Hi all - I am new to this forum and to all related issues. I'm 34, was lifting weights or doing cardio almost every day, and was eating very healthy, so this AF has really put a cramp on my life.
I believe my AF happened about two weeks ago after I switched to a high fiber (lots of vegetables) diet, but I let myself get dehydrated after a long flight. I must have been constipated after the combination of increased fiber + dehydration, which led to this tear. I've had hemorrhoids on and off over the past few years, but nothing that lasted more than a couple of days.
Anyway, after a few days of excruciating pain, I found this site and a few others and educated myself on all things related to the anus. I believe I also have high muscle tone down there (I always thought muscle tone was a good thing), which is leading to spasms after BM's and throughout the day.
i'm at the point where i'm no longer freaking out about the AF and have an appt with a CRS in a month. To manage the issue for now, Here's what has helped me:
-500 mg of magnesium in the morning with a meal
-dulcolax stool softener 3x a day
-citrucel 2x a day
-water though out the day - up to a gallon a day
-very limited coffee, tea and dairy (minus Greek yogurt and very limited cheese)
-eat mostly cooked vegetables, limited wheat breads, oat bran with flax in the morning, very small portion of meat for protein
-sitz baths after work (and after BM's on the weekend- unfortunately not enough time before work)
-waiting for my restogenic cream which I bought without a prescription from some website in Australia
-use Vaseline before BM's
-baby wipes for cleaning, sometimes follow that with balneol or witch hazel for cleaning, then use any of the following: fissure control oil, a&d cream, calmoseptine. I use any of the three depending on the pain. The calmoseptine has menthol which helps with any itching or discomfort. The a&d is good for any stinging. I bought all from amazon.com. A&d is available at cvs in the baby aisle.
I'm definitely feeling very depressed because I feel I should avoid any intense activity (including sex) while this thing hopefully heals, which is very demoralizing. I'm normally an active gym-goer. This site has helped me out tremendously in terms of managing the pain and also knowing what to expect, so thank you all very much for your contributions. It's also nice to share this with others, although I wouldn't wish this on anyone else.
Hope everyone is having a blood-free day.

I forgot to mention that another things that has helped me tremendously is going very slow during BM's - no straining and adding limited amounts of pressure ever so slightly. Unfortunately it can take up to 20 minutes to have a BM, but it helps.
Also, picturing something peaceful or happy helps to take the mind off the pain. I try to picture the water from the ocean and swimming in the ocean. It really does help.
Finally, here is a post from another blog that I found helpful. Hopefully it will help someone else here:
Hello Dr Chris and everyone reading,
 
This is Jess - I originally started this post over 2 years ago.
 
For anyone who is suffering with an anal fissure, I wanted to stop by and update you on my condition, in case my experience can help you too.
 
Back in 2007 I was in agonising pain; I honestly believed my fissure would never go away and that I would be forced to have surgery on it. The pain was so bad that when I went to the toilet - (which felt like I was passing sharp pieces of glass) - I used to think I would pass out. It was ruining my life. I felt hopeless and depressed.
 
Well, I have been clear of pain for almost two years now. I do get the odd setback from time to time, where I feel that the fissure might tear again, but I believe I have a method to keep it under control.
 
So here is my personal method to help cure anal fissures...
 
1) Each healthily, avoid fatty foods, and eat plenty of insoluble fiber (such as vegetables and cereal/bran.) 
This will not cure the fissure but it will keep you regular and prevent you from getting constipated. If you've got a fissure, or have had one, you must avoid constipation at all costs! I ate and still eat a large bowl of Bran Flakes every morning for breakfast. Sprinkle All Bran on the top for even more fiber. With every evening meal, I made sure to include vegetables, especially root mash (which is basically sweet potato, turnips/parsnips, swedes, etc, mashed up like mashed potatoes ... it's a good way of eating lots of insoluble fiber if you don't really like green veg much.) I personally found that soluble fiber, such as fruit and beans, made no difference at all. It had to be insoluble fiber, which the body cannot digest and therefore passes out more quickly.
 If you absolutely hate veg and cereal, try taking fiber supplements such as Fibergel.
 
2) Drink plenty of water.
This is very important as it helps keep your stools soft. Try to drink a large 1.5 or 2 litre bottle of water per day. I find it difficult to drink large amounts of liquid, so I keep the bottle with me and sip throughout the day.
 
3) Take two magnesium tablets (300mg each) every single day.
THIS STEP IS ESSENTIAL! Discovering magnesium on this forum was a godsend to me. I can't explain how it works but it definitely softens the stools. I take one tablet after my evening meal, and another tablet before I go to bed. Magnesium was THE lifesaver for me!
 
4) Take three stool softeners, morning, evening and night (docusate sodium 100mg per tablet).
Again, this is another essential step in healing your fissure. In the UK I buy a brand called DulcoEase. You can buy them from any chemist or large supermarket. If you still feel your stools are hard, increase the tablets to 4 per day. (According to the instructions, 4 per day is the maximum.)
5) Use a tiny amount of Rectogesic cream applied three times a day.
All you need is about 1/2 - 1 cm of cream (the size of the tip of your little finger.) Make sure you thoroughly wash your hands with anti-bacterial wash before you insert the cream. Use your littlest finger as that's less painful to insert. Be prepared - it stings!!! If you use too much you will get bad headaches. Some people stop using it because of headaches, and that's a shame, because this stuff really does help. Basically it relaxes the sphincter / rectum muscles so that the stool can pass more easily. If you're getting headaches, try using less until you find an amount you can tolerate, but do stick with it. It will help! In the UK you can only get Rectogesic Ointment with a prescription from a doctor. I did not want the doctor looking at my bum! So I discovered that you can buy it from online pharmacies based in Australia without a prescription. International shipping is very expensive - but I decided any price was worth paying if it got rid of the pain!
 
