Yesterday, I had a setback, about as bad as it was around when I first posted here 18 days ago. It never really got good, but I've had a few days where my pain isn't too intense (my bottom basically always hurts, every waking moment).
I've been eating a pretty strict diet of vegetables, fruits, cereal, and occasionally fish. Taking a dose of miralax before bed each night, and some docusate sodium and a probiotic after dinner.
When I poop, it generally hasn't hurt--only afterwards, most notably after my bath. I rarely feel any spasms, and when I do, they don't hurt. It is difficult to walk fast or for more than a few minutes, as the pain starts to intensify. If I sit for more than around two minutes, it starts to hurt more and more.
Anyway, I somehow became constipated until yesterday... went around 52 hours without pooping, despite the miralax, docusate sodium, probiotics, and strict diet. Don't think stress was a factor.
My poop was kind of a pasty consistency. It passed fairly easily and wasn't thick, but was dense. This part's gross... it stuck to the hairs around my anus because of how pasty it was, was very difficult to wipe as I didn't want to cause any damage to the area. Still didn't hurt when I pooped it out, and took my normal bath afterwards. About two hours later, my pain just got worse and worse. Still no spasms or anything, just this general pain down there, almost feels like it's inside or something. Basically, my whole butt just feels like it hurts. Felt somewhat better after I slept at night and woke up today, but still some pain.
When I pooped today, it again had that same pasty consistency, difficult to wipe, and so forth. Didn't hurt much coming out, but the pain just got worse and worse in my bottom area over the next few hours, and now here I am.
I'm wondering, does this sound like fissure pain? I've been wondering lately (and afraid) that it might be some other, somewhat similar condition? My GP and general surgeon both said they think it's an anal fissure, but neither gave very good advice on how to treat it. I haven't bled from my bottom since maybe 6 months ago, and even then it was just a tiny bit and one time... but nonetheless, I'm in constant pain every day, even when it doesn't hurt to poop.
The doctors also didn't have a good answer for what this round lump is right at the entrance to my anus. The lump is soft and feels smooth, and I don't seem to secrete anything from it lately, although a few months ago, it may have been secreting something (I thought it was anal leakage, though). It never goes away (been at least six months now), doesn't hurt when I touch it, and occasionally seems smaller some days. Is this a hemorrhoid, or something else?
Overall, just wondering if anyone has any idea if this sounds like fissure pain or something else. I have blown through way too much money on doctors over the last half year, and can't really afford to see a CRS (though I'd like to, if I can afford it somehow). It's extremely frustrating and depressing that I can't even sit for more than a few minutes without a lot of pain, as it's seriously affecting what I can do with my life. The pain just never completely goes away, and I feel hopeless, like it's never going to be better enough to sit for even an hour :(

Hi ZeroEscape
When I had a fissure I had the sort of pain you describe - pain all the time to one degree or another. Also, bowel movements themselves weren't particularly painful - not like passing razorblades as some people with fissures have described - but the pain would often start up in earnest a couple of hours after the bowel movement.
I couldn't distinguish the internal sphincter spasming, in that I didn't experience contractions which I thought would indicate muscle spasms. Yet nevertheless, the pain WAS due to muscle spasm connected with anal fissure. I know this because the third CRS I saw told me, performed the LIS on me, and it cured me. I think what was happening was that the internal sphincter was going into spasm in response to the pain (a protective mechanism) and staying in spasm, thus squeezing down on the fissure to create more pain, which in turn created more spasm. When you have a bad back for instance, and the muscles in the back go into spasm to protect the injury, they stay in spasm for long periods, which is why it's so painful. I think the anal sphincter was doing the same thing in response to my fissure.
Like you, I never had much blood with my fissure, a few small spots and very rarely. Furthermore, even when my major fissure healed spontaneously, after about five months, I was still in pain because the muscle tone in the anus had become so high with the spasms, that I was forming minor fissures with most bowel movements. For me it took the LIS procedure break the cycle and allow the muscle tone in the anus to reduce. I'd had two lots of botox previously and whilst it made things a bit better, it didn't cure me whereas the LIS did.
I suspect a specialist (a CRS) would be able to sort you out. The CRS I saw said that the anus is a delicate mechanism and can take some time to revert to normal when something disrupts it (like a fissure). Also, when you have a fissure, other things can be affected - e.g. muscle tone, being relaxed when passing a stool, etc. A CRS understands the whole process (or should). If you do see one, try and get a recommendation for a good one. I saw three all in all, and only the last one fixed me. He really knew his stuff. However I was an unusual case in that even though my major fissure had healed, I was still getting muscle spasm and pain. Most people with anal fissures are more straightforward than me! A CRS will also be able to confirm whether it's a fissure, or combination of fissure and haemorrhoids, or whatever. Your round lump could be a haemorrhoid or a sentinel pile (which forms with a fissure - I formed one with my fissure). A CRS can recognise what it is.
As to the pasty poo consistency - is there something in your diet that might cause this? For instance, when I eat chocolate (the ordinary milk chocolate kind, not the expensive kind) it produces very sticky stools which have a bad effect on my anus - even now I'm cured! Thus I don't eat chocolate. I wonder if there's some other foodstuff that might be affecting you. Also whether dehydration might be a factor. When the heating goes on in the house in winter, I have to up my water intake as much as I would if it were summer and a heatwave outside.
Wishing you all the best.

Sorry about all of this pain -- I would ask your surgeon to consider whether your symptoms might be those of an 'anal fistula' -- I had two doctors and one surgeon tell me I just had a fissure for a couple years, but just recently was told by a new surgeon that he was actually fairly confident of a fistula. Something to ask about!

you must see a good CRS, find the money somehow. The CRS needs to look up in there to see whats going on. General doctors know next to nothing about this condition.