Long story short, I got my first fissure about 3 years ago after I had my son and struggled with constipation. By some miracle, it went away after 2-3 weeks and didn't return until I had the bright idea to have another child.

Now it's been about 6 months of both good and bad days, but overall, it won't heal. It often bleeds quite a bit (along with intense pain) so I finally went to the doctor.

He confirmed it was an anterior fissure and thought it was superficial. No idea how he could tell since he just did a quick DRE. He said superficial ones tend to bleed more for some reason. Anyways, he gave me some diltiazem cream to try and basically explained how he will very rarely do an LIS surgery on a woman due to their weak pelvic floor muscles and the possibility of incontinence when we are older.

I've read a lot about this issue to try and cure it myself, but I've never came across someone saying their surgeon was hesitant to do the surgery. I tried the cream for about 10 days and it helped some, but I am definitely nowhere near cured. I can somewhat manage my pain and bleeding by keeping stools soft and by kind of squeezing my cheeks together when I go. Sounds ridiculous, but it helps

Anyways, I've reached the point now that I fear I will never fully heal without surgery, but my surgeon's response made me nervous. I'm currently pregnant with #3 so will just have to suffer without the cream or anything, but I'd like to solve this issue once and for all after the baby.

Anyone else hear a similar thing from a surgeon? Or have any recommendations to manage while pregnant?

It seems to be a location issue. From other posters' experiences on the board, the UK is not at all keen to do the procedure on women, but it is the gold standard for both men and women in North America. There would clearly be some in both areas who feel otherwise, but as a rule, that seems to be the case.

Where are you located?

Hi agree totally with CCC, I’m in the UK and was told by my GP and one CRS that there was no way I could have LIS as I’m a woman and would end up incontinent.
Also yes superficial fissures do bleed more...mine was down to the muscle and nearly two inches and it only ever bled a few times with only a tiny spot of blood.
The NHS should let you have Botox which was great for me as it gave me some pain free months. I eventually found a CRS who specialises in IBD’s who was willing to give me LIS (I have crohns). It’s been a year now and I have no signs of incontinence even when I’m having a flare and my BMs are just liquid. I still get pain at the fissure site when I’m having a flare but nothing even close to how I was before LIS.
If you pay private then you can have LIS straight away although they may still offer Botox as your fissure is due to childbirth and may have nothing to do with a high resting pressure.
Good luck

I'm actually in the US. I wonder if there's any truth to it then? Both living with this forever and having incontinence makes me feel depressed. Hopefully I'll have some luck with either the creams or Botox, but the fact that I still had it after 3 years of remission makes me doubtful.

Also, is there any way to tell if it's actually superficial (without looking obviously)? I was in complete misery while I was breastfeeding and super constipated, but now I'm able to have less painful movements without bleeding if they are soft and I do my "trick" of squeezing the cheeks and barely push. It will still rip without reason sometimes too so it's still not really healing. Even though I'm in less pain than before, I'd really like to not do poop gymanstics every time I go lol.

Hey your story is just like mine my fissure started a few weeks after having my first son 4 years ago I then have baby no2 7 months ago my fissure went away while I was late preg maybe the last 4 months because of all the muscle relaxing hormones running around in my system I hope this is the same for you but once baby was born maybe 4weeks old it was back I really noticed how much worse breast feeding was on the fissure I'm not breast feeding now and I'm waiting to get botox I was also told they don't like doing lis on woman who have or want to have babies it's a last last resort according to the surgeon so I've heard the same thing I will be getting a fissurectomy also known as tidying up the fissure an botox I just hope the botox kicks in straight away not getting it till afterChristmas I don't want to be in pain an healing over Christmas which is our summer also I live in New Zealand please stay I'm contact I mite want 1 more baby like you but my reason is because I have two boys and would love to have a little girl i hope your pregnancy is going well

Thanks for the response. I really hope it improves in the last few months of pregnancy. That would be fantastic! I'm only 6 weeks right now and the constipation has already hit me which always makes the fissure WAY more painful. I'm trying find any way possible to cure the constipation but it's hard to fight those pregnancy hormones haha.

We're actually on our third (and final) baby now. We already have two boys and our hoping for a girl. I figure if I do need surgery, it would be best to be finished with babies so I don't just reinjure it.

Good luck with the Botox! I hope it helps. It will probably be next on my list if the creams don't work.

Oh that's so crazy your story gets even more similar to mine haha 2 boys an hoping for a girl mine fingers are crossed for you that you get your little girl : ) I don't feel complete yet so I'll probably have one more but I really struggle once my baby's are born this time was worse then the first my fissure has been on an off every 4-6 weeks since I had my first but I got that nice 4month break during my pregnancy I really thought wow it's gone maybe it won't come back but it did. Your lucky because yours went away for years so I think the cream or botox should really work for you I did 5 months of that exact cream just recently an it still came back while I was using it so I need something stronger botox is next. Did your surgeon say they clean up the fissure by scraping away the old scar tissue an fissure? Then put in botox? My fissure is also in the anterior position do you also have a skin tag? I do but that's because my in chronic.

My doctor didn't say anything about how they did the Botox yet so I'm really not sure. I do have a skin tag as well which is kind of annoying but I could live with just that. I wish I knew how I managed to go 3 years without a reoccurrence! This time, I've tried every home remedy I can think of and it still won't heal after 6 months. I'm wondering if giving birth damaged it some more. I'm definitely terrified of how bad it will be after #3. I probably won't be able to breastfeed very long because the pain then is almost too much.

I hope your botox goes well! I really hope it's a good solution because I am so scared of the surgery and incontinence! Keep in touch!

Hey not just the fissure gave me a hard time I had his of other stuff going on so it may not be worse for you this time around just wanted to clarify that for you I have mastitis 4 times an iv antibiotics plus baby was unwell I ended up overwhelmed and having panic attacks everytime I thought the mastitis was back or I thought baby was sick again so I had alot going on the fissure was bad but it was one of many issues. My skin tag gets so red an large extremely painful but that's only if the fissure is at its worst I'll likely be getting the botox an fissure tidy up which they call fissurectomy in other places but no nz and I will document it on this site so people can follow my story to see how it goes an ask questions about my recovery I'll most certainly keep in contact email me if you want you just click on my user name this find (email) and if you send me a copy of your 12week scan I can try figure out if its a boy or girl you can see the gender of a 12-13 week scan : ) also do you use lax satchets they are a powder that you mix into water an it tastes of salty water they are safe during pregnancy I used 1 a day during my last pregnancy an it was great stuff really helped with the constipation ask your doctor so a power that you dissolve in water it's called something different in every country tell them 1 of its names is lax satchets well in nz anyway. Best of luck an feel free to email me.

I'll have to look into the lax satchets. I just ordered a bunch of prunes and Metamucil so we'll see how well that works. I think I'll try just about anything! I'll try and update at my scan. I think we have one at 8 weeks and 20 weeks. So just less than 2 weeks! I'll probably get the DNA test to find out the sex at 12 weeks. I'm putting all my money on boy haha