My fissue experience and post LIS surgery

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My fissue experience and post LIS surgery

Postby Badfissure » 27 Apr 2015, 19:37

Hi everyone

I am so grateful for this forum! Thank you to all who have posted about their fissure experiences...I am sorry you have all sufferered with this horrible condition but at the same time I feel relieved I am not the only one dealing with this torturous recovery process!!

I have had an ongoing fissure for a year now- I began experiencing intense pain with bowel movements and my GP thought it was an internal hemmerhoid flaring up. He prescribed me suppositories which of course caused me more pain! Strangely I have never suffered from constipation and have always had a healthy lifestyle with balanced diet and exercise. I could not understand what was happening to me but had faith in my gp fixing me with something!! I went on dealing with it for 5 weeks and remember always having excruciating pain when having bowel movements- just like people have described like glass cutting!! So distressing to go through. I then saw a different gp and from my description of symptoms he was convinced it was a fissure and referred me to a CRS to properly diagnose. He put me straight onto rectogesic and told me to up my fibre with Metamucil.

Luckily my CRS had a cancellation so saw him 3 wks later. Diagnosed bad fissure straight away and said to keep on rectogesic and high fibre diet for a few weeks to see if that worked. My condition improved a little with this treatment but I still suffered pain with bowel movements and had burning sensations for a couple hrs afterwards.

So next I had first lot of Botox 9 wks before my wedding in sept last year. I was so hopeful that this would cure me once and for all! Straight after Botox my CRS kept me on high fibre diet, rectogesic 3x day 0.2% strength is all we get in Western Australia. He also said I should take 1x movicol satchet a day to keep stools soft. I did all this and drank 3litres water daily. I improved a bit more but still some pain during and straight after daily bm. It was quite uncomfortable to walk/ run so my life of daily exercise diminished to slow walks with my dog.

I kept positive and managed my wedding without too much discomfort but I knew I was not completely healed.

This stupid fissure totally consumed my life- everything I ate and did seemed to relate to that dreaded bm in the mornings and the constant fear of going backwards again.

After follow up app with CRS at 12 wks post Botox he said I still have a decent fissure- I'll never forgot those devastating words- all this effort with little improvement!! He recommended a 2nd lot of Botox but I wanted to hold off for a few wks to see if I could heal on my own.
I know i am rambling on so I'll try make the rest short and sweet! My sister is a women's health Physio and she recommended I see a colleague of hers. She found I had an overactive pelvic floor probably from tightening to protect the area down there for months! I began internal massage treatment(vaginal) to relax the area and she also did ultrasound around my Perenium to encourage blood flow to the area to encourage more healing. I brought a therawand off a pelvic floor website and this helped me massage the tight spots in my pelvic floor region at home.

Over the next few months I continued with Physio treatment 2x week, movicol and high fibre diet plus 3L water. I also began applying different lubricants eg organic coconut oil, KY jelly, Manuka honey 15+ And supersalve just inside and around the Anus before bm. I was also taking a couple weeks break from the rectogesic as I had read it should be used at a maximum of 8 weeks at a time. I forgot to mention I was applying dr wheatgrass Superbalm2x daily to help the skin heal...his website had rave reviews from fissure sufferers and I used it continuously for over 6months alternating with rectogesic- it may have helped a bit but def didn't heal me!!

I returned to my CRS after 3 months of intense treatment on my own. He said my fissure was small now and almost healed- hooray I thought! But I was still experiencing low level pain and burning with bm and discomfort walking so I felt my quality of life was still low. I was becoming quite depressed as I felt it was a battle everyday to get better. I'd have a couple of good days then go backwards again even though my stool was always between a 4 and 5 on Bristol stool chart!! I had not strained at all when on the toilet for over 6 months- I learnt that was a big no no! I also used a small stool to put my feet on when sitting on the toilet as this helps with correct position to have bm. I recently purchased a lilypad stool from NZ online and this allows you to squat naturally over the toilet. I am still adjusting to the lilypad but find it helps with a complete emptying without having to push down there!
I ended up having a 2nd lot of Botox at the beginning of Feb and thought if I continued doing all of this great treatment that it would heal the small fissure properly. My CRS also removed a small skin tag at the same time. I found this has helped a lot with the discomfort exercising but I am still only doing daily walks and yoga.

