Ok, I am new to this forum and new to the world of fissures. One month ago I had horrible pain and thought it was my hemorrhoids. My family doc sent me to a Hemorrhoid Treatment Center. They tried to do an exam and I about jumped off of the table it was so painful. They gave me cream to use with Nif in it. I used it for a few days and it did not help relieve pain. That weekend I ended up in the ER with severe pain and suffering from lack of sleep. This was worse than childbirth, worse than a appendix attach. They did a flexible sigmoidoscopy and it revealed a fissure. I was sure I had a tumor or growth but they did a CT scan as well and it is all "normal" in there except for the fissure. The Gastro doctor at the hospital sent me to a CRS. He said if I was a man he would do surgery asap but since I am a woman and have damage to the sphincter he would not do it yet. He said I would run the risk of becoming incontinent. I am only 52 and active so that does not appeal to me. He wanted me to use the cream for 2 weeks and if it was not better to schedule surgery. I am up every night until 2 a.m. or so because the spasms are so intense at night. This is affecting my work, family life, and every aspect of my life. Help! What suggestions do you have. I really want to avoid surgery. I am keeping my stools fluffy with my diet, using the cream, drinking plenty of fluids, but still the pain follows me day and night. Especially night!