Don't have a fissure, but thought I'd share my fistula/fistulotomy story since its relevant to a lot of people on here. After I had read a lot of the horror stories about fistulotomies on the internet, I was having doubts about going through with my surgery 2 days ago. However, it actually wasn't nearly as bad as everyone was making it out to be and I feel fine (minus the mental toll of having a large open wound on my buttcheek).
I guess I'll start about 8 months ago when I went to the bathroom. After I wiped I noticed a large amount of blood and some sort of yellow pus on the TP which obviously freaked me out. When I checked in the mirror, to my surprise I noticed there was what appeared to be a small hole about 4 inches up from the actual hole that is supposed to be there which was leaking this stuff :o. Was I the first person ever to grow a 2nd asshole? I dealt with this pus-filled mystery hole thing draining for about a week by lining my underwear with paper towels. Eventually it stopped and I sort of forgot about it.
Fast forward several months, and I developed a very tender area on my lower left cheek about an inch from my anus which began to swell & harden. If I squeezed it, the same smelly pus that was coming from the mystery hole came out. It became extremely painful to walk due to the friction. After some research I believed it was a Pilonidal Cyst. I dealt with it for the next few months, too embarassed/unmotivated to see a doctor. It became extremely painful, and was really detracting from my quality of life. I would try things like putting preparation H on it and taking A LOT of showers which sometimes gave temporary relief. At one point, the thing swelled to a little larger than a golf ball, and then popped, draining a lot of pus and blood. After it popped, the area felt much better, but soon began to swell again like before. It went on like that for a while, swelling painfully and then draining in week-long intervals.
After I read cysts can potentially cause dangerous infections if left untreated, I sucked it up and finally went to see the doc. He waded through the jungle of hair on my bum and agreed with me that it was a Pilonidal Cyst, then referred me to a CRS. The CRS I ended up seeing was very highly rated, but the fact that it was a woman made me a bit uneasy. Although she was friendly, the 1st examination was awkward to say the least since she had several young female interns in the room as I was bent over a table with my pants down and she prodded around parts of me where nobody has prodded before. She said she didn't think it was Pilonidal due to the location, and ordred an MRI of the Pelvis. Upon an even more awkward followup where she stuck a camera (looked more like an anal probe from a cheesy UFO movie) partway up my bum with a new set of (all girl) interns, and a fairly attractive female nurse on hand to witness, she concluded what I actually had was a "fistula in-ano". She explained it was a tunnel connecting the swelling/painful pus-filled part with the inside of my rectum, and said I would need surgery to correct it. Aweome, I would finish my last months of college by having my balloon-knot cut open.
We decided I could wait a few more months until I graduated college for the surgery. Over those months the pain in my ass literally became the center of my life. Many days it would hurt so bad to walk I would just lay in bed instead of go to class or out with friends. Eventually it stopped swelling and draining, and turned permanently into a red pimple-like hole which would bleed when I wiped and was very sensitive and painful. I was miserable.
After graduation, I scheduled the surgery as soon as I could to get rid of this thing. She explained this surgery was "exploratory", since she didn't actually know where the opening was inside my anus. Depending on where it was, she would either just cut the tunnel open if it was accessible, or stick a seton in to let it drain over a month or two, which would require a second surgery. The good news is she said either way the surgery would not require the wound to be packed, which was what I was dreading due to the pain I had read about.
Day of Surgery
Come day of surgery (July 5th), I was nervous as hell and hungry & thirsty (I wasn't allowed to eat/drink due to the general anesthesia). But when I got to the hospital the staff was all very friendly and answered all of my questions which calmed some of my nerves. I was given an IV which helped my thirst and asked a bunch of questions from the nurses, anesthesiologist, and CRS. After an hour of waiting they took me in the operating room, shot some general anesthesia into my IV, and I was out. Before I knew it I was awake in the recovery room (about 45 mins after going under) and didn't even realize what happened. They gave me some IV pain killer and a percocet while they let me come out of it for a while (I was on cloud 9 at this point feeling pretty great). When the surgeon came in, she told me the fistula was actually very superficial, and did not connect inside my anus (which I was very happy about since that means my balloon knot was in tact!). Instead, it actually connected with the mystery hole from earlier that she had originally thought was unrelated...unfortunately I wouldn't win any award for the second second butthole. She had made about a 3 inch incision from the abcessed area upwards, which she left open to heal. The best news was she said I would not need a 2nd surgery, it would NOT need to be packed, and should heal fairly quickly possibly under 2 weeks) They sent me home with a sitz bath & some Dilauded for pain which I expected to come once the hospital drugs wore off. However, to my surprise I felt almost no pain at all besides the occasional dull sting which was hardly noticeable. The most uncomfortable part was probably having to walk around with several large guaze pads taped into my crack.
I took some of the pain killers for the rest of the day just to be safe, and ate normally as the surgeon said I could. I also bought some more large guaze pads and tape to change the dressing. When I took a look at the wound it was pretty shocking... it was a fairly large open hole in my right cheek. I was very surprised it didn't hurt more.
Day 1 post op
I had expected to wake up in more pain having gone 8 hours without pain killers, but woke up and still felt almost no pain at all. Took some pain killers anyway just in case (I probably didn't really need it, but what the heck). Soon had my first BM which I had been dreading like everyone else after the surgery. But, since the incision went up the crack instead of down to my anus, it wasn't painful at all despite some constipation. I took a sitz bath anyway with some epsom salts mixed in to make sure it was clean and put on a new gauze dressing.
Took it easy all day and didn't walk around a lot so I didn't aggravate the wound. I had no problem laying on the sofa or in bed. The only uncomfortable thing was sitting on my hard kitchen chair.
Day 2 post
Woke up, still no pain. Didn't take the pain killers. Alternated taking sitz baths and regular baths with epsom salts to keep it clean. The Sitz baths actually are kind of uncomfortable to me due to position of the wound, it gets stretched out when I sit in it. Regular baths are find though Still taking it easy on walking around a lot just to be safe.
Overall the experience has not been nearly as bad as I thought it would be (hopefully i'm not counting my chickens too soon). I guess I ended up getting lucky with the thing being superficial. My CRS was very experienced and helpful, I would highly recommend her. As long as this thing doesn't get infected I expect its smooth sailing from here. If I no longer have to experience that pain from the fistula anymore, it will definitely be worth it.

