting point:
http://anal-fissure.org/general-anal-fissure-discussion-f2/i-have-an-af-what-should-i-know-t1849.htm
Sorry the exam was so bad! :( We have all been through that here....
Kim

Hey there, your story sounds *exactly* like a lot of people here's. It usually goes like this:
1. Terrifying crippling pain/bleeding happens while pooping.
2. Clueless doc prescribes suppositories which hurt like hell to use and don't help.
3. You see a CRS who gives something that helps but doesn't fix the problem.
4. You end up eating a very narrow range of foods in a holding pattern.
That's 100% what happened to me and how I ended up eating basically nothing but veggie soup for a year. I lost a bunch of weight in the process but that wasn't so cool for me because my BMI was around a 3 to begin with and is now 2 or less :(
Anyway after reading your story, several thoughts immediately came to mind:
What kind of stool softeners are you taking? Docs love to suggest docusate sodium but many of us, myself included, find that Miralax (polyethylene glycol 3350, it's available in some generic store brands too) works much better.
Were you given other ointments to try besides diltiazem? The ones that can be used are 2% diltiazem, 0.2% nifedipine, and 0.2% nitroglycerin. I've tried them all and found that nitroglycerin works the best for me. You do get bad headaches at first with it, but you get used to them and they get less intense with time. If one doesn't help you can always try another, although to be honest I have a hard time getting excited about them since none of them cured my fissure.
If none of the above work, then surgical treatment (e.g., lateral internal sphincterotomy, fissurectomy) can work and have helped a lot of folks here. Botox injections are also sometimes offered. I personally opted for Botox shots first (I was also reluctant to get surgery) and they did help immensely, but the relief only lasted a couple of months. If you don't want to jump into surgery though (which is perfectly understandable) then you could ask your doc about Botox. Some docs believe in them, some don't. After everything failed for me, I finally got the surgery after having had my fissure for a year. That was only a few weeks ago so the jury's still out for me though as to whether it worked.
And yeah, I'm with Kim, we've all had that terrible scope exam with an active fissure, unfortunately. Most docs have never had a fissure themselves and just don't know how bad it hurts! As for diet, I cut all meat except fish and boiled chicken out of my diet, and ate basically nothing else except boiled vegetables. That kept the fissure pain at a manageable level so that I could at least bide my time and try different treatment options.

I still think my idea that all med students and med residents should be forced to have an AF b/4 becoming a full-fledged doc is a good one. At least they would be able to better understand the pain and suffering (both mental and physical) that is associated with having one!! In my opinion the docs (basically) understand the treatment options for AF, but don't have a clue as to how bad having one really is.
Funny but my psychiatrist (and his accompanying med student) didn't think much of my idea when I shared it with both of them!!!!!

I hope the surgery has and will help you out. I am just sooooooooooooooo terrified of surgery. I'm 42 and have only had surgery once in my life and it was something I wanted to have done and not something that I needed to have done. I don't know what scares me more the thought of surgery or the BM's. All I know is that I am just a nervous wreck every morning when I wake up until I go to sleep. At least when I am sleeping I don't have fear hanging over me. There are many days I just sit and cry out of fear, and it's like my family just doesn't understand .
As for stool softeners...I have been taking Phillips stool softener 3x/day and drinking Benefiber with plenty of water. I was taking the softener 2x/day, but I decided to up it to 3. The only med that my CRS has prescribed is Diltiazem. The only advice he gave me was to get my stool to a soft consistency, which I did have my BM's at a very soft consistency until the external exam, which killed me, so I was scared to eat much...so now my BM's are somewhat back to the normal...no too soft and not too hard, but it was much easier when it was a very soft consistency. I am having a hard time getting back to the very soft BM's. I think that I might change stool softeners, but I am just trying to be careful because I work very long hours a few days a week...and I really hate having a BM at work because I never know what to expect. I just miss the days when I could just have a BM and then be on my way. This fissure has changed my life in every way possible
As for what I am eating...I don't even know if what I am eating is right. Here's my list:
Chicken that is cooked all day in a slow cooker with water to keep it nice and moist.
Cooked celery...I have never been really like cooked or uncooked vegetables at all. But for some reason I love cooked celery.
Chicken flavored noodle soup with really small noodles and saltine crackers to make it more filling.
Peanutbutter....I love peanutbutter, but almost everyday I eat a couple of teaspoons just for something yummy.
Yougart...I eat approx. 4 ounce mid morning and the other 4 ounces in the evening because I don't want to get diaherra.
Applesuace...I just added this yesterday to my list of things to eat.
Cheerios...Dry cheerios for something to munch on while at work.
And yes...occasionally a piece of chocolate.
I have never been a healthy eater, and I am still not. I have never been a big eater, I pretty much eat to survive. I have lost approx 5 pounds in the past 2 months since I am eating less than what I did berfore the fissure, but I guess that's not too bad. I was underweight before this started and really don't want to lose any more weight. I just want this nightmare to end
Thank you both for your replies :D

