Hi folks,
I've been lurking for a few days so thought I'd introduce myself. I'm 26/f, living in California. I'm two weeks into my fissure, and holy hell, this is *miserable*. I got it from straining too hard a couple weeks ago (usually my BM's are no problem but I was on a saltines & popsicles diet for a few days because I had mono & was basically having serious flu-like symptoms... when it rains, it pours!). The next couple days I had excruciating BM's, and then I couldn't go anymore - I would try but the pain was so intense that my muscles would just freeze up.
So, I went to health services at my university (it's my first year of grad school) and they basically dismissed it and said, oh not everyone goes every day, you just have a hemmeroid, get some hydrocortisone and you'll be fine. So apparently I do have a hemmeroid - but it's never caused me any pain.
Anyway, I went back the next day, and they said, oh well maybe you have a fissure, and gave me codeine (no warning that it's constipating!) and told me to drink coffee to stimulate a BM. Still no luck. I ended up in the ER on the 5th day without a BM, where they gave me 2% nitroglycerin (topical) and percoset and magensium sulfate laxative and I had a BM from hell.
That was about 10 days ago, and things are still pretty rough.
I'll feel like things are on the upswing, a couple days of soft BM's, and then there will be blood again.
Yesterday was the first day I didn't have to walk as slowly as a snail just to not be in too much pain, and the first day I could sit okay, didn't have to lean over and put all my weight on one butt cheek...
But this morning, despite taking 200 mg colace 2x/day, eating only fruits, veg, whole grains, peanut butter, hemp fiber supplement and citrucel, and senna last night, the first few inches of my stool were HARD. How that is possible on my diet I don't know! There was the most blood yet, not just a streak on my BM but drops of it in the water too. I don't know if it's all the fissure; the dr said I had a small internal hemmeroid too.
I just feel so discouraged - I am eating really clean, taking my drugs, using nitro, taking gentle walks but refraining from the heavy weight lifting I used to do, drinking water like a fish - and yet it's like 2 steps forward, 2 steps back.
Any advice or encouragement would be greatly appreciated! I've been thinking about mineral oil, definitely want to try miralax. Also thinking about going on a soft foods diet - like just fruit smoothies and pureed vegetable soups, til things improve a bit. Any input?
xoxo
hothead

I am so sorry you are in such pain! I know what that is like. I highly recommend taking Miralax everyday. It will help keep your bm's regular and softer. I also want to recommend soaking in the tub or even sitz baths. That is the only thing that would help relieve my pain most of the time when I had excruciating pain. My CRS (colorectal surgeon) recommends soaking for 15-20 minutes 3 times a day. It helps relax the sphincter muscles and lets the blood flow down there. Having the blood flow down there will help the fissure heal. I'm sure others will have more advice for you. These were the two things I recommend that I didn't read that you were doing yet.

Oh, I forgot to mention I have been doing the baths! That is definitely the best thing for post-BM pain.
Do you take miralax only at night? Or through out the day? I think I'll pick some up later...
I know my message was long; thanks for reading, and thanks for the reply. <3

Are you a coffee drinker? If so, make sure you are drinking enough water during coffee consumption time. I battled with my BM starting hard and then soft for awhile. I finally figured out that in the morning when I had sipped my coffee I didn't drink water for those couple of hours in the morning. So now I only have a small amount of coffee with breakfast and a large glass of water.
I would also try Miralax since it has helped so many people on here.
Good luck.

Also, I should add. You need to strike a balance with fiber intake. Fiber can bulk things up to much also causing issues. Basically, you may need to tinker with the diet to achieve ideal BM - soft but formed.

Best of luck, no one will understand the pain unless they have had an AF. Even I feel like a drama queen with all the crying, but how long can someone take the burning, shards of glass pain before breaking down. I pray it yes better for you.

Hey Hothead, I take my Miralax once in the morning- just one dose. As Paul said you kind of have to tinker with the diet, stool softeners , etc to see what works best for you. I really don't think morning or night would make a difference as long as you are consistent with the routine.
I wish there was a one size fits all. It would have been so much easier for all of us!

Hey Hothead - welcome and I'm sorry you have to be here! :D
I agree with all the Miralax endorsements. It really worked for me. I also agree that you'll want to be a bit careful with the fiber, since it can add bulk to stool too, and without enough water, it can even constipate.
Your story is a familiar one - many of us were given hemmie creams at first, but those really made things worse a lot of the time. I'd recommend that you be very careful with those if you are still taking them. If you are, I would suggest not using them for more than a week. They can thin the skin and make fissures worse. Many of us were a bit messed up by GPs and ER docs who don't know much about fissures. Also, should you be using 2% nitro or .2%? Anyway, I really hope that heals you up fast. Meanwhile, I think it's a good idea to get a referral to a good colorectal surgeon asap - fissures are stubborn little b@stards and you might need some extra help from a person who specializes in butt issues.

Thanks for the replies! Can't tell you how nice it is to be in touch with other people who understand. My boyfriend is very nice and attentive, but he just can't get it since he hasn't been there.
I tried the miralax last night and I think I'm going to stick with it for a while.
hopetoheal, I'm also wondering if the 2% nitro applied externally is another dr. mistake... I'm seeing a specialist in a week. Just have to keep it all together til then.

Dear Hothead,
I got anal fissures a year ago and let me tell you I wanted to die!! I was like Lordy just take me. I was seen by a total of four doctors and I was so fustrated. I tried nitroglycerin, Lidocaine...you name it. One of them gave me a constant headache. Even a year later I have to watch my diet I do not want one again..its really just eating healthy. The only thing that cured me was Dr.Wheatgrass miracle cream and a high fiber diet with lots of water. Lay of the coffee, its a laxative and the stool changes form(harder I noticed) .
I know this is the hardest thing but try it, relax and stay positive! Stress messes your bowel movement.
Before I eat like a salami sandwich (somethig that I would assume needs fiber) I would take 2 fiber pills. They are the easiest thing. Target has the UP brand...it says you can take up to five but I just take two(makes you gassy)...in the morning eat oatmeal with a banana and later a pear. And drink lots of water. With the wheatgrass cream I was good on the third day but went to the restroom like 4 times due to the high fiber diet. But I didn't care because it didn't hurt. Now I'm good:)
Good luck!