I am so glad I found this site and many thanks to whoever created it. I have read the posts and realize I am not the only one living in pain.
To begin with I am a senior citizen and have had AFs off and on for years. This last bout has been over a year. Trips to the drs and a speialist have yielded no help (as before). Eat more fibre, drink more water, take metamucil, shove Nifedipine 5% up your *rse with a rubber glove and if that don't work come back for Botox and maybe an operation. Here's a book on roughage and stop taking pain killers. The examination made me go from a kneeling position on a bed to laying on the floor. I will not go back!
I stopped taking Metamucil - I am not plugged up and I don't need more bulk. If I eat any more roughage I'll turn into a cow. Nifedipine burns my ass, causes headaches and stains my clothes. I didn't use a rubber glove to apply - I bought these things called "Cots" available at drugstores - they look like small condoms and go over your finger. All this and no relief -Max pain, level 10 or more for 6 - 8 hours per day for weeks. And I had enough of taking hot baths 3 to 4 times a day to try to kill the pain.
Thank god for Ibuprofen 400 mg gels.
What I needed was something to shove up my rectum to lubricate the channel so whatever is up there has a smooth passage and does not retear or affect what is allready torn. (my diagnoses)
I needed some kind of lubricating suppository and my lovely wife phoned a Naturopathic medicine centre and they recommended a suppository called Avenoc and liquid drops called R13. And let me be perfectly clear - I am not selling or endorsing anything - I am only relating this story to you as it may help you as it appears to be helping me. I insert a suppository every night at bedtime (with a goodly dollop of vaseline) and at first after a BM. The drops, I take 10 drops in a glass of water twice per day - they are relatively tasteless and what they do I'm really not sure but were recommended by the sales person at the health centre. I have had no side effects. My diet is about the same as before but I have cut out everything that is spicy, acidic or is hot.
After a week now I am BETTER. Not healed mind you but BETTER. No searing pain for 8 hours after a BM and my stool is relatively soft and passes easily. It has been an hour since my morning routine and I am sitting here in somewhat comfort having a cup of coffee (and have not taken any pain killers) and typing up this message. I may even go to the shopping centre today with my wife - something I hate to do on the best of days - but I am starting to feel better.
You can do a search for Avenoc and R13 for prices, content etc., it may help you, it may not. I am not advocating, selling or prescribing anything. I am just relating my story to you and I thank you for letting me do that.

Welcome to the board and thanks for the tip mucho piano we fissure sufferers are always looking for advice and good information on what works best for some.
Anything to keep the discomfort and pain at a minimum. :D