Hi everyone,
This is my first post here and I apologize in advance if this topic has been discussed previously. I am 24 and I had a fissure when I was 22. I had to get emergency surgery and the painkillers I was on constipated me causing a fissure. I did not see a doctor, but I was pretty sure that it was fissure because of the excruciating, broken shards of glass pain. It took me 2 months of high-fiber diet, metamucil, and stool softeners to heal it. It was definitely the worst time of my life. Roughly 3 months ago, I started having pain during a BM, but not as bad as when I had the fissure. I am a grad student and visited the health clinic on campus where the doctor told me that I had a hemmorhoid (sp?) and prescribed analpram. I can feel the a tiny hemmorhoid, but I can also feel a crack right next to it. The pain is not as bad as the time I had a fissure before, but it hurts, itches, pricks, and burns for hours after a BM. The doctor insists that it is only a hemmorhoid, but the analpram has not helped at all ( applying for 3 weeks now). I can't see a CRS for at least a month. In the meantime is there any way I can determine if I have a fissure too? Is that or the hemmorhoid causing the pain? When I touch the crack I don't feel any pain ( maybe some pressure), but touching the hemmorhoid does not hurt either! I'm so confused. I appreciate any help! Thank you!

hey desigirl,
Sorry you have had to go through this and congrats on healing your last fissure. I am not very informed about hems but i do know its not a good idea to use hem cream if its a fissure. So i would go to the doc and see what they say and make an appointment to see the crs.
When having a bm does the pain feel anything like your last fissure pain??

My guess from spending countless hours reading about all this and my own personal experience is that it you have a fissure. most family doctors assign rectal discomfort to hemorrhoids when it is usually fissure or some other problem
Internal hemorrhoids which dont prolapse (temporarily or permanently) do not cause any pain or burning or discomfort 99% of the time. hemorrhoids could bleed painlessly but pretty much the only time they cause lot of pain is when they are external and thrombosed or when they are prolapsed. when they are small and internal they will not cause any pain or burning.
from what you say my guess is that you have a mild to medium chronic fissure. also remember chronic fissures cause less pain than acute fissures and may not cause the broken glass pain.
if you have not already started the fissure diet that you followed the first time start it right away along with sitz bath etc
good luck

forgot to add. you could have internal hem too but it wont cause all the pain , burning symptoms. also remember if your fissure is chronic (which it probably is since it has been there for 3 months) then you could have hypertrophied anal papillae which could be mistaken for internal hem
since conservative therapy for hems and fissure is the same - extremely healthy , no junk , no fat , fibre rich vegetarian diet, lots of water , metamucil , colace and sitz bath you might as well get started on it

Hey there,
Sorry you are having butt problems, but welcome!
I'm not sure if you are aware and I'm no expert but chronic fissures can develop skin tags which resemble a hem. I had a CRS who mistakenly diagnosed my skin tag as a hem.
I later had the tag removed with my LIS after another CRS knew what it was. I would say there is a great possibility that you have developed one because your fissure is chronic....
I'd like to add: A chronic fissure has nothing to do with size. If your fissure is over 6 weeks old, it's considered chronic.

Hi - You can have both at the same time... but as thegreat_in said, the internal hemmies aren't going to cause you the same pain as the fissure does unless they are prolapsed. I had both at the beginning of my fissure time, but 4 months later, the hemorrhoids are gone, but the fissure remains.

Hello desigirl
I don't know much about hems, but I agree with the previous posts that it sounds like your fissure is back again.
Your 'hurts, itches, pricks, and burns for hours after a BM'
symptoms are exactly what I've had for a long time and I don't have hems (to the best of my knowledge!).
Sometimes I've found a hot water bottle can reduce the pain as it relaxes the internal sphincter like a hot bath does.
It might help if you could find a doc who would let you try some Nitroglycerin ointment subject to her/him thinking it advisable, but perhaps you might prefer to wait for the diagnosis to be confirmed by the CRS. (I've used the Nitroglycerin ointment for years and no-one's actually seen my fissure yet.)

Thank you all for your advice! I'm so frustrated right now. I have no idea what caused my fissure again!! I have been a vegetarian all my life, hate coffee/soda, drink lots of water and alcohol rarely. It sucks when I see my friends eat/drink anything they want and not worry about it. :(
Hopeful lad - From reading the posts here it appears that Nitro is available by prescription only? How did you manage to use it without being diagnosed?
Should I try Miralax?
My biggest concern right now is whether a chronic fissure can be fully healed without surgery?

If it's any consolation I know how you feel when you see others eating whatever they want without worry and you have to watch what you eat, it's frustrating!
The chances of a chronic fissure healing without surgery are quite slim to be truthful, most if not all of us have had chronic fissures and have tried everything to heal them without success which has resulted in surgery.

For me, my pain decreased when I could get my BMs as soft as possible. To do this I take a half-dose of a fiber supplement and a half-dose of miralax per day (everyone is different). I started just by using the fiber supplement, but this didn't get things consistently soft for me. After introducing miralax, now I've got the "recipe for success" down.
If you have the shards of glass or spasms, then I would recommend trying it.
As for healing a chronic fissure without surgery, I'm not sure - I've had one for 4 months now, and am giving healing a shot. I think cherylk is one of the few here who healed without surgery, and the whole process took about two years.