Hi everyone.
I have been suffrering with an AF for 4 years now and it isn't getting any easier! I try to do all the correct things, with diet and stool softners etc, but when i have one bad bowel movement i'am back to square one, after months of trying to heal. I have a few questions that i'm hoping you very kind people can help me with??
Can the actual fissure continue to get bigger in size over the years?, because mine seems to be getting bigger, i would say it is abou 3cm but not sure.
When i have soft bm's the pain isnt there, only if its a bit harder, and when i put cream on the actual thing it hurts then, is that classed as healed or not?.
How likely is my AF to heal after having it for 4 years? is there a chance it could even though it is chronic?
Thank you for taking time to read guys. (its driving me crazy at the moment!!)

Hi Idol, welcome to the board,
So you've been suffering for 4 years with a fissure, have you actually been diagnosed or had the fissure visualized by a CRS?, also, what stool softeners are you using, most of us on here are using Miralax or Movicol as it's known here in the UK, this is the best laxative around and isn't harsh on the system like other laxatives.
You say that your fissure is about 3cm, is it visible, have you seen it yourself, some fissures are visible but others are hidden beneath anal folds or deeper and can only be seen with an anuscope or colonoscopy.
Keeping BM's soft is the key to managing the pain, as for healing after 4 years, this could still happen although being a chronic fissure the chances are a bit slim, what kind of ointment/creams are you using? once again,most of us here have tried almost everything, including Rectogesic, Nifedipine, Diltiazem and other things, personally i've found the most effective thing is Diltiazem, Rectogesic causes headaches but Diltiazem can cause a severe itch but is very good at relaxing the sphincter which is essential for healing to take place, infact, all of the above mentioned are treatments aimed at relaxing the sphincter to stop those horrible spasms and promote blood flow to the area.
Finally, we know how you feel, we've all been through and some of us are still in fissure hell, rest assured you will get valuable help and advice here on the forum, hopefully someone else will chime in soon enough.
Best of luck.

Thank you steve, i'm from the uk too. I havn't actually seen the fissure but i can feel it when i apply the cream, i have tried both rectogesic and diltiazem, i also take laxido stool softners twice a day.
The CRS had a look a few months ago, but he only looked for a quick second no other examination or anything.
You say my chances are slim of it healing, do you mean without an op? the CRS recomended botox, do you think i have a chance if i have that done? or does chronic mean for life?

I am so sorry to hear that :(
Yes, after 4 years it is definitely chronic (actually after couple of mos any condition is considered chronic, not to mention years :( )
Your fissure probably formed great deal of scar tissue to protect itself - that is why you have only occasional intolerable pain and the rest of the time it is kind of just irritation.
I do not think that at this point it is possible for your fissure to close completely and nicely without a LIS and possibly fissurectomy (cutting out the edges of a fissure). I had my first fissure only for 5 mos and it had scar tissue forming that needed to be removed !!!
I am wishing you the best of luck with it all

Thank you Fissulyna, at the hospital where iam being seen they are only offreing me botox! so you dont think there is any chance with that? do you think it would be a waste of time?

Hey there, based on what you've said, I'd also agree with Steve and Fissy that it's definitely chronic and almost certainly won't heal on its own without more aggressive action. Since you've already tried two of the ointments and have kept your stool soft, you've already covered the conservative treatments.
You'll get different opinions on Botox. I'd personally try it before getting surgery. I don't think anyone can really guess whether it'll help without seeing your fissure and what state it's in. 4 years is a long time so as Fissy says there may be scar tissue, sentinel piles, etc., and Botox has lower success rates than surgery. But IMO you don't have much to lose by trying it. The main complaint people tend to have about Botox is that it didn't work, or that the relief it gave wasn't permanent. But if that ends up being the case you can still get surgery later.
When I first got my fissure, it healed on its own in about 3 weeks with just some very minor diet changes. Then it came back with a vengeance and no cream or diet change helped. After 5 months of bad pain, I got Botox injections, which completely healed the fissure for about 2-3 months. But then it re-tore, so I finally ended up getting surgery about a year after everything started.
So in my case, I got very fast and very complete relief following Botox. It's just that it didn't last. But I'm glad I did it because those few months afterward were great.
My surgery was less than 2 months ago so I haven't arrived at any solid conclusions on it just yet.

Thank you so much for your advice NG, you know when you say it has healed is it still possible to feel the thing when you apply cream etc? is the scar always going to be there?