I have had a chronic anal fissure since at least March that went misdiagnosed by me as hemarhoids. Since getting the correct diagnosis from my local colo-rectal surgeon, I am carrying an A-F survival kit with me 24-7 just to be sure I can continue.
AF to me has been debilitating. It hurts so much (untreated) that it could take me right out of the game, send me home from work, cause me to cancel meetings etc.
It was important to me that I get to the bottom line of what I could do to be sure I could manage a BM in addition to all of the other lifestyle changes.
To put my kit together, I took a small sandwich bag with a zip lock and added 10 unscented wipes (the witchhazel has 20 alcohol which irritates my AF, so I have mothballed all of my witchhazel wipes), 20 or so finger cots, my nifedipine gel, a tube of CVS anti-itch medicine (generic gold bond with praximine and menthol) and two tubes of oraljel with 20 percent benzocaine.
The kit has been changed several times since the original which contained witchhazel wipes and a lidocaine cream that didn't work. I actually stopped carrying the original lineup because it seemed to make the AF worse. Since the new line up, I am confident. I can pretty much stop the pain instantaneously with either the praxamine/menthol prep or the benzocaine. I will swap out the orajel for Nupracainal (Dibucaine 1%) or Americaine (20 percent benzocaine when it arrives) as the orajel is designed for tooth aches and is a paste that isn't that misceable.
The big caveat is that the kit will only work for me if I stay on program for losing weight (to mitigate AF), exercise, and diet (primarily whole food plant based with a little fish). Also, colase stool softner, miralax but no stimulative laxatives or magnesium citrate.
The kit is one tool in part of a bigger picture for my AF care. I will be doing a 10 day therapeutic water fast in mid August to enhance healing before my next appointment with my doctor/surgeon. I have water fasted for 21 days before so 10 days is no biggie.
I think I can beat this without surgery. Time will tell.
Paul