[quote="cherylk"]I still think my idea that all med students and med residents should be forced to have an AF b/4 becoming a full-fledged doc is a good one. quote]
Not that I would wish this on my worst enemy, but I sooooooo agree. Maybe then they would show some compassion and know better ways of treating the fissure.

Fire,
Do you live in the U.S.????? Try eating oatmeal for breakfast, and baked squash is another good food to eat. Strange how we all gravity to a very small list of foods to eat while having an AF, and most of us lost weight during our time of suffering, partly due to fear of eating something that would cause havoc with our digestion and the butt.
I ate a turkey sandwich every lunch for months and months. Then I switched to quinoa for awhile with sauteed squash. Quinoa is another good food (grain) to try and easier to digest for some. Baked apples were also another staple in my fissure diet. Try to stay away from processed foods as much as possible. But chocolate (a little) is goooood for us!! And good to eat!! :D

Yep...I am from the US.
Well I glad to hear that a little chocolate is gooood for us :D It's number one of the "foods" that I LOVE. I really could go for one of those huge chocolate chip muffins, but I won't...maybe a bite here and there. Although...over the past couple of months I have had some small choc. chip muffins and small pieces of cake. LOVE, LOVE, LOVE sweets!!!
Although I love the smell of oatmeal....I seriously gag everytime I try to force myself to like it. My husband eats it alot...so everytime he eats it I try a spoonful to try and force myself to like it, but I almost get sick to my stomach
I also have never liked vegetables. Athough I do like zuchinni, but it has to be fried and dipped in marinara suace. I know...I am somewhat picky on how I like my foods, but I generally eat just very blah boring foods. Anyone ever have a problem eating zuchinni??? What about tomatoes???
I miss eating cheese. I love mozzarella, cheddar, provolone and swiss. I guess I should stay away from those though?? Oh my...now I could go for a grilled cheese sandwich.
I miss soooooooooo many of my boring foods right now...it's killing me

Cooked carrots are also good to eat. Maybe you could try cream of wheat for breakfast, and yogurt is also good with probiotics in it, but I don't like to eat yogurt and many other foods including mushrooms, mayo, cream cheese, cottage cheese, feta cheese, sour cream, and liver. I think we all have foods that we really don't like to eat!! :roll: I also used to make stuffed peppers with rice and tomatoes and a tuna casserole with carrots and potatoes. Good luck with everything!!

Firecracker, you food list looks okay to me. To be honest I don't eat many of the foods on that list, but that's because I was a big junk food eater before the fissure and ate nothing but boiled veggies after. But nothing jumps out at me as really terrible for fissures. I personally find boiled broccoli, cauliflower, and carrots (make sure to boil them until they're very soft) to be good for soft poop. For meats I like boiled fish the best but chicken is okay too. I don't care much for zucchini or tomatoes but have eaten them and they didn't seem to cause problems for my fissure.
I'm not sure what the active ingredient in Philips stool softener is but would definitely give Miralax a try. It's available as SmoothLAX at Walgreens and PureLAX at CVS Pharmacy. Your CRS should know about both nitroglycerin and nifedipine. Maybe Botox too. It's worth asking about. I think it's reasonable to try everything possible before surgery unless the fissure is really really killing you all the time. If you have good days and bad days then I'd personally try a couple different approaches before committing to anything more invasive.