Hey
Unfortunately, like you all, i am suffering with an anal fissure. im 21 years old.
I dont know why i got one, as i havent been constipated in years, but im guessing its triggered from tightened pelvic muscles. 6 months ago i suffered an injury to my penis. this led to alot of pain and urinary issues - which then led to epididymitis. i had all this pain for about 5 months and have also been diagnosed with prostatits. the pain in my testicles had only just started to ease about a month ago, and im still having urinary problems, although this is slowly getting better.
As if i needed anything else though, about a month and a half ago my anus suddenly started hurting. alot.
I went to the doctor and he gave me some sheriproct. i applied this for a week, and things felt much better. i could actually sit down with out any pain. i was then soon back to square one though..and was again given sheriproct. slowly got better.....pain came right back. i was then given glycerin trinitrate 0.4% (is this the same as nitroglycerin?). i questioned the percentage as ive read 0.2% is what is usually used.. but my doctor assured me 0.4% was the norm. ive been putting it in with my finger, but i feel like most of it comes off my finger on to the sides of my arse. whats the best way to put it in, and how far in do you need to apply it ?
i have been using this cream for about 5 days now and improvement is very slow. i still cant sit with out pain, and unfortunately i work in an office. so ive had to call in sick which i hate doing.
i have also started taking fibogel, and a stool softener. is there anything else i can do?
to be honest im feeling quite depressed. on top of all the problems ive had previously with my urethra and testicles, i now have this to contend with, and again it seems to be a problem which just wont go. im starting to feel like nothing will heal for me. ive spent 6 months with pain in my urethra and testicles and now i have this.
i was under the impression that this fissure would just heal, but after reading a few places on the internet ive become quite worried that this is yet another chronic problem. i really dont want to have surgery..
anyway, enough rambling from me.

Hey Andy,
Welcome and I'm sorry you have to be here but we can all relate to what you are going through. I had a fissure for 8 months before getting surgery last year.
Fissure's commonly heal when they are acute but once they become chronic (after 6 weeks) it's almost impossible to heal them on your own.
We have another boardie who is like a walking encyclopedia and knows all about the nitro and %. Hopefully he can answer for you soon!
Stool softener, fiber supplements are a good place to start. You got that covered! There's foods that you should probably avoid such as meat(except seafood and chicken), sharp foods like pop corn, nuts or anything that doesn't digest well that can hurt coming out. Many folks avoid dairy which can constipate or cause harder bm's.
I'm sure you probably already know this but warm baths can really help with discomfort and spasms. They help to relax the sphincter.
Please feel free to take a look around and ask any questions. There's some great people on here who are happy to offer support and advice.

Hey Andy! You really are dealing with an awful lot right now! I'm really sorry you are suffering with all this. You've come to the right place, though. Everyone here understand anal fissure pain, and you'll get good advice and lots of support from the great people on this forum.

If I'm not mistaken, glycerin trinitrate is a nitrate, but I'm not familiar with it's use for fissures. Perhaps there are some folks here would know more about that. What kind of stool softener are you using? Movicol/Miralax has a very good reputation among the boardies here, and I recommend it too. I've used it for a while and it really helps make those nice soft stools. I also agree with Dawn that warm baths are very good - they help stimulate blood flow to the butt, which promotes healing.

I'm really sorry that you are having such a rough time right now. But hang in there! The fissure can be healed, one way or the other and it's good that you caught this relatively early.

Hey Andy,
glycerin trinitrate is Nitro.
You may find this link useful.
http://anal-fissure.org/t1914-anyone-used-02-nitroglycerin-and-02-nifedipine-together#44385
And this one too.
http://en.wikipedia.org/wiki/Glyceryl_trinitrate_(pharmacology)

Wow Dawn - you are a great researcher! :D

Thanks for the replies, its nice to have a bit of support. my girlfriend has also been away for the last two weeks now and theres still a few weeks till shes back, and she has pretty much kept me going up until now, so i guess i just needed some reassurance from somewhere!!
do either of you know if anyones had any benefit from doing enemas?ive been reading a lot tonight and a few websites suggest this helps

I'm sure most of us here would cringe at the thought of an enema! I wouldn't insert things up there unless it is absolutely necessary. You don't want to cause more tearing or irritation. Stool softeners are really the best way to go and neither of my surgeons, who are experts on fissures, suggested an enema. It's your call, of course, but I wouldn't do that myself! (yikes!)

Andy,
I wouldn't do an enema unless you are constipated and nothing else works. There's loads of garbage on the internet that's really not good to do.
If you aren't already taking Movicol, I would highly recommend getting some. It has worked wonders for many fissure sufferers.

thought i did everything right yesterday. two fibogel drinks, 2 spoonfuls of lactulose. plenty of fibre and water throughout the day.
had a bowl movement this morning, right back to square one. really losing the will here

Andy,
One of the hardest things to do while dealing with a fissure is figuring out how to make the perfect bm and even when you do it's not always enough to keep from having a re-tear.
It may have nothing to do w/ your bm. When the muscle is tight and in spasm nothing can keep it from re-tearing.