Hi there, I've been dealing with my fissure now for about 10 weeks. I'm trying my best to do everything possible to get this better. I do sitz baths religiously, I've changed my diet to almost entirely soft, bland foods (high fibre cereal in morn, yoghurt mid morn, veggie soup for lunch, boiled veg/fish for dinner) for the last 3 weeks, I'm on a stool softener, have switched to squatting for BMs and use retrogesic twice a day.
My problem is that I have 3 days of perfect consistency poos, but then on pretty much every 4th day I re-tear again. It seems to happen because it comes out very very quickly and in a much larger quantity on the 4th day. But how do you stop it from coming out quickly if it wants to?? The consistency is still fine on the 4th day (like toothpaste) but I still tear really badly.
It's so painful I am struggling even to walk (let alone get daily exercise). Depending on the day I'm usually in pain from the time I go to the toilet (usually very early morn 5ish) until about 2-3pm.
Does anyone have any ideas for what might work with this?? Should I cut down the stool softener maybe? I take the recommended amount a day. Or going more often to try and reduce how much I'm passing? Will that just irritate the fissure more, going more frequently than once a day??
I live in a remote area so don't have access to a CRS (within 1500kms anyway), however thinking about going to stay in a capital city for a few weeks to try and consult with some specialists.
Any advice would be so much appreciated if anybody else has had this issue too, I'm starting to think I'm someone who'll have to live with this forever
Best wishes to everybody else struggling with this condition <3

My doctor is against stool softener, cause it just makes you go more often. He also claims too soft stool is just as bad as hard stool, cause it's more acidic and it irritates.
When I feel it comes out too fast, I just contract the sphincter to slow it down and let it out in small chunks. And I never let the sphincter open completely, cause I feel that is when the tear happens.
He does recommend to have stools daily, but that doesn't makes sense to me. My body tells me to try and use my anus as rarely as possible. I was at my lowest when I went 4 times a day, had pain for 2 days afterwards. So now I'm just holding it back, trying to get some healing between stools. I know it's crazy, but I have a stool every 4th day. The challenge is to keep it soft, so far so good.
It works for me, but don't try this at home :)

[quote="bgd"]My doctor is against stool softener, cause it just makes you go more often. He also claims too soft stool is just as bad as hard stool, cause it's more acidic and it irritates.
When I feel it comes out too fast, I just contract the sphincter to slow it down and let it out in small chunks. And I never let the sphincter open completely, cause I feel that is when the tear happens.
He does recommend to have stools daily, but that doesn't makes sense to me. My body tells me to try and use my anus as rarely as possible. quote]
Yes, now that you say that I do notice I can feel a point when it fully opens and this is the point when the tear seems to happen.. Yeah maybe I need to cut back on the softener. I'm wondering now too if squatting is maybe contributing also - between this poop-friendly diet, baths, creams, softeners and proper toilet technique it's maybe making things a bit too smooth lol. I'm just a control freak and hate pain, so have desperately wanted to do everything 'right' to get it better quickly.
Geez am starting to feel like a little 80 year old woman these days, it's certainly getting difficult coming up with normal conversational topics with friends/colleagues when 95% of your day is spent focussed on getting yr bowel movements correct..

I have mine into 13 wk now, I think you might want to try to reduce the softener so that you can keep the frequency at 1 daily.
For me, I too try to control a little bit if I feel it's going too fast (unless it is a diarrhoea), to minimize the damage.
You would be alright with rectogesic and good diet, i think information from this forum and your own trial and error could be better than advice from doctor :)