Hi All---always nice to see a site like this one. Great resource........It started for me about 17 years ago (I am 51 now). Got a fissure from hard stool, did the hydrocortisone, baths, did not change diet much, but started to drink much more WATER; after about 3-4 weeks, I had it kicked and was essentially healed.
Kept it at bay all these years, with minor flare ups until just nine weeks ago. Not really hard stool, but one that felt "stuck high up"....just shoved a bit and afterward the dreaded red TP. Very little pain, thought it was a hemorrhoid, and forgot about it. Played rousing full court basketball the next day with very little discomfort, and thought a little HC and all be right with the world.
Next two days, fine, third, excruciating "fissure-like" pain we all know and love. Made it through and the next two days seemed to be dramatic improvements. Then, 1 week in (Saturday), pain all day, quite bad. Next day was off the charts pain--(mind you, every day stools were soft). Called nurse, went to ER to check for anything else it was so bad. Seemed like fissure. Went to see my gastroenterologist two days later, one who performed my first colonoscopy on March 21 this year. I also have a couple of hemorrhoids that have been "hanging out" asymptomatically for many years, but they are there now. She prescribed 0.2% nitroglycerin and I had some proctosol, so I went on my way. Changed diet to fruits, veggies fiber and little if any red meat, greasy stuff, desserts, sugar. Drank 3-4 quarts water/day. Used nitro and I seemed to dramatically improve next 1-2 weeks. But had persistent "stinging" pain that came and wen throughout day. Banking that this was the same course as 17 years ago, I thought all is good, but I should go have a scope done to check about the persistent but tolerable pain. Gastro said it looked like some ulceration and one of the Hemorrhoids was probably thrombosed, but go see a CRS since this was not her specialty. I saw the same guy I saw years ago--did a large anoscope and confirmed small fissure with what he called an "abrasion" and a thrombosed hemorrhoid. Gave me proctosol and said it just needs to heal.
Next day is when the fun started. After not bleeding for about 2 weeks and relatively minor pain, BM that day was the classic glass shards and blood. Same for the next 5-6 days. I had been using various "natural'" creams before this scope exam, like wheatgrass skin cream. Tried everything for a week or so----fresh aloe, vitamin e oil, tried to keep Hem. at bay with natural herbs. All the while maintaining a strict diet and soft stools (Metamucil, some Colace and lots of water). Was not healing, which was very surprising given my first experience but I suppose not so unusual from the comments on some of these forums. Last Thursday for some reason was off the charts bad again for no particular reason, and then I gave Tinactin a shot (some others have found this works well) and it felt better. Next day was a very good day, and saw a second CRS who was more thorough and better informed. He said it is about the time frame to consider surgery. I really don't want to do that, so he said, since the exam I had which seemed to set me back to square one was only about 2.5 weeks ago, give it another month and we will recheck. I thought good plan, and went home feeling pretty good.
That was last Friday. All days have been reasonable since then, and yesterday was the first day that I felt like I did before my large-scope exam. Just some stinging but very minor all day long and really little pain. I had the same morning routine today that I had yesterday (soft stools, wash right after regular BM in early morn, using nitro and lidocaine) and today, the pain is about 7-8 out of 10 where yesterday was a 2---WTH??? As those whom experience anything like this, its truly frustrating to the point of maddening, when you make progress, and then regress when you are still doing "all the right stuff". If anyone has experiences like this I'd love to hear from you, as my next option is to throw up the hands and do the LIS
Any comments appreciated---Thanks ALL

Welcome to the board, Jchem!
If you still have the prolapsing hemorrhoids, I have to wonder if and how they are related to your fissure. The only time I ever had them was when I had a fissure, I had never been bothered with hemorrhoids before or since. Just something to think about as you look at your healing options.
As for the "pattern," (or lack thereof) of pain, that is VERY MUCH the way it goes with a fissure. One never knows from one day to the next just how bad it may be. There may be days of moderate to severe agony, followed by a day or two of no pain at all. In this respect, AF is like a snake, it bites just when you are hoping and praying it is gone. Unless you have gone a month or more with symptoms, (IMHO) you cannot really know if you're healing or not.
Imagine, though, how severe it "could" be if you weren't doing all the right things. Personally, i was frightened to death of surgery, just surgery in general, not necessarily becoming incontinent, but I would do it again now in a heartbeat...

