I was just diagnosed with a fissure last Monday. The pain has been agonizing. I have IBS - D so usually have no problems going to the bathroom (well besides that fact that I go all the time!). A couple of weeks ago our family was hit with a stomach bug and a few days after that I started to experience severe pain following a bowel movement. I thought it was my hemorrhoids (but also recognized that they had never hurt that bad). I winded up going to an urgent care on Black Friday and they said it was both internal & external hemorrhoids causing the pain. Gave me some proctofoam and lidocaine jelly. I used those over the weekend and the pain didn't subside at all.

Thankfully I called a CRS that Monday and they were able to fit me in. Before she even examined me the doctor said she thought I had a fissure. I have to say the exam was awful - she wanted to make sure that it was a fissure an that she didn't miss anything else. I left that appt with an Rx for nifedipine gel and was told to apply that internally 3x a day (and after bowel movements) and also to use Calmol-4 suppositories 4x a day (and after bowel movements). She also recommended sitz baths. She also suggested I get in to see my gastroenterologist to get my IBS under control. Most of what I've been reading says that fissures are caused by constipation/hard stools. I'm the opposite -mine was caused my severe diarrhea.
I have not been able to go into work at all since before Thanksgiving. Thankfully I have a work laptop and have been able to log some hours working from home. But this past week has been awful. The pain after a bowel movement is so severe - I equate it labor pain. It's so intense it brings tears to my eyes. I just can't seem to find any relief. Sometimes soaking in a hot bath will help some and I've taken to sitting on a heating pad for most of the day. I find if I stand up for any length of time I get a feeling of pressure in my backside and that just adds to the pain. But it's the spasms after a bowel movement that are the worst.

For those are you that have been through this - how long after starting medication did you begin to feel some type of relief? Are there any other ways to treat the pain or help it subside? I called the doctor today to let her know that I am seeing no change in the severity of the pain - I was basically told that fissures are very 'slow healing' and to give it another couple of days. I can't imagine going through this for years as some of you have. I'm also stressed about work. I can't physically go into the building because the pain after a bowel movement makes me want to curl up on the floor in the fetal position and weep. I've had to tell my boss what was going on (lovely conversation there), but am fielding questions from co-workers now and giving them vague answers. Not a topic that many wish to discuss!

Sorry for the info dump (haha...at least I haven't lost my sense of humor), but I am just hoping to get some feedback from people who have been through this.

As you know diarrhea really irritates the anus. Getting it under control will definitely help. In the meantime you can try putting diaper cream or petroleum jelly in and around the opening before and after a BM. Whenever I get diarrhea or have toilet paper burn I use petroleum jelly and find it very helpful. My doctor recommended diaper cream. I haven't tried it yet so I cannot comment on its effectiveness. Apparently it works.

For the pain and spasms I take full baths. I find laying down in the tub very soothing, because it takes the pressure of my anus. Another thing that helps is sitting on a pillow.

What have you tried to get the diarrhea under control?

I am so sorry I failed to come back and reply to this message. Unfortunately I am still dealing with this "PITA!"

I did follow up with a new gastro. He had me do some bloodwork which indicated possible Crohn's disease (rather than IBS). I had an endoscopy and colonoscopy done on 1/2. I saw my CSR this week who says the fissure has not healed at all and that concerns her as it puts me at risk for infection or abscess. I'm at a loss. Her suggestion would be to try Botox next as I am not a good candidate for surgery.

I can say my pain level has decreased...if I was at a 10 before, I am at about a 5 now. I have still not physically returned to work. Thank God for being able to work at home or else I don't know what I'd be doing right now. I feel so down because all I ever seem to do is sit around on my heating pad (which brings me some relief) - it's hard to do much w/o being in pain! Standing up for too long or walking around seems to bring on additional pain. I'm miserable.

Colostomy on me soon. Sweet

Hurtlikehell - have you had botox and/or the surgery and they were not successful? I am so worried that this is going to be a problem that will never seem to go away - even if it does heal, I feel like I will be constantly worried about it coming back.

No no botox or other surgery. They just told me that my life would be normal again. Many people was afraid of doing this and would rather live in pain. So when i told them i would have colostomy they just sayd it was a good choice.

They did not find any fissures just a small hemo, but they did not want to cut in it and make me very soar. It would go away by itself. But i have pain after every bm and it drives me nuts.