Thanks for the post!
PLEASE continue to update us regularly on your progress. I also have a superficial fistula and am going to be having surgery soon, so any comments you leave will be greatly appreciated!

Hi Deepol,
Great! another fellow fistula sufferer! (well, it's not great but you know what I mean.....!)
Really interesting to read through your experience and really glad to hear your surgery went better than you expected and you are now on the road to recovery!!..I've posted on this thread too (3rd day Fistulomy!) Have a read through....It sounds we've been pretty much going through exactly the same (although I think my fistula never developed quite to the extent of yours) but Yes, I got advised it was also possibly pilonidol just like you by 2 GPs and it was only on the day of my surgery, they confirmed as a definite fistula. Just like yourself, mine was very superficial, so the surgery was straight forward, no packing and now constant meticulous after care and still maintaining very healthy eating to keep it all soft. (My fistula was closer to my anus opening) so can still be a bit sore- OUCH!.....
Really glad to hear you're doing so well. I was the same - virtually nil pain for the first two days but I got to about day 4 and then did feel a lot sorer but all manageable. I think the GA had properly worn off by then, so I was feeling the real effects of the post-surgery!!....Then it all subsided and I'm now about 3 weeks post but been having a lot of different soreness and twinging, which my GP advised me yesterday is all NORMAL. In fact, its a bit sorer than now than ever but I've been assured it's part of the healing process and can take a full 6-8 weeks to feel back to normal again. Pls keep me updated. Would love to hear how your recovery is going. Did you get any stitches in there too??? (normal not Seton)...Good luck with it all!!!!! xx

Ever the Optimist:
A couple of questions . . .
1. On a daily basis, what has your pain been like on a scale of 1 to 10? How does this compare to before the surgery?
2. What exactly are you eating to keep everything soft?
Thanks!

Hiya,
Daily pain basis now is a 1 and that's not all day! On & off and a short while after a BM and when I'm really tired. Probably peaked at a 1.5 on one ocassion!!! It's not pain, it's just a bit sore with very ocassional twinges. Nothing to worry about......
Pre Op, daily pain was about a 4/5 when the fissure was inflamed and draining more, but down to a 1 when it "calmed" down for a the few days between the draining. So, in conclusion, it's not been any worse after since having the op and better than before. It's like a healing soreness I'm now feeling and tonight, I don't even feel it!....
Keeping soft - Basically, bran, bio yoghurt and fruit for breakfast with 1 cup chamomile tea, 1 glass water, multi vit + vit C (500mg) + zinc, followed by 15mg of lactulose.
I eat a bran bar and 2 pieces of fruit mid morning, lots more chamomile tea and just keep refilling my water bottle on & off all day!
Lunch normally a cup of soup/ sandwich (wholemeal bread) with ham or/ tuna/ cheese & salad or a salad itself. Mid afternoon, snack on more fruit/ nuts but chew them thoroughly/ rice cakes/ oat cakes....Lots of fluid.
Dinner - I eat pretty much anything but have avoided any "tough"/ red meats and processed stuff - so lots of jacket potatoes, bean dishes, wholemeal pasta dishes, lots of fish/ chicken/ turkey/ always lots of veggies/ oven chips/ brown rice/ chicken sunday roast/ I'm just really careful to balance with lots of fibre. I eat loads of yoghurts too. Always have another 15ml of lactulose after dinner and a tablespoon of olive oil,just before going to bed....swear by it!!....I can honestly say this works for me and I still eat chocolate and had a beer for the first time in 6 months last night and I've been fine!!!!
I am wary of high fat pizzas/ burgers/ beef/ greasy fish & chips & white bread & pastry and careful not to eat too many bananas as these definately all tend to be more constipating. Had no issues with milder curries or chinese takeaways (but avoid the deep fried stuff).....
I hope this has been helpful for you :)

Some great advice here - almost exactly what I do ETO. Deepol and thisfissure, hope you are both ok. I am 1 day post fistulotomy and not feeling bad at all. My fissure had turned into a fistula because it had healed over leaving a tunnel. Luckily it just needed to be laid open, I have had botox injected, so hopefully things will be all good from here! Not had the dreaded first bm but had some lactulose, movical and lots to drink so hopeful. Bleeding has almost stopped, just slight discomfort when sitting. I hope this is the end of my fissure journey and can then really focus on sorting my dermatological problem so I will be 100%. Wishing you all the best Deepol and ETO, and this fissure for your upcoming surgery. Will update at some point over the next few weeks :)

Hi Sue:
Congratulations on your surgery! I hope things continue to go well! Please keep us updated on your progress.

Hi Deepol,
If you're still on the site, how is your recovery going???
Well, I hope ..... :D