Hi all, I have had lis 20 years ago to great success but have relapsed badly recently. Macrogol (movicol, miralax etc) has nursed me back to 70pc healed and I think another few months and I should be ok. I think if I do nothing else then I will need to be on 1-2 sachets a day for life to prevent a retear. Not something I want to do so I intend to try dilation once back to 100pc. (The clean up operation when on macrogol pretty much necessitates a bidet or shower)

Anyway, I saw a CRS a week after the relapse and he couldn’t inspect it as I was in too much pain. He has booked me in for an “internal investigation” under a general anaesthetic. Could this set me back to square one? I saw a video on the friendly proctologist where he talks about the sphincter just opening up when under a general so not an issue but also lots of peoples fissures appear caused by a colonoscopy.

For me the main issue with examination under anaesthetic is the constipating element of the general anaesthetic. I had this 6 months ago and had a very hard BM after which set me back significantly. I took laxatives beforehand etc but it still happened with all the anaesthetic drugs. I’m scared of another anaesthetic for that reason. I wonder if anyone else has managed to have a soft BM after an anaesthetic and if so how?!!
My CRS used installagel to examine me (a wonder product with local anaesthetic and lubricant in) I am currently using this to try dilation daily under my CRS instruction altho it terrifies me! It’s getting a bit easier…
I think you would be better braving the CRS examination - I thought I couldn’t but my latest doctor (3rd opinion doc) just made me!! He could see my fissure clearly just on inspection, no need for GA. Plus he used numbing gel so it was not as bad as I expected.

Thanks and good to know. I can feel the fissure running on the left side.

I think he wants to rule anything else out.

How many laxatives did you take?

I am on 2 movicol sachets a day at the moment that keeps it just about in check. I think they say up to 6 for an impacted stool. Any constipation at the moment would be agony for days.

So I take Lactulose (works really well keeping things soft) and took the max dose the day before plus after the procedure plus full dose stool softeners but sadly my first BM after was hard and painful (the doc said after my examination that I had no fissure!) well I certainly made a fissure straight after the anaesthetic. Altho possibly that CRS (not my current doctor) missed the fissure as the pain was bad before the investigation so I can’t believe it wasn’t there all along. All very confusing! But if your doc needs to check you generally I guess you need to do it and just take max dose of everything and maybe it will be fine! Other people on here seem to have survived the anaesthetic side of things.

Ah ok I find lactulose to be mildly effective. Finding movicol/cosmocol was a game changer - it’s extremely effective

Also keep us updated on the home dilation I am hoping to start that once I am somewhere near healed.

Oh that’s interesting. I have Movicol as my next move if Lactulose stops working but for now it’s perfect (when no anaesthetic involved!) but I will defo use it if I need Botox/Fissurectomy. So my CRS says I need to dilate in order to heal.. the theory being that it aids healing due to releasing the internal spasms which make everything worse. We will see. It doesn’t really hurt the fissure to dilate weirdly. Mine is posterior and you have to angle the dilator towards your tummy so in my case away from the fissure so that’s useful. No idea if it will work. Felt better yesterday but bit sore again today but spent a while in the car which winds it up. It’s time consuming and grim to dilate but I don’t care if it works

When is your investigation?

I’m not sure yet, it’s nhs so maybe a while.

All this stuff seems grim at first but quickly get used to it!

And by the way I have read on here and elsewhere quite a few people who have had success with dilation so I hope the same for you. I don’t really understand it, since effectively a large dilation via a big hard stool is what got many of us into this mess or causes retears. I guess if done once healed then dilating when relaxed causes it to stretch in a good way as opposed to a bad way of pushing a hard stool. I’ve heard others say it is a way to relax the internal sphincter, stopping the spasms and allowing it to heal.