I just found this forum so I'll spend some time going through the threads when I can. Just a quick query about pain. I've had this fissure for about 2 years I guess (though suspect had a few acute ones over the years that healed). Sometimes I get horrific pain during BM and it can last for hours - my worst was about 2 weeks ago when it lasted nearly all day, throbbing and feeling like salt being rubbed into a wound. Anyways, last week or so things are changing and pain during BM is bearable. But the pain builds up afterwards especially if I have to drive. Today I'd hardly any pain during BM, small bit blood, but was harder than the last few days. Mild pain after but unbelievable pain on short drive. Thought I was going to cry/scream - probably would have if kids weren't in the car. Been home 2 hours and pain has subsided (though could be from taking nurofen)
I'm seeing the doc on Wednesday, but anyone had this?

Yes those are classic fissure symptoms AND so very painful!

When my fissure is "active" and I have painful BMs, I can't sit for a long time. I found it is better if I can walk a bit and I stand to eat breakfast. Long drives can be unbearable. Glad you're seeing a doctor.

Yes, those are familiar symptoms to me too. I also stopped having pain during the BM, but had pain/discomfort that would start 20-30 minutes after, and build over the next several hours. At an earlier stage it would last almost all day, but a month later, just some discomfort was lasting at best only an hour or two. Then some tougher days come along every once in awhile, and it lasts 4,5,6 hours. I think these are muscle spasms. For me, moving around makes them worse. Sitting on it makes it worse... unless I am sitting on a heating pad/warm wheat bag. Have you tried this?
Everyone is a bit different, and it's alot of experimentation to find what works for you.
When you see the doc, try to get one of the ointments - rectogesic or diltiazem - that will help with the muscle spasms.

Hi catnap,
I've had similar experiences: uncomfortable BM but really sharp pain a few hours later - lasting for a few hours and accompanied by uncontrolled spasms.
The good news is that they've recently eased quite a bit - I suspect through the onslaught of all the usual conservative methods: diet, stool softeners, water, exercise, healing and pain alleviation. I've been using lactulose, been prescribed GTN and some lidocaine, eat a high fibre diet with a fair amount of liquid and take a magnesium supplement.
Do tell the GP how bad the pain is: we all know that you are _not_ exaggerating; and ask about pain relief (as well as GTN or diltiazem if you're not already using one of those).
Sometimes I try to take exercise and walk-through the pain. I have also tried paracetamol (and my GP said try ibuprofen as an alternative). However I'm not convinced that either of these approaches made much difference (but that's just me - and a real frustration is not having a control: I don't know whether the pain would be less, the same or more if I took a different course of action).
I also get relief from the hot pads (I've got a couple of 'Stay-warm' cherrystone pads - Oooh the relief). We've just recently got a new car and we've got heated seats - if you ever get the chance I'd recommend that option (an essential part of the option pack for AF sufferers!). I also take an additional hot (sitz) bath when the pain is bad.
So you've got good friends here, lots of understanding and sympathy and plenty of advice. Mine took about a week of these comprehensive conservative treatments to reduce from the horrific pain to the mild discomfort level - so I do hope yours will respond at least as quickly. As Bumbutt so perspicaciously says: there is a wide divergence in the best treatment for AF, and trying various combinations is the order of the day.

Since my fissure re-opened in mid November last year I can't sit without pain for more than a few minutes at most. Driving seems worse than sitting.
But if your doc decides to give you the GTN (NTG) or diltiazem, as Spamfree says, then you should have a very good chance of relief/healing.

I can't take ibuprofen but sometimes take paracetamol at bed time which may help me sleep.

Thanks all for the responses, really good to hear that this is a normal (albeit horrible) part of this condition. I saw a doctor about 2 years ago for bleeding and that's when I was diagnosed with a fissure, but it's only in the last couple of months that the pain has really kicked in.
Had a much better day today. Read on here someone advising use of olive oil before BM - had been using vaseline, but found the olive oil much better. Hardly any pain this morn. 1 hour car mess wasn't good but not as bad as it's been - I think for me if I can really relax and not stress about the actual BM then the spasms after are not so strong.
Who knows what tomorrow will bring...

+1 for painful driving, it defoe sets off horiffic pain!!
I found if i could relax for at least an hour after each BM (standing, leaning or squatting) the pain would be a lot less, but obviously this is not always possible! I bought a memory foam ring cushion for the car which helped a lot.

I used to love driving....I have a heated seat pad that plugs into the cigarette lighter, bring my microwaveable wheat bag for firmness and warmth. I find it's caused by vibration and also car seats r designed so u sink into them, AF sufferers need firm seats I find a cushion in the bend of the seat keeps me from sinking in and alleviates the pressure.

I've had chronic fissure pain with periodic flare-ups for nearly two years. One way I know how bad it is is whether I can stand driving! I,too, bought a thick memory foam seat cushion and just keep it in the car! BTW donut or ring cushions were terrible for me. I use solid memory foam or a cushion with nothing down the center (for people with interstitial pain...not sure my terminology is quite right).