Dear Jack,
First of all, I would like to thank you for creating and maintaining this page. For those of us who have suffered in silence, it is truly a godsend.
The first of two agonizing, longterm fissures appeared shortly after the birth of my first daughter. I mistakenly thought I had a case of hemmorhoids and used suppositories, which did nothing for me, for about 6 months. This fissure healed after I became pregnant with my second child. In retrospect I think that the fact that I could not eat solid food for about two months due to severe morning sickness allowed my body to heal.
The second fissure appeared exactly as the first had, a few weeks after my second child was born. I didn't take it seriously and it progressively, painfully worsened. I knew that neither surgery nor drugs would be my choice of treatment, as I was nursing my newborn and could not afford time away from my two babies. Out of desperation I went to a gastroenterologist, who confirmed that I indeed had a fissure, and recommended a conservative course of treatment with Metamucil. I took her advice, but to my disappointment, the Metamucil, which increased the size of the stools, made my condition all the more painful and I soon gave it up.
After a couple of periods of remission and recurrance, I finally have come upon a natural course of treatment that seems to be working better than anything I have tried thus far. In addition to sticking to a high-fiber diet and steady intake of water, I am drinking a half-cup of pure aloe juice (not diluted) twice a day, and using the Dr. Christopher ointment (2-3 times a day) mentioned by another person in this forum. The aloe juice is bitter, but soon becomes tolerable. It has the double effect of soothing the digestive system and softening the stools. I buy it in a large gallon jug at Trader Joe's for about $7.00, and I know it is also available at health food stores. My vegetarian diet is based mainly on Japanese food, and for those who are familiar with Japanese food, I very highly recommend natto (fermented soy beans) and konnyaku (devil's root, available both in noodle and cake form). Both of these fiber-rich foods have a lubricating effect on the digestive system and soften stools. Natto is extremely pungent and most Westerners find the taste, smell and texture unbearable, but konnyaku is tasteless, odorless (and calorie-free). Consult any Japanese person or cookbook about how to prepare these foods easily and edibly. (I would also be happy to share my own preparation methods with anyone who is interested.)
I have a couple of theories about fissures that occur shortly after childbirth: My guess is that in addition to weakened intestinal/anal walls from childbirth, hormones and nursing must play a role. I imagine that much of the liquid intake of a nursing mother goes to supply breast milk, and if the liquid is not adequately replenished, stools will become harder and tax an already weakened colon/anus. I was not paying attention to this as it was happening, as I had never been constipated before, but in retrospect, I don't think I had an adequate fluid intake, and what would have normally gone to my large intestine went to breast milk. By the time this occurred to me, the vicious cycle of partially healing and tearing again had started, and only after weaning my daughter and implementing the aforementioned program has my condition dramatically improved.
I don't want to become complacent, but I finally think I have hit upon a combination of factors that are facilitating my healing. For those of you who are looking for non-surgical treatments, I highly recommend the above-mentioned program.
I wish you all freedom from pain.