Hello, I'm new to the forum. I had a bad fissure in 2010, ended up getting LIS in 2011. I was also told that they removed a hemorrhoid. My recovery was very painful but I was feeling much better after a month or so. Had no problems for 6 years. I didn't think about my butt, my BMs etc. Felt normal.

Fast forward to 2017, had a large hardish BM and felt the pain. Since then I've been battling this fissure. I take milk of magnesia every night, which is the only way I've been able to deal with this fissure.

Tried nifedipine a few different times over the years. It's never done anything for me. I don't think I've been offered any other ointment. I was supposed to have botox in 2018 but found out I was pregnant right before I was supposed to have it. Had my daughter 2019. The fissure wasn't bad through my pregnancy and for a few months after. It got more painful so I had botox in 2020.

The botox didn't heal it. Probably helped a little. It also made it so I couldn't hold my BMs for more than about 10 seconds. I had a few embarrassed accidents during the months after botox. After that I pretty much gave up any medical intervention and figured I'll just take milk of mag and hope one day it goes away.

Had another baby in 2022. Again the fissure was there but not too painful during pregnancy. Became much more painful soon after my son was born. I dealt with it and things were manageable until late 2023. Things got super painful for some reason, even though my BMs were soft as usual.

January 2024 I decided I need help. Made an appointment with a CRS. She gave me nifedipine and sent me on my way. Things were up and down after that. At my follow-up 6 weeks later I was offered botox. I scheduled it but knew I would probably cancel. They do it with no anesthesia which I don't like. When I had it in 2020 I was knocked out. Also I really don't want the incontinence issues I had last time, I didn't really like this doctor and I'm concerned about any complications that could make my problem worse than it already is.

I have an appointment with a different CRS in about a week. My pain level is generally really bad now, with a decent day here and there.

So that's my story so far. Just wanted to share with my fellow fissure sufferers. It's a very painful and embarrassing condition, so I'm glad to have a place where others understand. I will update soon.

I want to add a few more details about myself. I'm a 39 year old woman. I have IBS, mainly the diahrrea version. I'm an anxious, nervous person. I don't handle stress well and I'm sure that has contributed to the chronic fissure issue.

I have hypothyroidism and chronic migraine. I take synthroid for the thyroid and Gabapentin, Sumatriptan for the migraines. I'm also on zoloft since 2022 because of ppd after having my youngest child.

My 2 kids were both born via c-section. I tried for a vaginal birth with my first, but had "arrested descent" after several hours of pushing. Perhaps my pelvic floor is weak? Not sure.

I think I have some form of stenosis from having the fissure for so long and from using laxatives for so long. I've sometimes gone a few months with no pain in the past several years, but always needed to take milk of magnesia to keep the fissure from retearing. I basically can't pass a BM wider than an index finger, and it has to be very soft, even when I'm doing well. Currently even super small and soft poops are very painful during and for many hours after.

Just wanted to share these relevant details. I have my appointment with a new CRS on June 6. I will update after that.

So I had my appointment yesterday with a new CRS. It went well. She prescribed me diltiazem ointment and oral valium (5mg to take nightly to help relax the muscle spasms).
I have a follow up in a month. If I'm still not doing well, we'll schedule botox. This doctor does it with anesthesia, so I'm happy about that. I'm still concerned about having incontinence issues with the botox like I did last time, but I can't keep going on as I am now.
Today my pain is really bad. Earlier I was laying on the floor whimpering because the pain was so intense. I'm stuck in a place where I have to take a lot of laxatives so it will be really soft coming out, but then I have to go many times per day. If I take less laxatives, I go with less frequency, but tear really badly and the pain is even worse. Neither is good.

Hey I’m glad you saw a new CRS and got some new medication. Interesting you have valium? I wonder how that feels - I would imagine it works well to relax the spasms and pain generally. Let us know how this goes. Good luck with the diltiazem I was allergic to it sadly. I can totally relate to needing the laxative but then going several times a day which is really traumatic and hurts too. But then not going makes you anxious as you know it will hurt also. I found that taking a half dose of Movicol/miralax was the sweet spot for me. I’d make up a dose then drink half after dinner and leave half in the fridge for the following day. This way it softened just enough but doesn’t lead to repeated trips to the toilet. I also eat a lot of fruit and include magnesium citrate powder mixed into fruit juice. This helps keep things soft. I’ve recently stopped the Movicol after reducing it literally sip by sip and I’m kind of ok. Also I don’t eat anything too fibrous/bulky as this makes the BM hard to pass. I used to eat bran. Big mistake… and any form of fibre supplement made things so much worse for me. I hope the horrible pain subsides for you soon.

Thanks for your reply, it's comforting to know someone can relate!

I honestly don't feel any effect from the valium. I take it at night, an hour or 2 before going to bed, which is my most relaxing time of day anyway so maybe I just don't notice. I've been taking it for a little over a week and feeling about the same as before.

I also haven't noticed any effect from the diltiazem other than a burning, stinging, itching feeling for about 15 minutes after I apply it. I wouldn't mind dealing with that if it helped the fissure heal. So far my pain is about the same.

I think I will probably call the CRS next week and just schedule the botox. I really don't want to, but my pain is impacting my quality of life a lot.