Hi there, newbie to the forum and I'm guessing you get a lot of this .. people joining to get help and jumping straight in with the questions Nothing in the other threads seems to match my situation but please feel free to show me the error of my ways if I've missed something.

Basically I've suffered with IBS-D for 20 years - I'm a 36 year old male. Controls my life to a great extent, but I learnt to cope with it. Then in Oct last year I got what I thought was a nasty pile. After a week of the creams doing nothing I went to my doctor, who agreed (even by looking) it was a pile and gave me more cream .. after a further three weeks and two more doctors I eventually saw one who diagnosed the fissure and at this point I was spasming and it was waking and keeping me up at night. I saw an anal surgeon who said he would operate within 2 weeks if no improvement.

I tried all the pile creams in the world as well as every other cream suggested online and it was only when my doctor finally gave me Rectogesic (glyceryl trinitrate) did serous pain subside. The spasms stopped after a few days of using it but after 4 weeks my bum was sore and applying it seemed to be aggravating the area. I asked my surgeon and he told me to stop using it as the fissure looked to have closed. - This is mid Dec.

My anal tone has (I think) now returned to normal, I don't get the same odd feelings but I'm getting good and bad days regarding anal discomfort. Some days I can't feel any pain but like to day, my bum is generally sore and sore to touch, but none descript. I can't pin point where it hurts. A new doctor told me the cream should have been used for longer and I should use it again, the fissure will have closed, but not healed completely (as they can't seem to see it now) I don't want to just start using it again as I know it's a serious medicine, it wasn't actively helping, or didn't feel like it was and it took me an hour each time to recover from the head rush.


Basically I'm getting quite depressed about it now, the feeling makes me feel sick and although no where near as painful as before, the occasional feeling gives me anxiety too. I'm just so unhappy .. add in having to deal with IBS and going the loo 5 times a day - side note, it seems to be more uncomfortable when I need to go (which is most of the time) but doesn't hurt when I'm going.

Sorry for the long post .. but my question is basically what do I do .. how long do these things take to heal .. is this a normal healing process? do I need to try another cream (assuming topical isn't working because the pain is coming from inside behind the closed skin) .

Will I have this for the rest of my life? I'm sitting on padded cushions throughout my house and car to try and help, using heat pads but baths seem to annoy it more

Any advice would be very welcomed

if it helps I'm of a very athletic build, previous was very active, never strain or get constipated and don't smoke or drink. I also live on the FODMAPS diet to keep my IBS symptoms lower.

I've just read more of the threads on here and I feel like such a wimp compared to what many of you go through .. I can't imagine

Sorry you're still suffering. Have you looked into the possibility of Botox and/or LIS? If creams, ointments and other similar treatments aren't working, that might be a road to explore. Another alternative could be physical therapy - try googling Pelvic Floor Dysfunction on the web.

Hi Rothera,

I understand exactly what you're going through. I also have been in this sort of limbo where I'm not sure if I am healed or not. Technically my fissure is closed, but I still feel pain and spasm after many BMs.

I think this condition can be extremely mentally taxing because it's almost not enough pain to warrant surgery, but its so annoying that you just cant live a normal life. I would say don't compare, it will only make you feel worse.

In my case, I think my fissure closed up about 1.5 months ago, and while there is less and less pain, any slight reinjury causes pain and spam to flare up again. It's a constant cycle of this until - hopefully - it will go back to normal. This had been my day-to-day for the past 4 months.

You're not alone! Hope you feel better soon.

Fissure is not gone at all, the fact that cannot be seen doesn't mean a thing. The first hard BM rubbing the area will re-open it. I am not saying this to put you down, on the contrary, to prepare you for the worst and to ensure you take all the necessary measure to keep your stools soft for at least 1 year since the last time you saw blood drops on the toilet paper.

Good luck!

Sometimes I will still see blood, though the pain is nothing like what it was when it first began. Seems to be the healing process is like feels better, small re-tear, feels better, tear, feels better, tear. You never know what is going to happen. It can be extremely mentally taxing. Especially if you want to live a normal life, travel, etc.

Thanks all, I never saw any blood at all, and pooing was ok. It was the spasms and now the aching that's getting to me.

I've just driven 5 hours on a cushion and I was ok, sat on the hotel bed for 30 seconds and it's hurting again.

What do you guys do for pain relief?

I take pregabalin 150 mg twice daily. Some posters here prefer gabapentin. Anticonvulsants like these can be effective for relief of AF and pelvic pain, but people have different reactions to them, and your mileage may vary.

So am I better just keeping my poo soft and waiting do you think?

It will heal just eventually.. I'm guessing as it's not reopened in three months that's a good sign . Not great but some hope ..

Paracetamol does kinda help .. no creams seem to

It depends what you mean by 'heal'. My fissures healed years ago, but I still suffer from pelvic pain, which stubbornly refuses to let up.

Yes, paracetamol can help - it's probably the safest analgesic, though one needs to be careful with it and not exceed the stated dose. Sitz baths - and baths in general - are good. A stool softener like Miralax/Movicol is recommended.