Wow, what a find to discover this website, I really didn't know it was so common (unfortuantely). I feel almost guilty saying I have only really been suffering for 2 months now. It all started after a lovely holiday to visit relatives overseas who, unfortunately, do not seem to eat veggies or fruit. After 12 days with white bread, white french fries etc... well, you can imagine. Not the wonderful ending to a long awaited trip. Finally went to a walk-in clinic after a month (because I knew the doctor would not check me) and asked for Proctoseydl as I had had that 15 years ago after having a baby. Tried that for a week, but really didn't think cortisone was what a person should use, THINNING the skin, hmmm, no, I want it healed. Over the counter stuff gives minor relief. Finally went to my GP, yes, he did check me, OWWWWW! He said to just use Anusol and if it didn't work in 2 weeks, then to go back and he would think about Nitro cream. Well, have my appointment with him tomorrow. Am worried about headaches etc that I have read about here, but want to clear this thing up before the summer ends. He said if that doesn't work there is minor surgery but didn't elaborate. So, to try the nitro or not. Am even considering the wheatgrass stuff etc. Have increased the fibre, water etc. but that was never a problem. It seems any little BM will rip you apart again, so short of not eating..... Any suggestions? Thanks

Hi Bottominal Blues - welcome! I am sorry you have to be here, though. There are lots and lots of stories here about just what you are asking about. Many of us were initially given hemmie ointments which only made things worse. So the first bit of advice many of us would give is to stay away from cortisone! Also, nitro doesn't give everybody headaches, or at least not really bad ones, so you could try it (just remember not to stand up too fast after you apply it, and maybe lie down for a while after you apply it too). If the nitro doesn't work, you could talk to your doctor about calcium channel blockers, like Diltiazem. This doesn't seem to cause headaches, although people have mentioned that it causes itching and sometimes burning.
The surgery your doctor mentions is an LIS, or a lateral internal sphincterotomy. What usually prevents a fissure from healing if the sphincter muscle is too tight and/or is spasming. The internal sphinter muscle is cut (a very small cut!). This loosens the muscle so that the fissure can heal.
I got an LIS in May, and it did cure my fissure, so I do recommend it if you find a good CRS (colorectal surgeon) and s/he thinks it's a good option for you. The surgery itself, if done under a general anesthetic is a breeze. Recovery can be a bit rough for the first week, but most people say that post-surgery pain is minimal compared to pre-surgery fissure pain.
Some folks here have used Wheatgrass and found that it helps with the symptoms, but didn't heal the fissure. What ultimately matters is how long you've had the fissure. After about 6 weeks, it's considered chronic and it's quite challenging to heal - many of us ended up getting the surgery after trying nitro or dilt for a while.
I don't know if you are taking warm baths, but they really help too. They help with the pain and can also help with the healing because the warm water stimulates blood flow in the butt.
Anyway - there's lots of information here and great people who can give you information, support and advice.
I'm so sorry that your visit ended the way it did :( I hope you find relief very soon!

Thanks for the info. It is great to be able to talk about this rather sensative subject. Most of my friends think it is funny, as they don't understand that this really is painful. Question: What are these spasms people keep talking about? I just have the sharp stinging/burning pain that sometimes lasts for hours (but not always) after BM. Every day is different! Cheers!

Hey BB! Spasm pain can differ from person to person, but commonly it involves an intense burning pain, sometimes it's quite sharp. My butt felt like it was on fire and like there was a knife shoved up there - often at the same time
Spasms do tend to last for hours too, and that can get worse over time, unfortunately. That's why many folks with AFs take so many warm baths and sit on heating pads :)
It is difficult to talk about this kind of problem! Even close friends and family don't really get how incredibly painful and debilitating AFs can be! I've been obsessed with my butt and my poop for a very long time now, and I'm just now beginning to understand why my dearest friends and family aren't as fixated on my butt and BMs as I am.