At a glance
The feeling of wanting to give up on fissure treatment is one that many people with chronic fissures describe. After months of dietary changes, sitz baths, topical medications, and daily pain, the effort can feel pointless. The fissure is still there. The pain continues. The routine is exhausting.
This guide is for the moment when you feel like none of it is working and you are running out of hope.
The exhaustion is real
Living with a chronic fissure is relentless. The daily routine — fibre, water, sitz baths, medication application, dietary vigilance — takes time and energy. When that routine does not produce the expected results, the natural response is frustration and despair.
People commonly describe:
- Feeling like they have tried everything
- The exhaustion of maintaining a routine that does not seem to be working
- Anger at their body for not healing
- A sense that their life has been taken over by a condition that no one around them understands
- The temptation to stop all treatment and just live with the pain
These feelings are valid. Chronic pain is exhausting, and the emotional toll of an invisible, stigmatised condition amplifies that exhaustion.
What “tried everything” usually means
When people say they have tried everything, what they usually mean is that they have tried everything within a particular level of treatment. Most commonly, they have tried:
- Dietary changes and fibre supplementation
- Sitz baths
- Over-the-counter products
- One or two prescribed topical treatments
These are all important and appropriate first steps. But they are not everything. The treatment landscape for chronic fissures extends beyond conservative care:
- Botox injection — a temporary but often effective sphincter relaxant
- Fissurectomy — surgical removal of the chronic fissure tissue
- Lateral internal sphincterotomy (LIS) — the most effective treatment for chronic fissures with high sphincter pressure
- Combined approaches — such as botox with fissurectomy
If you have been managing conservatively and feel like nothing is working, the next step is not to give up — it is to have a conversation with a clinician about escalating treatment.
The mindset shift
People who eventually find resolution for their chronic fissure often describe a mindset shift that preceded the turning point:
- From “I have tried everything” to “I have tried everything at this level — what is next?”
- From “nothing works” to “this approach did not work for my specific situation”
- From passive endurance to active advocacy for their own care
- From viewing surgery as failure to viewing it as a tool
This shift does not make the frustration disappear. But it redirects the energy from despair toward action.
Practical next steps
If you are at the point of wanting to give up:
- Acknowledge the feeling — it is legitimate and does not need to be suppressed
- Assess what has actually been tried — make a specific list of treatments, durations, and outcomes
- Seek a specialist opinion — if you have been managed primarily by your GP, a referral to a colorectal specialist may open new options
- Ask specifically about next-step treatments — botox, fissurectomy, LIS
- Consider manometry testing — if it has not been done, measuring sphincter pressure can guide treatment decisions
- Address the emotional toll — the psychological impact of chronic fissure pain is worth discussing with a healthcare provider
The path forward exists
The most important message for anyone at the point of wanting to give up: the path forward exists. It may not look like what you expected. It may involve a procedure you were hoping to avoid. But many people who felt exactly as you do now eventually found resolution — and most of them describe the treatment that finally worked as something they wish they had tried sooner.