I took great comfort in reading other people's stories for the last year or so while I was going through a horrible experience with an anal fissure of my own. I am a 29 years old man, 27 when this started, and I have fully recovered from my fissure and have a completely regular, pain-free life again. I would not have thought this possible two months ago. I will start from the beginning.
Around the spring of 2003 I noticed a burning in my rectum when I was sit on a hard chair for a long amount of time in my college classes. By the fall semester it was worse and would hurt after every bowel movement. Sometimes I would have bleeding and sometimes I wouldn't, but the pain was becoming much more consistent and intense over time. By late fall 2003 I finally got the courage to go see my doctor about this problem, with my wife's strong urging. My doctor felt around inside my rectum (this was the first time I had this done and was EXTREMELY nervous and embarassed). He was looking for a hemorrhoid and didn't find one but he sent me to see a colon-rectal surgeon anyways. A few weeks later I saw the surgeon who immediately diagnosed me as having an anal fissure. He told me my first option was to eat more fiber, drink more water, etc. I tried that for a few months but it only got worse. I went back and he had me start using the Nitro cream that most people on here now know about. The cream worked, it healed the fissure over a few months (however I was still in amazing pain). When I went back he said that another fissure had formed, but he did not want me to have surgery. Instead he told me to continue with the nitro cream and to keep eating lots of fiber and keeping stools nice and soft.
By fall of 2004 I was in so much pain that I couldn't function in any sort of realistic manner. I was starting to miss time from work and I had my entire life dictated by this problem. I would eat certain things at certain times knowing that it would make me have to go to the bathroom. I would not eat anything after 7 or 8 p.m. so that I wouldn't have to go to the bathroom in the morning before work. I would never go to the bathroom while at work because I would be in so much pain afterwards. Every time I would go to the bathroom I would have to sit on a hard chair for hours until it would go away enough for me to sleep. If I ever woke up during the night needing to go to the bathroom I would be terrified because I knew I wouldn't go back to sleep again. I lived like that for a LONG time.
Finally, I saw my surgeon and told him that I was in so much pain that I wanted to have surgery. He looked and said that the fissure was actually completely healed. He said that what was causing pain now was that there was scar tissue from the fissure, and since my muscles inside my rectum were so tight that they were spasming. He said that trying Botox injections would not fix the problem since they are mostly just for healing the fissure. The sphincterotomy (spelling?) would erase chances for re-occuring fissures and would reduce the pressure and tightness of the rectal muscles. I decided to have it, which was an easy decision at that point considering I no longer had a life of my own. I was VERY concerned about incontinence and the doctor told me that the chances of someone my age and in my shape having it were extremely rare. He said that the national percentage given is about 15% and that is mostly because of surgeries performed by non-specialists. He said that his groups' percentage was about 5% and that was mostly made up of very elderly people who were already borderline incontinent.
I had the surgery, it lasted 50 minutes, on a Wednesday afternoon. I was not put completely under, just partially (monitored). After the surgery I was required to take sitz baths (salt) three times a day for two weeks. I was scared the first time I went to the bathroom but it wasn't as horrible as I thought it would be. I was in pain however that first night and needed all my pain killers. The pain lasted, though was much less intense, for only a couple of days. I noticed within the first two days that I no longer had the intense, lasting pain that I used to have after going to the bathroom before the surgery. After two weeks I was completely and totally pain-free. It is now six weeks later and I have a completely normal life again. I eat whenever I want. I no longer plan it out. I have no pain after going to the bathroom. I have no pain from sitting a lot or walking/standing a lot. My life is normal once again and I am so thankful and happy. I wish that I would have had the surgery a year ago to avoid all that pain and misery and depression that I went through. I truly thought my life would never be the same again and was jealous of everyone else that had normal lives. I have absolutely no incontinence to gas or liquid or anything. I am happy and fortunate and I strong urge any of you reading this (should this be published on the site) to have the surgery if your pain is too intense to try the other methods. And do not be afraid to have a doctor look into your rectum. They are trained and paid well to do it every day to many people. It is not a big deal.
Good luck to you all and may relief find you all.