I have a question for those AF sufferers using conservative treatments and managing their AF for some time now:
IF and when your AF is in remission (e.g. no blood or insane pain during and all day after BM) and you are managing with Miralax (or other stool softeners) and creams and sitz, (conservative measures, etc.)
How long does it take (days, weeks, months, years?) before AF comes back again and you have to nurse it back to manageable state?
I know it's a vicious cycle but have you had pain free days and how long can it last?
Also, when do you know that AF has healed (has it been the case for anyone without the surgery?)

Hi Hope,
Well it varies - and I imagine from other posts it varies from person to person. It is months to years for me - and for me it depends partly on how much care I take.
The typical cycle for me is that immediately after an episode of pain and blood I stay on stool softeners for a while, keep up a high fibre diet and plenty of liquids to start with - and then as the memory of the pain and my confidence returns I slowly let things slip a bit, and eventually it returns.
This cycle is not the best strategy, and partly the problem is that when it comes back I switch back into full AF conservative treatment mode BUT it still takes a while of pain for it to go. I've had 4 episodes over 8 years (not evenly spaced - if anything they are becoming more frequent).
However, this time around, although I was in pain for a while, almost as soon as I switched to both a macrogol-based stool-softener (like Miralax - I'm on Laxido which is an exact equivalent but a bit cheaper and available OTC in the UK), and a new prescription of diltiazem, the pain and bleeding went away quite quickly. I'm still using both of those; and being scared of an operation I think I'll persist with the conservative measures and hope that an early application of the macrogol-based stool softener and diltiazen will work as quickly next time.
I don't really know it has healed - but after a couple of weeks completely without pain or blood I usually declare a won battle - it is in remission.
How are you getting on?
Good luck.

well i had a good period of time between 2008 and 2010, and this was since i got my fissure in 2004, that my fissure didn't give me any issues but it was my skin tag that volunteered to take me to places that i never imagined i would go!
it was at the very beginning of december 2010 that things just got out of hand and pain returned unlike anything i had imagined so in to the CRS i went and the rest is history!

In my year of fighting my fissure, I didn't have one pain free day. I had days I had less pain, but never no pain unless I took Valium, this was the only thing that completely stopped the spasms. I finally had LIS April 28, and there's no looking back. Now most days are pain free. I hope you can get a handle on it, I know some can manage it with ointments, but if the muscles too tight, nothing else will fix it IMO.

Hi. I have basically had no pain free days, maybe pain free hours. I started Mirilax tonight, just on tsp in some juice, together with my milk of mag. I have noticed that I can now manage to get the Nifedipine inside without pain to my anus, using the little applicator that came with my Analpram. So, that is something. I have pressure a lot of the time, too, and have to press to get the last poop out, as it hurts like hell otherwise. All in all, physically and mentally debilitating. And that is where I am!

Hello Hope,
I think my fissure first started giving me problems sometime in 2008. It hurt like hell for about three months, and then went away for maybe five months. Then it came back for about three weeks, and then went away again for maybe six months. When it hit me most recently, in January of 2011, I immediately started all of my usual remedies (Wheatgrass skin recovery cream, high fiber diet, soft foods), and I also added an oil that is supposed to heal fissures.
Well, I don't know if the oil did much, but I know that the other measures usually took care of the problem, and by the end of February, while I was on my way to the airport to take my two week vacation trip to Colombia, the pain just miraculously stopped. I mean, just like that. And the fissure didn't bother me at all for the two weeks I was down there; however, two days after I got back, the fissure plagued me again worse than ever. I was very discouraged and depressed, since I really felt that I had that fissure on the run with my conservative measures, which had always worked in the past. This went on for about a month until I finally screamed, "ENOUGH!!!", and had LIS on March 30th. I am a new man. No pain, no problems.
Conservative measures should always be tried first -- ALWAYS. But if those fail, and the fissure just keeps right on coming back, it may be time to look at other options. When a fissure becomes chronic, it would appear that it is just not going to heal without less conservative measures being taken (surgery and the like). LIS happened to be the option I took, and I have no regrets. It's been almost two months, and I felt wonderful within 24 hours after the operation.

After 9 months AF "finally" diltiazem, sitzbaths and Movicol made everything feel normal. But as I stopped taking anything, it returned, and I immediately went back to sitzbaths and Movicol. Now I only take one "letter" per day of Movicol, and everything's been fine for weeks. Don't know when I dare to quit the Movicol (or "dolphin-fodder" as I call it due to the dolphins on the package) :-)
Maybe when another week passes peacefully, I will try to replace the dolphinstuff with a lot of water and a raw carrot.
Also: I try to avoid eating things that make me feel bloated, i.e. raisins (which I love). Also meat, especially beef and pork with a lot of wine :-) doesn't feel so good "down there". And I agree: Bread of white flour slows down digestion.