At a glance
If you have reached the point where you feel like giving up, you are not alone. Many people dealing with chronic anal fissures describe reaching this exact moment — the exhaustion, the frustration, the feeling that nothing will ever work.
This guide is not going to tell you to try harder or be more positive. It is going to be honest about what this moment feels like and offer some practical paths forward.
What this moment feels like
People describe hitting this point with striking consistency:
- Exhaustion — not just physical pain but bone-deep weariness from managing a condition that takes over everything
- Loss of hope — treatments have been tried, routines have been followed, and still the pain persists
- Anger — at their body, at the medical system, at the unfairness of the situation
- Isolation — this is not a condition most people can talk about openly
- Grief — for the life they had before, for the things they cannot do, for the time lost
These feelings are not a sign of weakness. They are a normal response to an abnormal situation. Living with chronic pain is hard. Managing it in a location you cannot talk about openly is harder.
What you may not have tried yet
If you have been managing with conservative treatment alone, there may be options you have not explored:
Medical review
- If you have been managing with your GP only, a referral to a colorectal specialist can open up options that your GP cannot offer
- If you have seen a specialist and their approach has not worked, a second opinion is reasonable and common
- Some fissures that appear chronic on examination actually have contributing factors that were not identified — pelvic floor dysfunction, for example
Procedural options
- Botox injection — a step between topical treatment and surgery, with good success rates
- Fissurectomy — removal of the chronic fissure tissue, often combined with botox
- Lateral internal sphincterotomy (LIS) — the highest success rate of any fissure treatment
If you have been told to keep trying conservative measures and nothing is working after months, it is reasonable to ask about these options directly.
Pelvic floor assessment
Some chronic fissures are complicated by pelvic floor dysfunction — muscles that are too tight, which perpetuates the cycle of spasm and poor healing. A pelvic floor physiotherapist can assess this and may offer a new angle on treatment.
The emotional side matters
The psychological impact of chronic fissures is underrecognised. People describe:
- Anxiety that has become generalised beyond the fissure itself
- Depression from months of restricted life and chronic pain
- Avoidance of activities, socialising, and intimacy
- Strained relationships from the constant impact of the condition
These are not secondary concerns. They deserve their own attention. Speaking to a therapist or counsellor — particularly one experienced with chronic pain — can make a significant difference. This is not about the fissure; it is about you.
What comes after “I give up”
The feeling of wanting to give up does not have to be the end of the story. Many people describe this as the moment before a turning point:
- The moment they asked for a second opinion and found a better surgeon
- The moment they finally agreed to surgery and it worked
- The moment they started pelvic floor therapy and things began to shift
- The moment they got support for the emotional side and found the energy to keep going
Giving up on the approach that is not working is not the same as giving up entirely. It might be the signal that something needs to change — a different treatment, a different clinician, a different kind of support.
If you are in crisis
If you are having thoughts of self-harm or feel that you cannot cope, please reach out:
- 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 deserve support, and it is available.