I just started Nifedipine two days ago, but before that I had been on Nitro for a month. For a couple weeks I’ve been eating almost no dairy or carbs to try to make sure my stool stays soft. It seemed to be a bit better, and then today I had a BM where the very first bit maybe was hard? But the rest of it was totally soft. I have no idea why this happens sometimes, but it sets me back. I may have a few good days, but if I just have that tiny bit of stool at the beginning of a BM be too hard then I immediately start bleeding again and have tons of pain. I’m on stool softeners, drinking plenty of water, and eat mainly veggies and fruit now, some whole grains, and a bit of protein. I’ve changed my entire way of life to try to solve this.

So if the Nifedipine doesn’t work, then I will need to consider surgery. Does anyone think surgery could still be successful if I never seem to be able to get my stool under control entirely? Would surgery make that much of a difference in healing compared to the nifedipine? Wondering if anyone has any insight or experience with this.

I have not had surgery but I imagine it would make your body more resistant to the harder BMs without reinjuring. One thing I have tried that helps is put a bit of water up there with a clean plastic syringe before a BM. That helps to reduce any potential pain and make the beginning easier to get through.

I'm the same my bm tips are sometimes harder which has been my setback issue for 7 years now. I've had 2 rounds of botox but it still sets me back sometimes. I'm considering lis next year. I honestly don't think we can avoid that harder tip with every bm for ever I think it's natural an we should be able to pass it fine like we did as kids an before the fissure but I think the pressure from the fissure causes the area to not be able to handle it. It's a terrible cycle. Fix the pressure to fix the fissure to prevent the the fissure from flearing up an setting the pressure off again. We'll all get there one day.