At a glance
If you have reached the point where the pain feels unbearable, you deserve to hear this: what you are going through is real, it is serious, and there are steps forward — even if it does not feel that way right now.
First: if you are in crisis
If you are having thoughts of self-harm or feel that you cannot cope:
- Samaritans (UK): 116 123 (free, 24 hours)
- Crisis Text Line (UK): text SHOUT to 85258
- 988 Suicide & Crisis Lifeline (US): call or text 988
- Lifeline (Australia): 13 11 14
You are not overreacting. Chronic pain is a legitimate crisis, and these services are there for exactly this.
What this moment means
Reaching “I cannot take this anymore” is not a failure. It is a signal. It means the current approach is not enough and something needs to change. That change might be:
- A different treatment
- A different clinician
- A different level of care
- Support for the emotional side
Immediate practical steps
Escalate your medical care
If you have been managing alone or with a GP only:
- Request a specialist referral — a colorectal surgeon can offer assessment and treatment options your GP cannot
- If you already have a specialist, contact them about your current level of pain
- Ask directly about procedural options — botox, fissurectomy, LIS surgery
Ask for better pain management
If your current pain relief is not controlling the pain:
- Tell your doctor specifically what is not working
- Ask about timing — pain relief taken an hour before anticipated bowel movements works better than after
- Ask whether a different type or dose of pain relief is appropriate
Get support for the emotional side
The psychological impact of chronic fissure pain is significant:
- A therapist or counsellor experienced with chronic pain
- A trusted person to talk to
- Acknowledgement that the emotional toll is real and deserves attention
What people describe at this point
People who have been through this moment describe:
- Exhaustion — physical and emotional
- A sense of isolation — nobody understands
- Anger — at their body, at doctors, at the unfairness
- Desperation — willing to try anything
And then, often:
- A turning point — the moment of crisis prompted a change
- A new clinician who took them seriously
- A procedure that finally worked
- Support that made the wait bearable
The pain has an end
This is not a platitude. Fissures are treatable. The vast majority heal — with conservative treatment, with botox, with surgery. The path may be longer and harder than anyone expected, but it exists.
The people who felt exactly what you are feeling now — who could not take it anymore, who were at their absolute limit — are the same people who later describe being past it. Being on the other side. Having their life back.
You can get there too. The next step is the one that counts.