Hi Sophie
Just wanted to see if my experience can help you.
Chronic fissure is anything that lasts 3 months or more.
Recurring is a fissure that heals then comes back.
I fell in to the severely chronic category as mine lasted 2 years straight with mere days of feeling moderately ok, but I can say now I'm cured, and NO surgery.
So I won't bore you with what didn't work for me as what works for one does not always work for another.
I've got a really good doctor who doesn't push for surgery unless he absolutely believes nothing else will work as any surgical procedure is permanent.
So mine got me to the end of my tether...didn't want to leave the house, couldn't sit for too long and ended up that I couldn't even share my bed with my wife because of the pain I felt all day and night.
My bleeding was sparse but the pain was always there and toilet trips were dreaded. The irony is that at my worst I was having to go up to 8 times a day because I just couldn't empty myself fully because of the pain.
So here was what worked for me
No more toilet paper- Preparation H wipes only (bought from Amazon in qtys of 6 packs)
Allow plenty of time to go poo- you want to relax and not feel rushed as hard pushing is what causes more pain and damage.
Buy some Lactulose solution from your pharmacy (cheaper than prescription) and start using it twice a day.
Forget the suggested dose, I took 1.5 ml twice a day. Too much will cause irritation and make you want to itch which will cause more damage.
I take a sachet of fybogel every night before bed to add more fibre to my system.
I found that when I was ready to go a sort of slight push then relax method worked for me but do NOT force it
Add plenty of water to your diet.
Now here is what solved it for me
The information above will help to start easing it but my doctor prescribed 2 things that cured me
1- a 14 day course of scheriproct suppositories (apologies if I spelt it wrong) and a tube of Betnovate ointment to apply twice a day.
You keep the suppositories in the fridge and only take them out when you are ready to use one.
I found that if you weren't careful opening them they would snap in half and you don't get the full effect so be careful with them. Once in I would then apply a pea sized dose of the cream around my bum and slightly inside it.
I know this sounds like the last thing you'd want to do but it worked, you just have to relax and know it will help. It helps if you insert them after a shower as you are more relaxed but do it slowly and it helps. Then put on the cream.
I started to go commando to avoid irritation from my underwear and I slept naked to avoid irritation too.
I did admittedly get a second 2 week course of the suppositories as I snapped most of the first batch but after 2 years I'm pain free which I thought would never happen.
I've got my life back. No one can understand this pain until they have had it and I've suffered migraine since I was 13 (now 42) and I can honestly say that a fissure is THE most painful thing I've ever dealt with full stop so I feel for you.
I'm now back to once a day and no pain (although I know that for the rest of my life I will always have to be cautious going to the loo) and I can do everything I used to do without feeling lousy.
None of the normal treatments worked for me and the typical creams gave me bad headaches.
I was too terrified to have surgery and thought I'd be stuck with this for ever but I was wrong
Here is a quick list of what and when i did what I did
Morning shower
Bowel movement
Clean with wipes
Insert suppository
Apply cream
Drink first dose of Lactulose
Evening shower/ bath
Insert suppository
Apply cream
Just before bed
Second dose of Lactulose
Drink sachet of fybogel
Use painkillers to manage at the beginning but avoid codene as this can bung you up bad!
Have faith, it CAN be cured
Relax and stop worrying as this makes it worse
Avoid too much alcohol and coffee and add plenty of fresh veg to your diet
Also lay off eating too much meat.
Protein bungs you up
Avoid junk food and spicy food and takeaways for a while
Good luck and let me know how you get on.
Pete.