So I was dx with a fissure back at the end of November. It has been a very painful, very slow healing experience. During all of this I had bloodwork done which seemed to indicate I had Crohn's. I also had a colonoscopy and endoscopy - neither of those confirmed the Crohn's. My gastro is still treating me as if I have Crohn's. I'm on Pentasa (pills) and also taking Canasa (suppositories).

I went to my CSR for a follow up this week to check on the fissure. We had previously discussed Botox but I felt at this point I was healing (finally!) and was going to put that off. (My pain level with the fissure started off at about a 10 and is now around a 2.) LIS was not an option as I have chronic diarrhea and after having 4 children (and episiotomies) my CSR felt pretty strongly that cutting the muscle would be too risky. My CSR did an exam and unfortunately in addition to the fissure that is still there she also found a fistula. She said it appears to be superficial, so she does not think she will have to cut muscle but she said I need to have surgery to fix it. I am feeling totally overwhelmed at the moment! The surgery is scheduled in 2 weeks and I have no idea what to expect. I mean she gave me the basic overview...but like I said I was kind of in shock at the moment.

I'm worried about the surgery itself. I'm worried about the pain afterwards (and also dealing with the fissure that she said might feel worse after the surgery!). I'm worried about recovery time, how long will I need to be out of work, etc. UGH. Any tips or advice you could provide would be much appreciated. Thank you!

Hi Cheryl,
I hear you, it is pretty difficult to deal with these things... but one thing at a time. Don't be worried about the fistula surgery, it is not painful, it doesn't last long and if you take your pain killers after the surgery regularly it should be fine. Just take them every 6 or so hrs and after a week or so it should be better.
As for the work, it is individual, it took me around 3 weeks, maybe less, but I know some people go back to normal activities after 2 weeks. It depends...
but I cannot tell much about the fissure/fistula combination...
in any case, good luck, and no worries, you will deal with it better if you take it easy. :)

Thank you for your feedback Garrod! I went for my pre-surgery physical yesterday and spoke with one of the nurses on staff afterwards who also helped reassure me in regards to the surgery. I have my pre-surgery appt with my CSR on Monday so I am going to get together a list of questions to ask her prior to the surgery next Thursday. What is the 'care' like after the surgery? From what I understand it's an open wound that they are making to let the fistula heal itself - are you able to do the care yourself or did your spouse have to assist?

Hi Cheryl, glad you feel more confident now! Wound care can be a little demanding, you need to change wound packing, some have nurse do it, I did it myself, as it was simple and I could have done it on my own.
You need to have the wound clean at all time, especially after bowel movements. So each morning after BM, soap cleaning, shower and a sitz-bath - I did it in potassium-permanganate, but epsom salt works too, camomile I've heard is good too, it's good to have something that has antiseptic properties. And I'd do two more sits-baths by the end of the the day. I think my wound was small so I didn't need the whole package, I'd just put a gaze pad to cover it, for the discharge and blood. So I didn't need help form anyone for that...
Some people get antibiotics prescribed, I haven't..

Hi if you need to know anything about fistula surgery just ask I have had 10 surgeries in the past 18 months latest was reversal of a ileostomy and that was just one week ago. I have a very stubborn fistula that just didn't want to heal. Go back to my Dr next Tuesday praying all is over with.

Thank you! My surgery is tomorrow...looking forward to getting it over with. Best of luck at your next doctor's appt!

Keep us updated on how it goes

So the surgery seemed to go well -the CSR said it was a superficial fistula and she did not have to cut muscle, but that she did make the incision deep so I should expect to be sore (and I am!). No antibiotics here either. The only thing worrying me right now is I haven't had a BM yet....which is very unusual for me. I know with the anesthesia and pain meds, they are probably stopping me up - so I have been taking stool softeners, eating fruit, drinking apple juice, etc. Still haven't gone yet. Thought for sure my cup of coffee yesterday would do the trick but nothing....so enjoying another cup this morning and as much as I'm dreading it I hope I go soon. I finally got all the packing removed last night after my last bath - I thought I had removed it all but there was still some in there.

I did notice bright red blood this morning when I got up - not a lot, but the doc did say some bleeding and discharge was to be expected so guess that's okay. I've been taking the baths 3x a day as instructed and also sitting on a heating pad which has been my go to before the surgery to help with the pain. The doctor suggested I use these "B-Sure" pads (they are kind of a butterfly shaped gauze pad) and to put a tucks pad on top of that and use that to cover up the area.

I had a sentinel pile near the fissure prior to the surgery and now I have what seem to be two large "bumps" down there - not sure if they are external hemorrhoids or some kind of swelling? I've also noticed some muscle spasming which is painful. The doctor did mention that we will probably still need to do Botox in the near future to help the fissure heal.

Oh one more question - have any of you used lidocaine jelly in that area to help with pain post-surgery? The doc Rx'd it for me previously to help with fissure. I forgot ask her if I could use it after the surgery to help with pain.

Hi there,
Glad your surgery went well. I had a very similar things happen. Got a fissure in June, botox in July, fistula developed in October and I had a simple surgery to fix it. (if you are interested I have posted about all this all over this site, lol)
I took off 2 and a half weeks from work. Unfortunately, I am still having some burning pain, it is nerve pain. My fissure is healed though. You will most likely be fine after this. Good luck to you! Hope this is the end of it all!!