Hi I'm a 26 year old male who's been suffering with a pretty acute fissure for about 5 months. I have been eating what I would consider "very healthy" for the past 4 years - since I visited India and found out how awesome veggies can be (veggies / legumes are mostly my main source of nutrition). In december of last year I was prescribed some Z-Pak antibiotics for a sinus infection and ending up passing one of the hardest BM's I've ever experienced.. since then I've been dealing with pain and bleeding almost daily. Today I had a somewhat new experience in which I had some blood actually dripping into the bowl after a movement.. Needless to say I freaked out.
I've been on Hydrocortisone creams and suppositories, stool softeners, and had a colonoscopy to make sure everything was ok.. They didn't find anything and told me I had a small fissure. Well there's nothing "small" about the pain and discomfort that I'm having.. and I'm getting so sick of having to deal with it. I did have a few days a little while back where I thought it might be healing.. but it came back with a vengeance.
I hear that most of the pain is due to pressure / spasms in the sphincter. Is there anything that I can do to make this better? My GP has basically given up on me and I feel like I have to go tell him whats going to work. I've been reading a lot about Nifedipine, but also realize that its probably not going to be some miracle cure either. This is just hard for someone who's young and not out of shape, eating right (at least I think so..), and nothing is working..

It's definitely worth giving a topical medicine like nifedipine or diltiazem or nitroglycerin a try to see if it will help. Have you seen a colorectal surgeon for your fissure? 5 months would be considered chronic at this stage and it would be well worth it to be evaluated by a surgeon who can help you figure out a treatment plan. A CRS will be far better at providing you with options than a GP will be.

I totally agree with JR, see a CRS and get some nifedipine.
I would also recommend sitz baths and sitting on an electric heating pad to help that area relax. I like walking too as a way of circulating more blood to the area.
-Tanya