Hello, I’m new here and relatively new to fissures. I got my first one in December 2012. I never even knew about this condition before then! Unfortunately it won’t heal and it’s kind of ruining my life! Sorry to be dramatic, but this has had a huge psychological impact on me.
Anyway, my GP has referred me to a specialist and I have my first appointment there in two weeks time. My first question is: what can I expect from this initial appointment? I get pretty anxious in medical situations and have some issues with physical examinations due to a past trauma. Therefore I like to know what’s in store for me so I can mentally prepare. I’m in the UK. I don’t know if that makes a difference but thought I’d mention it as I’ll be seeing an NHS specialist.
I’m pretty sure constipation caused my fissure in the first place but I have a feeling that possibly one reason it won’t go away is because I wash that area of my body too much. Unfortunately I have OCD and keeping that area clean has become an obsession. Can over-washing stop fissures from healing? Also, is there any point seeing a colorectal specialist if the OCD is the reason for the chronic fissure? Perhaps I should be seeing a psychologist instead!
Thanks for reading!

Hi pample, first of all I'm sorry to hear that you have a fissure but do not despair! You've got on the right path, you're very lucky to be seeing a CRS so soon after being referred. I was referred in January (after a whole year of the GP treating me) to a specialist in Wales and by March, I still hadn't heard back about an appointment.
It was getting chronic by this time so I phoned up and got it put through as an urgent case because I threatened to stop eating. I was given a "threshold date" in which they needed to allocate me an appointment by, and that got pushed back. By May, I was at my wits end and my mum (who is a nurse) went to the CRS to beg for him to see me. He gave me an appointment before his normal day would start which I was so happy about.
I was incredibly sore when I went to see him, his trainee asked me questions while he was having his morning meeting to save time. When he came in, he could see the pain on my face. He asked me if he could take a look and said to his trainee, that without a doubt it's anal fissures because the presence of skin tags were indicative of fissures. I had a skin tag develop in the 4 month wait to see him.
He said I had 2 fissures of which he could see, he didn't do an internal exam as it was too painful so it was more of a visual exam from the outside.
He then said if the creams are not working, it's likely my fissures are chronic and he'd need to cut away the scar tissue that had been trying to heal (but because of my BMs - they kept tearing) by cutting away away or "excising" the scar tissue, it would make them fresh into acute fissures and therefore the cream would have a better chance of working.
He said during surgery, he'd do an examination under anaesthetic and decide whether to administer Botox or not.
My CRS was pretty amazing, very very sympathetic and rushed me in for surgery 2 weeks later.
Im now 18 days post surgery & Botox and things are looking up. No real pain whilst having a BM, no passing a razor blade feeling any more. I'm still healing though.
You're very fortunate to be able to see a CRS so quickly and the sooner you get this looked at, the better. They're brilliant. Honest. Don't be worried about your OCD, be honest with your CRS, they're very helpful.
If and when you get treated, bathing the area will be very important. I had sitz baths for a week after surgery and now I use flushable wet wipes after a BM.
Hope that helps.
Let us know how you get on,
Welsh x

Hi pamplemousse and  to the forum.
My only suggestion to add is do not wash the anal area with soap. Use only water, damp thick toilet paper to dab until clean, and finish off by dabbing with a wet gauze pad from Johnson & Johnson as I do. I very very seldom use soap, and the majority of Colon and Rectal Surgeons (CRS) will tell this.
If you would like to get an idea of what others experienced with their appointment, here is a link for you. Best I can suggest is to make sure you specialist knows just how much pain you are in. I had my examination under conscious sedation because of the pain I was experiencing.
Here is the link: http://anal-fissure.org/search?search_keywords=Visit
All the best,
Sav

Pample,
I cannot speak for the UK but here in the US I was rather disappointed with my visit to the CRS in late Feb 13. (I suspect my fissure started in October 2012).
 
Thanks to my brother, a surgeon in another state, I had started on nitro and Metamucil fiber supplement for about two months when I essentially gave up and went to see the CRS. When I explained what I had started, the CRS told me he didn't care for nitro (but recommended mineral oil, ugh).
After bending over the exam table, he took one quick look (no prodding), said  yes it was a fissure, and said to see the scheduler for surgery.
Fortunately the fissure pain subsided noticeably the next week and I cancelled the surgery. I also found this board shortly thereafter. The continued use of nitro, fiber, and the addition of Miralax have since put me in a "healed" condition.
Should this anal fissure condition deteriorate, I believe I'll find another CRS.

Thanks so much everyone for the warm welcome and helpful comments. It seems they just tend to look at the area, rather than do anything more invasive? That’s a relief to me! I’m not really concerned about the pain so much, but more the psychological impact a more invasive exam would have on me. Of course pain is horrible, but I’m much better at dealing with physical pain than I am mental pain!

WelshDoubleFissure, it sounds like you were really lucky with your surgeon. I don’t have much hope as my local hospital doesn’t have the best reputation! I’m so glad things went well for you and I hope your recovery continues to be smooth and permanent.
Savaici, thank you very much for the useful tips. I have been using a very mild, perfume-free shower gel but I will rethink that!
Now66, I’m sorry you had a less positive experience with a specialist. I hope your condition continues to improve.