Like most who stumble upon your page, I am very greatful. The wealth of information and support here is just phenomenol. I am not particularly looking for a response, but I did want to share some of my successful experiences with milder remedies, and thank you for providing the forum and allowing so many people to congregate to discuss such a hush-hush but life-altering topic.
I am a 24-year old woman who is currently undergoing the stress of graduate school and has recently started drinking a LOT more coffee. That, coupled with a poor-college-student diet, has led me (I believe) to my first few experiences with anal fissures. I have never actually been diagnosed because of lack of adequate medical insurance, but all the symptoms are there.
I would consider myself a mild-moderate sufferer at this point; it is only over the past year that I have had any long-term problems, and the first few "episodes" cleared up after a couple days without any specific changes to my life or diet. Recently that has changed, and I have become one of those who for days on end will dread having a BM. Although previously any pain or discomfort I would experience would dissipate quickly as I walked away from the bathroom, I am now leaving with tenderness that will make sitting uncomfortable for half hour to hour periods after each BM.
This time is different though, as I realize that my current experience of symptoms is very much my own darn fault. My last wave of anal fissure discomfort came swiftly on the heels of a period of lots of coffee drinking, poor diet, much stress, and little exercise. I did some research (found this page, among others), and decided that it was time to fiber-ize my life. While I believe that taking supplements and metamucil and such can be helpful, I figured I should make some genuine changes instead of just counterbalancing my poor choices. I dramatically improved my diet, which included taking a serving of prunes with a whole-grain cereal for breakfast, drinking water throughout the day, and integrating other dried and fresh fruits into my diet. I began eating fish and frozen veggies more often for dinner, and I knew caffeine was a bad culprit, so I cut it out. Dairy has never been a problem for me, and I consider it possibly one of the reasons I've been able to maintain a decent physique despite my poor eating/exercise habits, so I stuck with it, although I know it can be part of the problem for many.
Needless to say, I got better...but after getting better I slipped back into my old routine, thinking that I had licked the problem. Nope! It is now back with a vengance and I know that I really need to fix things and stick to them. It's really a blessing in disguise, as I've never really felt the need to make my lifestyle more healthy as I've never been overweight. I am reinstating my previous diet upgrade (I know I'm not a health-nut at heart, so I don't expect to live like a saint, but I enjoy healthy foods when they're flavorful/tasty and easy).
Overall, I just wanted to share that even basic interventions can help. While I believe that catching things early is one of the best ways to help remedy them, small changes may make more of an improvement than you'd think. Hopefully I'll be able to prevent it from becoming anything I'll need surgery or even nitroglycerin for.
p.s. Patient 8's primary care methods and does and don'ts pages were great basic references. I also like the idea of medittion/biofeedback in the effort at a full mind/body healing. Once I'm done procrastinating writing my paper by writing this email, I will give that a try. Also, I wanted to thank you for the section on pregnant women and new mothers as I am fearful that it will become a problem for me again if ever I do choose to have children. THANKS SO MUCH!