After winning the pain lottery in January of this year with back-to-back thrombosed external hemorrhoids + anal fissure, I finally broke down after 3 months and saw a CRS. I visited two doctors and was very happy with the second one. After another 3 months of Diltiazem cream and still feeling not so great, I scheduled an LIS procedure + two hypertrophied papillae removal with my CRS.

In recovery, I got the surprise that I also ended up with a (smallish) closed external hemorrhoidectomy in one quadrant. Oh boy! Recovery was an absolute nightmare, but fortunately (heh, can I say that?) my painful experience from January had prepared me well for what was to come.

Honestly, nothing could top January. At its peak, the pain (from the hems and fissure) had me sobbing and drooling in pain, and is something I really regret putting myself through. Can this stuff give you PTSD? I'm guessing it can, because I'm having trouble sleeping again, and my anxiety is through the roof at times.

Anyway, I took about 3 weeks off of work after the surgery, and was feeling more normal after 6 weeks. After about 3 months, I felt good enough to take short trips out of town. I thought I was back on the level, but was still (of course) maintaining a clean diet.

Then last Monday happened. I'm not 100% certain what triggered it, but I had a BM that required a bit of a push to get started. Nothing major, and honestly, I'm shocked that's all it took. Shocked. I felt the sharp pain of a tear, and throughout the day, the building discomfort of the fissure was back. One week later I have swelling on the left side to the point that it's firm to the touch and still very sensitive, so I called to schedule a CRS visit. Fortunately, I'm in the US so I got an appointment for this Thursday, but I'm so devastated to be facing this again.

The up side is that the pain is way less this time around. I suspect this is because the LIS procedure has loosened things up a bit down there, but this recurrence has scared the hell out of me. I work so hard to maintain good BM consistency. My average adult weight was around 230 lbs before I started to get in shape about 5 years ago, and I'm now down to around 185 lbs at 6'0" tall. I take a fiber supplement twice a day, eat a vegetable-rich diet, and stay as active as I can (when I'm not agonizing with a fissure). I avoid white bread and sugars like the plague. Meanwhile my wife and friends eat whatever the hell they want, and still I get hit with this. It's so frustrating to feel like you're doing everything you can, but still suffer!

Just venting a bit. This whole ordeal has been very challenging. I just want it to be over, and I feel like I do everything to get there, but can't seem to find success.

Sorry to hear you are having a rough time, I am just over two weeks post op LIS, I feel like its basically impossible to go without a little push, but I am really carfull and make sure I am breathing- it may not be the pushing as much as the stool type coming out that is hurting you. Do you have a squaty potty, and/or a bidet? the set up would be a bout $100 on Amazon. SP allows for less straining and the bidet is a lot easier on your butt for cleaning, I believe both and have been helpful for my recovery.

I tried the SP earlier this year. I’m a bit too tall in combination with the height of our toilets. Using the SP, I ended up very cramped, which resulted in a strain just to stay upright. The net result was quite a bit of bleeding and worsening of conditions, sadly.

My post-op was a real hard time with having had three procedures. I had packing that was extremely difficult to pass, and severe swelling at the site of the hemorrhoidectomy. I kind of wish the Dr had been more aggressive in removing hemorrhoid tissue, because I’d rather had gone through all the suffering at once. Now I fear I’m facing another round.

I’ve also noticed that any injury to my anus causes my hems to go nuts. This time around, I irritated my fissure a bit, and now the hems on that side are fully enraged. My stools are never firm thanks to my diet. I think I’m just stuck with a very fragile bum.

I can see that, I hate those tall toilets as I am just over 5'8''. Maybe just some books would under your feet would help?
One of the frustrating things about some of the posts on this site is that poster do not include all of the details of their procedures, they will say that they had LIS but they actually had many other things like yourself done, which will severely delay recovery times. You had a lot done, I would give yourself time, it also seems like have a lot of other issues in the area that are complicating the matter. Also are you sure you have a fissure? You mentioned swelling, I am not sure if I have read/ experienced any swelling with fissures.

Statistically speaking 8% of people that get LIS have a fissure again, of those 66 % are able to heal the fissure, so your chance are very good that you will heal.

Yeah, I'm not 100% certain it's a fissure, as I've had no bleeding. My uncertainty was a major motivator for me to schedule a visit to the CRS (this Thursday). I need a professional to have a look, because if there's one thing I've learned is that you can't really self-diagnose this stuff based on how you feel. Back in January, I thought all my pain was due to thrombosed hemorrhoids, but it turns out the underlying culprit was a fissure.

I'll definitely post back with the results of my visit.

My CRS visit went well... Kind of. He doesn’t think my fissure is back, but instead have a thrombosed external hemorrhoid on the left side. The swelling and pain continued to progress all the way up to my visit.

That night, things went really off the rails. The pain was excruciating. Normally I can find relief in the bath, but nothing was taking the edge off this time. I laid in bed until 4:30 AM, only dozing off for 10 minutes at a time before a pain spike would wake me.

After my evening bath, I noticed that the bottom end of the swollen area was turning dark and started oozing fluid. Then at 4:30 AM, it burst. The pressure must have weakened the skin and the whole thing burst. It made a real mess. The upside was, the pain stopped immediately. I was partly horrified, partly grateful.

Called the CRS and they said not to worry too much. Sometimes this happens and that I should keep my follow-up appointment next week. So I’ll be headed back to see about what’s next.

Since this isn’t fissure related, I won’t keep this thread going, but I will post follow-ups in the hemorrhoid forum.