I'm a 19 year old female and I think I have an anal fissure. SOMETHING is definitely wrong with me, and I am really really looking for help and appreciate any help I get here! I'll go over my symptoms:
- everything started 2 weeks ago, when I had a particularly difficult bowel movement and there was some blood on the toilet paper. i experienced discomfort for about an hour but after that it went away and i forgot about it.
- the next two bowel movements both were accompanied by blood on the tissue as well and I had gotten a little worried by this point.
- my mom told me it was probably hemorrhoids and to use preparation H, which I have been, but not too much as I don't really notice a difference when using it. I haven't used it in two days but was using it for 5 days in a row before I stopped.
- I have upped my fiber intake and water intake, and have tried to avoid eating too much junk food to avoid constipation.
- I have NOT been straining to make a bowel movement as I heard this was bad and could just further irritate any fissure I might have.
- Now, there is no blood on the toilet paper when I go to the bathroom. Stools come out easily and without pain.
- The problem is after the bowel movement. After, I have severe, cramping, 'charlie horse' like pain for HOURS. 16+ hours each time after. It is incredibly painful and uncomfortable to sit/lie down or walk. It feels like my entire butt has been beaten up or something and is bruised and sore all over, but it isn't.
- After the 16 or so hours the pain subsides. However, it's just a few more hours before I have to go to the bathroom again and then the whole process starts over.
I'm extremely worried and frustrated. I have no idea what is wrong with me. Everyone that I've talked to about this has said that when they've had symptoms like this they've gone away within a few days. Mine are not going away. I can't get to see my GP for a little over a week. I have a 3 hour exam to sit through on Sunday and I have no idea how I'll be able to... I've tried advil for the pain but it doesn't seem to be making a difference. holding in a bowel movement at this point seems better than going at all... but I now that constipation will only worsen the problem.
I'm just asking for anybody's advice here. Do fissures get worse before they get better? Is the lack of blood a good sign, even though the cramping pain is getting increasingly worse? Should I wait until I've had these symptoms for a month before I go to a doctor? Is there anything at all helpful that any of you can offer me? Is it common for anal fissures to go on for a long time, or are those cases exceptions? I'm just really hoping that since I'm young, relatively healthy and have been trying to cure this thing since I experienced symptoms that I will be able to cure it without anything drastic like surgery or anything.
Thanks a lot, I really appreciate anything anyone can help me with!

Hi sk!
I'm so sorry about your recent problems with pain and bleeding. We all understand how scary and difficult it is to cope with!
While there is no way for any of us here to know what is going on with you, it could be a fissure. It could be hemorrhoids. It could be something else entirely. It really is best for you to be seen by a doctor to get a diagnosis, particularly since you've had bleeding.
The pain you are experiencing after your bowel movements sounds like spasming of your internal anal sphinctr. You have taken an important first step by softening your stools through diet changes. It is very important to keep stools soft and easy to pass to prevent any further irritation or injury. Fissures are very common and mostly they do heal on their own, and if you do have a fissure you can increase the chances of it healing by taking very good care of yourself from the very beginning with diet, adequate water intake, and you are right... don't wait to have a bowel movement. It will only make things worse.
For the spasming pain you are experiencing you can try getting into a warm to hot bath right after your bowel movement and soak and focus on deep breathing and relaxation while you are in there. Taking several hot baths a day can bring a lot of relief, increase circulation to the area and promote healing. You can also try sitting on a heating pad on the low setting. Heat can be really helpful in getting the muscle to relax. You could also try using some ice wrapped in a washcloth and see if that provides you any relief. A coating of Vaseline before bowel movements to protect the area a bit from the passage of stool can be helpful. Sometimes a local anesthetic cream can help too, but be careful not to use for more than a week or two to avoid developing a skin reaction. Look for something that contains benzocaine, usually you can find something in the hemorrhoid aisle of the drug store. Also, don't use dry toilet paper to clean yourself after bowel movements. At the very least moisten the toilet paper with water or use baby wipes. It's important to clean the area very well, but be very gentle with yourself.
I hope you have relief from your pain soon, and really, please do make an appointment to see your doctor. Since appointments can require some waiting time it's best to get on the books as soon as possible.

The absolute best piece of advice I can give you is to skip your GP and go directly to a colorectal surgeon (CRS). You definitely want to see someone that deals with anal issues all day, every day.
If you have a fissure, your CRS can prescribe you some medication (i.e., Nifedipine) that will relieve the muscle spasms, which will reduce the pain and, in most cases, allow the fissure to heal on its own without the need for surgery. They can also prescribe you some Valium, which can also help with the spasms.
NSAID's, such as ibuprofen or naproxen (Aleve), are generally the pain relievers of choice, as anything stronger may cause constipation. If the pain is severe, you might ask you CRS about suppositories that contain Opium.
You should also ask you CRS about taking Miralax. It is a terrific stool softener.
I also agree with jr2 - hot baths can really help relieve the pain (at least temporarily).
Good luck!