I developed a fissure in mid March.  It was just painless bleeding for the first few weeks, but eventually developed into a very painful issue that was greatly affecting my life.  Riding in a car even 6-7 hours after a bowel movement was just pure misery, for awhile.  This is my advice for fissure sufferers based on what worked and did not work for me:

1. Make an appointment with a colon rectal surgeon now!  Can't stress this enough.  I do not have a primary care doctor and didn't know what to do.  I tried numerous things for about a month, and then finally went to an urgent care.  Not the right move!  That doctor told me I have hemorrhoids, claimed they can only be fixed by cutting them out, and otherwise you just have to live with them if you have them.  Wrong on every single count.  Then I was prescribed some suppositories(more on that later).  Finally I called a colon rectal surgeon.  But it was 3 weeks before I could get in for my appointment.  So in all, 7 weeks passed before I finally got some real help.  If I could do it over, I would've called the CRS immediately.  If I had a regular doctor I would go there first and ask for a referral to a CRS and probably would've gotten a much quicker appointment.  A CRS is an expert in this stuff.  Mine identified the fissure within minutes and prescribed rectiv.

2. Rectiv!  It's a nitroglycerin ointment available when prescribed.  Without insurance, it was like $600.  Luckily with insurance it was only $40.  Based on my experience, I would even pay $600 if I had to!  While I was starting to get better slowly before using Rectiv, I was healed in about a week after using it.  It works by drawing more blood to the area that it is applied, which speeds up healing.  It also stops the sphincter muscle from going into spasms....these spasms both keep the fissure from healing and cause pain.  I would frequently get these stabbing spasms like 3-7 hours after a bowel movement.  When using Rectiv, I did not get them at all.  Rectiv does cause headaches.  The first time, I had a headache all night and couldn't sleep.  However after that the headaches were more minor and lasted for a shorter time.  Personally, the headaches were far more tolerable than the fissure pain, so well worth it.

3. Keep your stools soft!  Hard stools and diarrhea are the enemy, as they damage the fissure and keep it from healing.  This may not be a quick fix, just be consistent with it.  For me, that means lots of fruits and vegetables every day, lots of water, some rice and foods with fiber like cereal, some fish.  I cut out red meat, alcohol(also a no no with Rectiv), and for the most part dairy.  I did not need stool softeners or fiber supplements to have a soft, regular stool.  Everybody's body is different, so find what works for you and he consistent.

 

4. Do NOT put anything up your rectum!  Can't stress this one enough.  Those suppositories that were prescribed to me?  Brutally painful.  All they did was irritate the fissure and make me fart and have loose stools.  Awful.  Don't know why I even used them.  Huge mistake. My other huge mistake was reading these sites and seeing that people were touting the wonders of coconut oil suppositories that they made.  I tried that early on and am 99.9% convinced that they are what took the fissure from a painless one to an extremely painful nuisance.  Tha was the first time I experienced the awful burning and stinging pain and it lasted for a good 14 hours.  Never again.

 

5.  After my brilliant move of sticking coconut oil up my butt I got real desperate as I was now in pain for at least half the day every day.  I bought numerous different products....creams, oils, etc.  nothing helped.  They all just caused burning.  My feeling is that the body heals itself.  Ultimately a fissure is just a small cut.  Cuts heal.  Fissures can be difficult because of where they are located but you have to give them the best opportunity to heal.  For me that was: soft stools, increased blood flow to the area, stopping the spasms, and otherwise leaving it the hell alone! Don't put anything up the rectum, use wet wipes and wipe gently, etc.  just my thoughts based on almost 3 months.  I think it would've healed much quicker and never would've gotten as bad as it did if I knew what I was doing a few months ago.  I've learned a lot. I seem to be back to normal now.  I am beyond excited and pray that I never get another one.  I honestly was wondering if I would ever be the same.  It was awful.....and now I'm back!Best of luck to all.