So pleased to have found this.
I am on my 3rd AF this year, got the first one in may after some constipation caused by my ibs which is normally the other way. It settled after using proctosyl (sp) reoccured again in august, we where on holiday so hadnt drunk as much, and again cleared up after a couple of weeks. Now has happened again 2 weeks ago, very painful loads of blood in the toilet, it shocks me. So disappointed as it had healed so well and I had almost got to the point of not checking every time I went.
In May was prescribed fybogel and have used this but only half dose every day as it seems to cause me tummy ache at higher dose.
Rang gp to get more cream but he want to see me tomorrow, and move to next stage of treatment, but I have no idea what that is.
Guessing it might be gtn cream, but I get headaches as it is, so dont fancy that.
I am drinking loads, and eating high fibre, but just feel like stopping eating forever.
Thanks for listening from a very fed up person in the UK

Hello,
I'm new on here too and also in the UK.
I have had my fissure on and off for nearly 4 years. Has come back badly after the birth of my second child.
First time round I found normocol plus really good, really eased the pain. Although this time isn't helping much. Diltiazem cream does the same as GTN and doesn't cause headaches although gave me a burning sensation.
Get referred to the hospital. I had botox a couple of years ago and am going for it again next month.
There are some very knowledgeable people on here.
Take care.

Hey there,
Sorry you are going through this. Just wanted to say welcome to the forum. As mumof2 stated, diltiazem usually doesn't cause headaches and is a good option. I did experience some itching and irritation after using it for a couple of months though.

Hi also new here. The GTN cream will probably cause headaches but you may find that if you stick with it the intensity may well diminish. If thats what he suggests its worth trying before taking matters further. The botox MO2 refers to above has a similar effect on yer botty but without the headaches, ie relaxes the muscle allowing healing to take place. This would mean a visit to a CRS and hospital as a day patient, (I've done this through the NHS twice!)
If your GP offers/refers you to a CRS don't panic accept it, the treatments you read about here are not as painful as you might imagine and remember they are the experts and an early catch of you AF may mean less hassle for you. GL.

Hey there, yep nitroglycerin will cause headaches, but there are alternatives. Diltiazem and nifedipine based ointments could be viable alternatives that don't generally cause headaches and may be worth asking about. I've used all three ointments and nitroglycerin definitely gave me throbbing headaches and lightheadness, but that subsided after a few days of use and I found it to be the most effective for me out of the three.
If you get offered Botox, it's worth a try. I had it done and got nice relief from it for a couple months. Eventually I re-tore the fissure and had to have surgery, but I'm glad I tried Botox first.
I would definitely encourage you to talk to the doc about what the next stage would be. The thing with fissures is you don't want to let them linger. The longer they've been around, the tougher they are to treat, and the higher the risk of complications like fistulas developing. If you had one before and it recurred now, treating it aggressively early on is going to be your best chance to beat it without surgery. Personally I got the runaround from poorly informed docs for a few months until I started fissure-appropriate treatments, and IMO that had a lot to do with why they didn't work (too little too late).
If you let us know what you doc wants to do for the next step, I'm sure someone here will have done it before and can offer their experiences.