Hi,
A few weeks back after my Fissure was diagnosed I used to have quite painful BM's each morning, ever sinced i have almost overdosed on water, fruit and fibre each day (not great for the tummy mind)
Currently i am as regular as clockwork and have one toilet visit each day straight after breakfast and the BM pan has gone away. However the pain comes within 30 minutes of the BM and wont go away for 4 to 5 hours following.
Does this mean a sign of improvement or is this normal? (apparently my fissure is external only)
Also i used GTN for the first time last night (with only very slight headaches) but it has made no difference to the pain - how long does this normally take before i notice pain relief?
Thanks in advance!

Sounds like you are having spasms after the BM. As soon as you get off the toilet, get into some warm water and soak!!! Then use the GTN, will help relax that tight sphincter. I get in the shower and use the shower head to get rid of any debris, take a couple of advil and walk. The creams have quit working for me, but this seems to help.

Hi Sue,
Funny you should do that but each morning i just straight in the bath for 20 minutes frollowing a BM an then i apply the GTN (first time today).
I did really hope for more relief with GTN mind but i am now hoping maybe it takes a day or two to work!

Give the Nitro more time to work, it can take weeks of use before you notice anything significant, after all it has to relax the sphincter each time you use it which only lasts for a short while until you use it again, IMO it doesn't relax the sphincter for long enough to let healing take place unlike LIS which permanently relaxes the sphincter.

Hey Davo, your pain is due to internal sphincter spasm. It very painful and difficult to avoid. If the pain persist for more then 1month in spite of all conventional treatment, better start considering surgery. I say this because i did the same thing and i am back to my normal life.Make sure you do not turn your fissure into a chronic fissure. Take care

hi davo, did you put some lubricant before BM? if u haven't, try using some vaseline, lidocaine or even aloe vera before BM. This helps to reduce the friction on ur fissure, thus minimizing intensity of spasms and also helps your stools to glide out easier without pushing on ur own.
Try taking deep breaths during BM, breathe in deeply and let out slowly. This helps to relax ur anus during BM. After BM, do not wipe, just spray water on it and dab dry with a soft toilet paper.
I have taken sitz bath (yes, i mean those pan which u fit over the toilet bowl. This is not the same as simply taking a shower) 15mins each after every BM for a month or so and i noticed spasms decreases as days passed. Healing is not straightforward, u wldn't be able to see it overnight. We all has been thru this.
Read my post on the thread "my success story" if u haven't.
Yes, if all else fails and u have had enough, do opt for LIS. Many ppl here has good results from it.

Hi, Thanks for the comments
dwarfs8,
I have tried Lidocaine before a BM but this made no difference to me - currently i have no issue with BM's and feel no pain whilst having them, it is the 4-5 hour spasms afterwards that cause me the grief. If this is the case do you think Vaseline could still make a difference?
Also a quick update on my GTN - today is day two of using it (Mine is the UK 0.4% ointment which you use internally) and the improvement is incredible!!! I feel great and apart from a mild tingling this morning this has been my best day in about 5 weeks. But what has felt even better is my state of mind, i can chat and joke with people at work, sit down without jumping all over the place and its the happiest i have been since this whole damn fissure came into my life!!! I appreciate there is a long way to go yet and hope that GTN has done this to me rather than me just having a good day. Anyway i have fibre and water to throw down myself so must go now!!!
I feel so happy i could cry today!!!
:-)

Yes gtn is able to relax the spinchter thereby bringing good bloodflow to the fissure, trying to achieve the same as LIS. Continue with it for 2 months, it has too brought me further healing with the gtn.
U can try vaseline before bm, or even aloe Vera, it will do more good than harm. :)

So as my fissure is external, do i need to internally apply the vaseline to aid the movement of the BM or do i apply it to the fissure itself.... or both?

I would do both, that way the inside is lubed up as well and the external part is protected.