Anal Fissure or not?

Hi I have had a burning and stabbing pain in my rectum for the past three weeks. It comes on about an hour after a bowel movement. It seems to come and go. One minute I am fine then all of a sudden the pain hits me and then it goes away again. I have tried all the hemorriod cream etc. and they have not worked.  Dr. says it is an anual fissure but just not sure. How on earth are these things ever suppose to heal when you have a bowel movement everyday and probably open back the tear. Any feedback would be great.

[Kaneda2112]

You obviously need a GI doc to do an anoscopy and a digital rectal exam (if not too painful).

Anal fissures often heal within a few weeks if you take steps to keep your stools soft and treat constipation or diarrhea. If the tear doesn't heal within six to eight weeks, however, you'll likely need medical treatment or possibly surgery.

The Mayo Clinic lists a host of If lifestyle and self-care measures — including adding more fiber to your diet, drinking more water, getting regular exercise and taking a stool softener — aren't effective, your doctor may recommend the following nonsurgical treatments:

    Fiber supplements. Taking a regular fiber supplement will help keep your stool soft and easier to pass, to avoid further irritation of the fissure.

    Sitz baths. Soaking in warm water for 10 to 20 minutes several times a day, especially after bowel movements, will help relax the sphincter and promote healing. Don't use soap or bubble bath, as this may irritate the area.

    Medicated creams. Your doctor may suggest a rectal cream or ointment (Anusol-HC, zinc oxide, others) to help relieve discomfort from a mild fissure.

    Nitrogylcerin. Applying nitroglycerin ointment to the anus widens blood vessels and increases blood flow to the fissure, promoting healing. This therapy also helps reduce pressure in the anal sphincter, which eases the spasm and decreases pain. Side effects may include headaches, low blood pressure and dizziness. Your doctor may advise you to wear a disposable glove while applying nitroglycerin ointment, to remain seated or lying down, and to avoid exercise immediately afterward, to minimize side effects. Men shouldn't use nitroglycerin within 24 hours of taking erectile dysfunction medications, such as sildenafil (Viagra), tadalafil (Adcirca, Cialis) and vardenafil (Levitra), because of the possibility of significantly lowered blood pressure. You'll probably have to have nitroglycerin ointment custom formulated at a compounding pharmacy.

    Botox. Injecting a small dose of onabotulinumtoxinA (Botox) into the anal sphincter paralyzes the muscle for several months, causing the spasm to relax. Possible side effects include pain at the injection site or temporary, mild leakage of gas or stool (anal incontinence).

    Calcium channel blockers. The blood pressure medications nifedipine (Adalat) and diltiazem (Cardizem), taken orally or ground into a gel and applied to the fissure, also may help.