I'm posting this to help anyone else dealing with the agony of anal fissures.

I had UC for 15 years and had j-pouch surgery in 2005. I had few issues for about the next 9 years, but around 2014 I started having issues with hemorrhoids, which eventually lead to agonizing anal fissures that I dealt with for about 5 years.

The first step was figuring out exactly what I had. Over 3 years I was given 3 different diagnoses by 6 different doctors (3 GI doctors, 2 GI surgeons, and a dermatologist). Three of them said I had a fissure, one said I had hemorrhoids,  one said I had a fistula (and Chron's!), and the dermatologist wouldn't give an official diagnosis. It was complicated by having a skin tag that was a result of the hemorrhoids.

One of them, a GI surgeon, finally gave final confirmation that it was a fissure. She took a picture of it with my own camera and showed me. Here are the things I did that finally gave relief:

• I identified foods that aggravated it. In my case, this was nuts and ground beef. Ground beef contains small bits of bone, and nuts are very sharp and hard and don't really get digested. I discovered that anything I had that was sharp or hard inflamed the fissure. I can still have nut butter with no issues as long as it's fully blended.
• I started taking the standard dose of Imodium every day. One of the problems I had was when the fissure was inflamed I would have to go more, adding insult to injury. Slowing things down with Imodium really helped. At first I took a triple dose to really slow it down, and after that went to the standard dose.
• I tried Calmoseptine and various other topical painkillers with lidocaine and nifedipine. The topical painkillers were very expensive and usually had to be made at a specialty pharmacy. I found that none of this helped much. What finally helped me was Jergens Moisturizing Aloe Hand Lotion. Something in it just really eased the pain. I apply after I go to the bathroom every time if there's pain.

These discoveries that took years to make finally got things under control. I occasionally have a little pain, but nothing like the burning, agonizing pain I used to have that hurt so bad I felt like I was going to throw up, and made it so I couldn't sit down. Pain so bad it took my breath away.

This was my experience and yours may be different. However, my hope is that something here will help someone else.