This forum is great. I read it a lot. Thank you for maintaining it. I hate that others are going through this, but I'm so relieved to know I'm not the only one. It's not a condition that is easy (or even possible) to discuss as you might something else.

This current fissure I've had since 2020. Been through all the usual non invasive - GTN (ok initially but limited use now), Diltiazem (rash!!!), marcogol and good diet (keeping BM managable but no fix and can be very hard to get balance right), sitz baths (minor relief and easier to keep clean but not a healing thing).
Beginning of last year had 100ml botox (okish, but no long term healing). Went to a 2nd coloractal surgeon as wanted 2nd opinion and she was far more proactive. She did rigid sigmoidoscopy, more botox, internal and external tag removal and fissurectomy - healing from this was quite painful, but got through it and thought things were on the up.
Nope!
Am still not healed, and now sitting here with what feels like a small shard of glass in my arse.
Am now waiting for another hit of Botox, but the wait will probably be a few months!!! So frustrating.
I'm in the UK and doing this privately as NHS wasn't even offered to me. And even going private is taking an age and not sure how I'm going to afford it.

Anyway, that's my rant. I'm sick of it beyond words. It's ruined my life.
LIS is off the table right now as I'm female and there is massive reluctance to do this surgery on females because our sphincter muscle is shorter than males and so the risk of incontinence is greater.

It's like being trapped. My life has shrunk, everything is dictated by this bloody thing.

I feel your pain and I am uk too.

I think I need a 2nd lis but male so can get it. To be honest, a stoma must surely be better than this???

Yes it’s rubbish and so stubborn about going away. It really dominates your life. Being scared of your daily BM is miserable. My pain I think is finally improving with just patience and living with it and accepting it. But it’s still up and down despite mostly perfect BMs. Eventually it has to go away surely??? My instinct is the more intervention the worse it gets. Unless you get LIS which is not an option for us females. Botox and Fissurectomy doesn’t seem to do the job sadly in most cases.

One thing I don't really understand about anal fissures is what they actually do and why they won't go away. My GP recently asked me to visit her surgery for a proctoscope examination, I duly went and the resulting diagnosis was that my fissure had healed and was no longer active, but could still cause trouble in the weeks and months ahead. I didn't get any further information about what this meant in practical terms. If the fissure had healed, why would it still be causing trouble?

Hazey123 wrote:Yes it’s rubbish and so stubborn about going away. It really dominates your life. Being scared of your daily BM is miserable. My pain I think is finally improving with just patience and living with it and accepting it. But it’s still up and down despite mostly perfect BMs. Eventually it has to go away surely??? My instinct is the more intervention the worse it gets. Unless you get LIS which is not an option for us females. Botox and Fissurectomy doesn’t seem to do the job sadly in most cases.

I feel the same, more intervention is a risk and can just make it worse. I need to try something because it’s come to the point where I can’t work long term and I am missing out on enjoying my daughter growing up.

Are you still dilating? I try but I can’t even get a finger up there

dmcff wrote:One thing I don't really understand about anal fissures is what they actually do and why they won't go away. My GP recently asked me to visit her surgery for a proctoscope examination, I duly went and the resulting diagnosis was that my fissure had healed and was no longer active, but could still cause trouble in the weeks and months ahead. I didn't get any further information about what this meant in practical terms. If the fissure had healed, why would it still be causing trouble?

I am jealous you can get a proctoscope up there!

At least your part way there? Spasms after it heals is not uncommon, I have read others with the same issue… I think they do fade over time

@fissuremanc I dilated religiously for 3 months twice a day. It was horrible and soul destroying to be honest. I persisted because I really believed it would help but it just made the soreness slightly worse. It was a total struggle to get the dilator in although I managed with serious breathing exercises. It did teach me the power or breathing for relaxation so there were some gains from it. It did not help the pain long term for me so I stopped.
@dmcff It’s a good question. My CRS says I look fairly normal and I need to go back to check if I am fully healed. I suspect that I am and my understanding is that the pain continues due to a form of chronic pain syndrome. The nerves in the area are ultra sensitive and prone to registering pain even post healing. Plus there is scar tissue and a risk of a re tear too. So I guess the issue can continue to be problematic for some time after.

I am trying dilation but it is almost impossible to get a finger up there. The internal sphincter must be spasming but the pain is low level at the moment.

How was your EUA? I have one coming up and I am terrified that will do a load of damage for little gain

Yeah my EUA was awful. The pain was worse after. Also the CRS diagnosed no fissure after the EUA. Then a year later another CRS said I definitely had a fissure!! So goodness knows my EUA was a disaster but possibly the CRS was the issue. Maybe discuss with yours exactly what will happen?? And your fears of extra pain following it. I didn’t do this and I regret it as I think if I didn’t have a fissure before my EUA I defo came away with one! It’s so hard to decide what’s best tbh….its important to know what’s going on but none of us want any more pain than we already have!