Hi everyone.

It has been such a great help to find this forum. I have been suffering with a fissure since April 2022 - although I was officially diagnosed in September as I was self-diagnosing up to then, thinking it was hemorrhoids (stupid of me). Pain was coming and going and was really uncomfortable for all these months..

I was then prescribed rectogesic, uniroid HC and the respective suppositories. I can't say I was consistent using them (possibly another mistake).. and in November things became really unbearable and I was crying from excruciating pain for hours and hours every day. After a few A&E visits, specialist visits.. I took a quick decision and had the Botox on the 30th Nov as it was recommended to me (I had it in Greece although I live in the UK - I was really in agony and could not wait a day longer - and also removed a skin tag, probably big mistake too). Forgot to say that started taking softeners (dulcoease) only a few weeks before as that hadn't been mentioned to me, although I was already on a high fiber diet..

The first two weeks were just hell after each bowel movement plus suffered from constipation at the start and also developed a really bad skin rash as I'm now using diltiazem instead of rectogesic..

I thought it was all a big mistake but last week I started seeing an improvement and was pain free for a good 3 days (I have at least one BM per day).. I really thought I'm ready to heal now after all these miserable days crying my eyes out.. Unfortunately since 3 days things got bad again.. pain.. stinking.. torture.. all the usual stuff plus blood again after so long... Back to zero. Probably a big mistake as I did strain.. I was really in agony for hours and wanted it out.

I'm so desperate at the moment, can't think of anything else.. I feel like my life is over. I don't know how I'm going to return to work next week.. I just dread every day that I wake up and want to disappear.

At the moment, I'm using the diltiazem cream at least twice a day, doing sitz baths after BM (or before some times too), take dulcoease and occasionally lactulose.. my diet is okay as I have cut out lots of foods and I'm already a vegetarian but I feel my stool aren't great.. and might be bulky?! I'm trying to increase my water intake.. I don't know what to do anymore.. I'm going to try the magnesium citrate and vitamin c and maybe switch to a mineral oil for lubrication (anyone in the UK, please let me know if you've used one!).

Like everyone I just hope this torture is going to end soon.. thanks for reading and I hope you all find ways to get rid of them and live a pain free life!

Hello. This sounds very much like my experience so far although not quite as far along as yourself.

I can answer a couple of your questions though that I have found work for me, your mileage may vary.

1) No straining ever, I know it’s super tempting but only go when you have to, I have IBS-M so it’s a rollercoaster trying to figure out when that is for me.

2) Squat if you can or lean forwards when you go. It’s the natural angle, helps.

3) The best lubrication I have found is just pure food grade organic coconut oil, just a little before you go.

4) Dulcoease is rubbish, see if you can be swapped to Fybogel or Psyllium husk, 1 drink after breakfast and 1 after dinner.

5) Drink a ton of water, like a lot. It helps.

6) Sitz bath for the loo, these are £15 on Amazon.

7) Sitz should be warm not hot and 15 mins tops I find longer wrinkles your skin and is counterproductive for me anyways.

There is no quick fix I’m afraid, this will take a while.

Good luck, I’m yet to even see someone at hospital, been waiting for 7 months now but that’s the way it is unfortunately.

I am sorry to hear of your suffering. I suffered for many years and my personal conclusion is yes you do want bulky stools. I feel stool softeners end up making things worse in the end. Stress is a major contributor to the fissure not healing and also causing your sphincter to tighten the more stressed you get. And if the sphincter is too tight the blood flow needed to heal will not be there. When you have loose or very soft stool that isn't bulky I feel it contributes to this process of tightening and lack of blood flow. In the end my sphincter got so tight I was straining to have every BM and I ended up getting the LIS surgery which allowed the blood to flow and heal the fissure in a couple of weeks. That was in the fall of 2020 and I have been great ever since. I don't know if what you are doing will work, but keep it up and try to include mental calming techniques along with what you are going. I don't think you need to change your diet. It's the stress you need to manage. If you allow the pain and stress to take over, I don't think any treatment will cure this other than the surgery (which in itself is very successful - at least in the US, I don't know about the NHS). So definitely be mindful of managing stress. Not just in the bathroom but in your life. Many people end up with chronic fissures because they have stress in their lives on a daily basis. Bad job, bad relationship, grief, financial problems, etc. Good luck!

Pinecone wrote:Hello. This sounds very much like my experience so far although not quite as far along as yourself.

I can answer a couple of your questions though that I have found work for me, your mileage may vary.

1) No straining ever, I know it’s super tempting but only go when you have to, I have IBS-M so it’s a rollercoaster trying to figure out when that is for me.

2) Squat if you can or lean forwards when you go. It’s the natural angle, helps.

3) The best lubrication I have found is just pure food grade organic coconut oil, just a little before you go.

4) Dulcoease is rubbish, see if you can be swapped to Fybogel or Psyllium husk, 1 drink after breakfast and 1 after dinner.

5) Drink a ton of water, like a lot. It helps.

6) Sitz bath for the loo, these are £15 on Amazon.

7) Sitz should be warm not hot and 15 mins tops I find longer wrinkles your skin and is counterproductive for me anyways.

There is no quick fix I’m afraid, this will take a while.

Good luck, I’m yet to even see someone at hospital, been waiting for 7 months now but that’s the way it is unfortunately.

Hi Pinecone, thanks so much for your reply.

I'm already doing all this but for some reason my stool wouldn't change.. Two days ago I was really fed up and two large tablespoons of lactulose plus magnesium citrate 300mg. I have spent the last two days on the toilet (more than 10 times in two days)... But not diarrhea. What is going on? Yesterday I went mad. I had itching, scratching, pinching, stinging, pain, you name it! I took two xanax to get myself down (second time in my life!!) Today the pain is better but the rest remain, I'm so confused...

I really hope all the best for you when you see the specialist. Stay strong.

Although I don't mean to be negative.. to three different colorectal surgeons I've seen, no one told be anything different of what we are already doing. It's really unthinkable that no one talks about this pain and there's nothing we can do!!

Rich44 wrote:I am sorry to hear of your suffering. I suffered for many years and my personal conclusion is yes you do want bulky stools. I feel stool softeners end up making things worse in the end. Stress is a major contributor to the fissure not healing and also causing your sphincter to tighten the more stressed you get. And if the sphincter is too tight the blood flow needed to heal will not be there. When you have loose or very soft stool that isn't bulky I feel it contributes to this process of tightening and lack of blood flow. In the end my sphincter got so tight I was straining to have every BM and I ended up getting the LIS surgery which allowed the blood to flow and heal the fissure in a couple of weeks. That was in the fall of 2020 and I have been great ever since. I don't know if what you are doing will work, but keep it up and try to include mental calming techniques along with what you are going. I don't think you need to change your diet. It's the stress you need to manage. If you allow the pain and stress to take over, I don't think any treatment will cure this other than the surgery (which in itself is very successful - at least in the US, I don't know about the NHS). So definitely be mindful of managing stress. Not just in the bathroom but in your life. Many people end up with chronic fissures because they have stress in their lives on a daily basis. Bad job, bad relationship, grief, financial problems, etc. Good luck!

Hi Rich, thanks so much for your time to reply. I'm so glad to hear you are healed and pain free, it gives some hope..

Stress is definitely one of my problems.. no surprise that my fissure got unbearable at a business trip before (!) giving my presentation (I dread public speaking). It was a long time coming.. I feel like my body is revenging me for not being well for years.. I hope I can live normally again!