6) Use quality toilet paper!
Poor quality rough toilet paper irritates the fissure even more. Baby wipes are a better alternative and they keep the area clean. I recommend the brand 'Simple' as they are un-perfumed and designed for sensitive skin. When you go to the toilet, be very gentle wiping yourself.
 
7) Take hot shallow baths.
After you've been to the toilet, you may feel extremely sore (I used to feel an awful throbbing pain) - so jump into a hot shallow bath, just enough water to cover your hips. The hot water will make your sphincter muscle relax. Do not add anything to the water, as that may cause further irritation. A bath is also a good idea as it keeps the fissure clean (and going to the toilet can be a bit messy with all those stool softeners!)
 
I consider all of the above as essential in the process of healing my own anal fissure - not individually, but all 7 tips combined together on a regular basis. 
After at least 8 months of excruciating pain, I developed this regime, stuck to it strictly, and within a week started to feel a difference. I was going to the toilet regularly, my stools were soft enough not to stretch the fissure, and the pain was going away. 
Please give it a try for yourself. It's a long process and you have to be patient - but you will start to feel better eventually.
 
After a few weeks, or even months, when you feel confident the fissure is healing well, you can alter the regime...
 
First, cut back the Rectogesic cream - use smaller and smaller amounts, and apply only once a day, until you can stop it completely.
 
Second, cut back on the stool softeners (they can alter your potassium levels after prolonged use). Eventually get yourself down to just one a day.
 
Continue to take 2 magnesium tablets a day. I still take them, 2 years later. I always will take them! They will not cause any harm; magnesium is no more harmful than taking calcium or any other vitamin/mineral supplement. In the UK you can buy them very cheaply from Morrisons supermarket. Chemists like Boots are expensive.
 
Also continue to drink plenty of fluids.
 
A few more tips...
 
- To sooth and cool the pain, try applying generous amount of Dr Chris's Wheatgrass cream twice a day (not at the same time as the Rectogesic cream.) Don't use any other creams as this may cause irriation. The Wheatgrass will help the skin heal and grow stronger too.
 
- Avoid eating anything containing seeds or nuts (such as strawberries, kiwi fruit, almond nuts). Seeds and nuts don't always digest, and if you pass them out whole, they could prick into the fissure, potentially re-opening it. I used to eat a lot of kiwi fruit, believing it would help me go to the toilet - but then I realised that I was passing the seeds in my stools. I could see them on the toilet paper! I cut them out of my diet and felt there was an improvement.
    
- Before you go to the toilet for a bowel movement, try putting some Vaseline around the anus (if it doesn't hurt too much, insert it a little way into the anus with your little finger.) This lubrication will make the stool a bit easier to pass. You must thoroughly wash your hands before applying the Vaseline, and only use a brand new tub of Vaseline (you don't want to add any bacteria to your fissure as it's trying to heal.) After you've been to the toilet, wipe the Vaseline away with a baby wipe, or soak in a shallow bath. You must keep the fissure clean. KY Kelly is another alternative, but I didn't find it as effective.
 
- When you go to the toilet, you must concentrate, and make sure you don't strain. I used to deep breathe to help me relax on the toilet. Take your time in the bathroom and try to control the speed of the bowel movement. The last thing you need is to be at work and have to use a public toilet - with people waiting outside! So I got myself into the routine of drinking a glass of hot water first thing in the morning. It starts the digestive system working, and, within half an hour, I usually went to the toilet. At least that way I felt I had got the pain over and done with for the rest of the day.
  
Unfortunately a bad anal fissure leaves the skin in that area weakened. You might have a skin tag there. From then on it's susceptible to being torn again. In some ways I've had to make slight lifestyle changes to keep it at bay - always taking magnesium, drinking plenty of water, and making sure I eat enough insoluble fiber. After your fissure has healed, you must keep a check on it. The moment you feel any pain, or your stools seem hard, take action to prevent it! This means increase your water and fiber intake, and start taking the DulcoEase stool softeners again. In fact, always have a supply of stool softeners for emergencies! If you do that quickly enough, you should nip-it-in-the-bud in time.
Please feel free to copy and paste this article onto any other forums where people are suffering with this awful problem.
 
Good luck to everyone trying to overcome their anal fissure! I hope so much that some of my tips will ease your pain too...
 
And thank you to Dr Chris for allowing us to help each other by posting on this forum.

Wow... Thanks tightly!!
OMB x

thanks very much - lots of very good, proven advice here. I follow the plan outlined above, although I don't use any creams down there anymore. I use oil internally instead of stool softeners, works for me.
Its amazing to me how many people out there suffer with this condition. When I first got it, I thought i was the only person on the planet like this.