I also tried laser treatment as well in the last couple months as well as ultrasound on the area 2x week- my sister treats women with stiches down their after giving birth and sore nipples with great success do I thought why not!! Such an expensive process but luckily private health insurance covered some of the costs of treatment.

My gp prescribed me a low dose of endep 12.5 mg a day to help with chronic nerve pain so have been on this too- not sure if it has made a difference though!

I do believe these methods all helped in some way but I could still feel daily discomfort- nothing major but I didn't want to live the rest of my life doing these exhausting measures to stop my fissure from getting worse! I also want to try for a baby soon and fear going backwards whilst pregnant.

At my 6 wk post Botox app my CRS confirmed my fissure was very small but still present. I was so distressed because I didn't know what else I could try other than the dreaded LIS surgery he had recommended as a last resort. He referred me to his colleague so I could get a second opinion. His name was dr Michael levitt and he is one of the top surgeons in Australia. He has his own website and has written books on constipation issues and women's bowel problems etc if anyone is interested..
Went to see him and he did a thorough examination- finger and sigmoidoscopy! So painful I was in tears and thought all my months of hard work had gone out the window!! Straight away he recommended LIS surgery due to very tight sphincter muscle and doubted it will ever heal properly on it's own because of spasm plus little blood flow to the area.

A week later I had my surgery with dr levitt. He reassured me he had done the simple procedure over 1500 times with at least 95% success rate. In the other 5% they were patients that healed their fissure after surgery but returned a few yrs later with another one. He said very low risk of incontinence and at worst may experience some lack of control when passing wind but to the point no one else would notice.. Hope he is correct as I couldnt handle that!!

So I am nearly day 7 post LIS. I was very swollen/ bruised and sore for first 4-5 days. The worst pain was the night of the surgery when the nurse pulled my padded dressing out- it was soooo painful I was crying out and swearing!! They said it was probably due to the swelling of the padding with blood and then it dried before they pulled it out- ouch. I Stayed overnight in hospital but was home the following day. Only had 1x oxytocin as was scared of becoming constipated on narcotics. Instead I have alternated with regularly taking 50mg tramadol, 1000mg paracetamol and 400mg ibuprofen over the past week and have tolerated discomfort ok with these meds.
I still can not sit directly on my bottom and it was quite uncomfortable to walk until day 6. I think the pain is more from the incision site though and it is a stinging sometimes/ throbbing and deep ache in the area. I've kept bm soft with 2x movicol daily along with magnesium supplements, 3L water and high fibre diet (approx 25g mix of insoluble and soluble) I don't always empty properly but refuse to push at all!! Never strain I say! You just have to wait till you get a stong enough urge and go straight away! Taking slow Deep breaths in and out helps me with getting stronger movements and better emptying but I still get frustrated when I don't!! Very little pain with fissure site and no blood on moist toilet wipes so far. I have 2 warm baths morning and night and shower the area after bm. After bm I also have Bathed the area using cotton wool and 1/2 cup boiled water (slightly cooled) with 1/2 Tspn of salt added. Just use a new cotton wool every time I dab water gently on area- never dip used one back into water to avoid infection.

Fingers crossed this surgery is slowly working it's magic.. I wanted to be back at work today but I am a teacher and there is no way I can sit or stand for long periods of time yet!! I think realistically another week to rest would be perfect but I'll take it day by day and see.

I honestly feel this LIS surgery is the best option to heal a chronic fissure- especially if you have a super tight sphincter that does not RELAX! I wish I had done it earlier because the ongoing emotional trauma of dealing with this fissure has ruined my life!! I always tell myself people do it so much worse dealing with cancer and other horrible illnesses but I just still feel I cannot enjoy and appreciate life properly with this nagging pain in the butt constantly there.

I know I'm not healed completely yet as it is still early days and I am still very tender in the area..but I feel today on day 7 I am making steady progress.
I will try and update or answer any queries people may have whilst I am still off work. I wish everyone the best of luck with their healing :D
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Re: My fissue experience and post LIS surgery

Postby chachacha » 27 Apr 2015, 22:14

Great story - thanks so much for sharing.

Sorry that you had to suffer so much at first, but it sounds like you're well on your way to regaining your old life and happiness.


Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
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Re: My fissue experience and post LIS surgery

Postby msimon » 28 Apr 2015, 02:19

Wow Badfissure. Thanks indeed for sharing your story. It sounds like you have been through a lot and have tried everything to heal your fissure. I hope you start to see some progress with that really soon. Do keep us updated.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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