ps....
are you having spasms hun? Try the warm baths in the tub for 20 minutes at leat 3 x's a day. The longer the better because they will help promote blood flow and relax your sphincter.
I use to just lay in the bath tub and keep the water pretty warm through out the whole soak. It brought me out of the shards of glass feeling along with regular bm's and diet for soft bm's.
You may try taking some ibuprofen. Taking prescription pain killers w/ a fissure is pretty risky because they can cause constipation:(

Thank you for the advice! I'm glad I didn't run out for that medication, I've been doing my research and had never heard it listed so I didn't think it was a good idea!
I'm going to call and INSIST to speak with my doctor.
I have been taking 3 sitz baths a day :) I took miralax yesterday and I take fiber supplements every day along with all kinds of fiber rich foods. 30g of fiber and 70oz of water may not seem like a lot but holy cow! I'm trying not to worry to much because I've never been an everyday "BM-er". I normally would go every 3-4 days sometimes up to 6. Boy do I regret that now!!!!!!
Thanks for the advice again! <3

Hi Rach,
I just wanted to chime in to try to help you out too.
I read a statistic the other day that said only 50% of general physicians could identify an anal fissure, while over 75% of colo-rectal surgeons could identify them. When my GP suggested I go to a surgeon for my fissure problem, I was a little shocked. Surgery??! But it turns out that colorectal surgeons (CRS) are the doctors that know the most about these problems. I was prescribed rectogesic ointment (in europe - in US I think they tend to prescribe diltiazem more often), which helped reduce spasms. THe baths have also been key, as well as a heating pad for reducing spasms and pain after the BM.
If you increased your fiber intake rather quickly, that could be one reason for a delayed BM. You'll have to find a good balance to get a right amount of fiber and not tooooo much. Also, female hormonal cycles tend to play havoc with it. That's the case for me - like clockwork. Two months ago, I didn't go to the bathroom for four days before my period - I just used a little bit more miralax each day, and then, when I get my period, my body makes up for the lack of the bathroom visits! It wasn't a problem, since this is just what my body does. Also, if you just started taking the miralax, I think I also read that it can take a few days to kick in and work regularly.
Yes, call your doctor again, and emphasize that it is the fissure that is giving you problems. If they don't know how to deal with a fissure, they should refer you to another doctor (preferably a colo-rectal surgeon) who does.

I might add that if you have a local gastroenterologist that you can get into quickly, they might know enough to at least prescribe the right type of ointment.
In the long run though, I think it's very important to find a good CRS.
I went only one time to the GI doctor and at least got some nitro ointment. I didn't even ask if they did the Botox treatment because quite frankly I don't want anyone other than a CRS poking around down there.
I wouldn't mess around with the GP more than you have to.
I hope you feel better soon!

I also think you should skip messing with the GP. My GP made my fissure worse by doing a digit exam and tore things more. This event tipped me into pure misery.
I am not sure where you are located. Here in the US, some insurance lets you self refer to a specialist - CRS. That is how my insurance works. So after the one visit with the GP I figured out who treats fissures and made the call myself to set up a CRS appointment.
I hope you find some relief.

I second Paul. I'd try to get straight to a CRS. I had so many painful exams by doctors who knew nothing about a fissure, caused more damage and pain and they still weren't looking for or finding my fissure.

HELPPP!!
Was able to get lidocaine! put it on and tried to go with absolutely no luck. first of all, how deep am I supposed to apply the lidocaine? because I think my fissure is pretty deep.
When I first started to push it wasn't bad but than I hit that "10" spot. Am I supposed to push through this? Is that pain something I'm supposed to get used to? And if so, any tips on how to distract. I tried so hard to push through but just couldn't bring myself to.
advice :(

Hey Rachxo,
I never used the lidocaine but many here who used some of the other ointments have applied then inside just a little with a syringe or q-tip. I honestly don't think I could have gotten anything in mine because it was so tight and I was scared to anyway.
As for the pushing, I don't think you should ever push but you need to relax and let it come, Deep breaths and just let it come naturally if you can. My sphincter was in spasm most of the time and would not allow me to go even though I had the urge. I would have to wait for it to relax enough to go. Sometimes a long warm soak will get it to relax.
If you could get one of the ointments prescribed for fissures like the nitro, diltiazem ,it may help the sphincter to relax. It's really a good idea to get one of these ointments while your fissure is acute as they will help the healing and your spasms.
Another thing, the softer the poop the easier it is to have a bm without much effort.
I'm so sorry you're going through this:(

I am not sure, but the lidocaine is a pain reliever, right? I think it numbs the area a little bit. But in my own personal (non-medical) opinion, you probably cause more pain than the lidocaine can deal with by trying to put it up into the anal canal. What about if you just rub it around on the outside, without trying to go in? Still, it sounds like you would really benefit from getting the diltiazem ointment.
When I called my GP the second time to tell her that I had a lot of pain, she wanted me to come in for another exam. I said I would rather not since it was painful and we already knew I had an AF, and then she rummaged her brain for what step to take next. I told her that I had been reading on the internet, and that rectogesic and diltiazem were often prescribed. She knew about rectogesic but not diltiazem, and called in the prescription for rectogesic over the phone. In the least, maybe your GP can do this, while you are waiting to see another doctor.
If your sphincter is spasmed, then like dawn said, that will make it difficult to poop. The sitz bath is good, but it can also be good to just plunge your whole torso into a hot tub. Not so that you burn yourself of course, but I personally liked to have the water quite warm. And as dawn said, to make sure your poop is soft - really soft - but formed. Hopefully the miralax kicks in for you soon.

Good lord, if your fissure is that deep, do not stick something up there to rub that lidocaine on. Lidocaine is just a numbing agent, when you feel that poop coming on, quick get to the "loo" or the bathroom, rub it on and relax.....or if you can, jump into a hot shower, as hot as you can and bend over and let the hot water get on there...squat over and stick your butt up, this is what I've done and it helps. Just do 3-5 minutes, put the lidocaine on and let go and let god!
If you are keeping up with water, fibrous rich foods, miralax, your bm should be smooth and soft, but still a bm that is solid in nature.
For right now, with my niphedepene cream, I push just a tiny bit almost like I'm pushing a *angel gas* out and then rub my cream on there, (as my butt muscles relax back up, it takes the cream a bit further up the canal, than trying to force a finger or q-tip up there) try that with the lidocaine cream before you have to go. And please, call your CRS or GP back and get the diltiazem or rectogesic right away.
Good luck.