Kim----much obliged for the nice reply! Yes I suppose you are correct about the "right things", and I have become more comfortable with the surgery option, since my everyday life, as it is for many of you here, revolves solely around this horror. Friday was great, yesterday truly stunk with spasms and burning off the charts.
The hemorrhoids have been there a while, mostly asymptomatic before this ordeal, but I know the prolapsed one is still there and theer is pain when you palpate it, but latest CRS says pain is definitely now coming from the hemmys as he sees it. I do use other treatments for those also, but noothing so far has kept pain and issues at bay for more than a day or two at a time. Now waiting for scheduling for surgery tomorrow morning---need to do something else to stop the cycle, as I know I cannot go on like this.
Thanks for the kind words and help. Will keep all informed
J

Hi
As Kim says I think most people (unfortunately) experience exactly what you described. You do all the right things but sometimes the fissure still re-opens or hurts. I certainly experienced that all the time. It is very difficult to stick with it (at least it was for me) but eating fruit/veg/fibre and drinking lots of water is the right thing. So over time this will give you the best results.
However I feel your frustration. I assume (but I have no medical evidence!) that on the bad days the spinchter muscle is a bit tighter than it is on the other days. This is completely out of your control of course. What is under you control is keeping BMs soft so on the bad days this will limit the damage that is done.
If you are apprehensive of surgery at the moment do some research Botox treatments as several people (including me) have found these very helpful although they don't always cure people for good.

Thanks Elfkin--I will keep this up whether or not I have the surgery, since as you know, you never want this to rear its head again if you get it healed. Good though to hear that others experience similar ups and downs. Reason I inquired is when I had the first one many years ago, I healed it with fairly standard measures and the course was NOTHING like this one. Sucks getting old I guess......but in all those years I have kept very active, am in very good health overall and never been overweight or had chronic diseases. I understand the spasm cycles, lack of blood flow in the area, etc., but you sometimes get frustrated when you see all your other cuts heal and not this one!
So, another point that some have discussed is the stool issue where the "start" of a BM seems "large" where the anus needs to spread a bit and then he rest soft and flows nicely, but that start can be the killer. This often happens to me.
What is the best course that others have used to keep the stool pretty much like "toothpaste? Comments welcome...
Cheers and Happy Dad's day to all

Happy fathers day to you as well :)
Again the BM experience you describe is exactly the same experience as mine.
One thing tho. You haven't mentioned whether you are taking any stool softener. If you aren't this could make all the difference. However careful you are with your diet it is good to have a helping hand.
I lot of people on this site (including me) swear by Movicol (called Miralax in the US). This helped me enormously and increased the length of time between 'bad' days dramatically.

Oops sorry just re-read your original post and you mention Colace and Metamucil. Sorry.
Perhaps give Miralax a go instead then.

Yes I do take SS's but not every day. I was trying to keep the fiber up and I drink tons of water as I mentioned, but sometimes it does not allow the "smoothest" flow....I am very regular and go once per day, but I don't think I can afford going more (ruins ALL hours of the day) so was a bit worried about using Miralax too often. What's your regimen??
Thanks!

I like you am regular and always have been (e.g. once per day).
Miralax (for me at least) did not increase the frequency of BMs at all. I take one sachet in the mornings. This just keeps my BMs soft (but not too soft). It just really helps. It is not always easy to drink all the water you need to and occasionally you may not eat all the veg you need and this keeps things on an even keel.
Everyone is different of course and it could be worth a try.

Thanks again, that's good to know.---since I seem to go in the early a.m., I have taken it before bed, and sometimes helps. There of course is a defined diet component which is sometimes difficult to put a direct finger on (think you eat all you should and it may be a slight strain to get going, or eat lasagna out one night with some wine and everything is smooth!)
Again, appreciate the comments and would love to hear other's stories on keeping things running smooth and least painful----Cheers