Hi, I'm new, and angry.
I've had an anal fissure for a little over a year now, and I'm very unhappy about it because I'm only 19, I feel like I shouldn't be having to deal with this :(
I never had any pain until this December, and even that was only annoying at best. Until then, I would have a mild amount of blood on the toilet paper a couple times of week, always painless. When I looked in the mirror I could see the tear, mocking me almost. For how visible it is i'm surprised it doesn't hurt more. I probably developed the fissure from pooping too much and wiping myself too hard with rough cheap toilet paper. My dad told me that he has experienced some blood on the TP from time to time, but never with my frequency.
I went to a doctor for the first time earlier this month (I know, I should have gone a year ago) and he looked at the thing for about 3 seconds before just confirming what I already knew. He told me that I shouldn't be worried about it unless it hurts me, gave me the contact information of a colorectal surgeon, and some steroid cream for my bum which I have yet to use. It doesn't hurt unless I have large bowel movements, and when it does it is never *too* painful.
I guess what I'm worried about is what happens next with my beloved fissure. Will it get more and more severe? Will I be limping around in pain, scared to death of the next time I have to poop? At this point I can assume the thing is chronic because I've had the visible tear for over a year, but what do i do?
I've never attempted any form of treatment other than putting some tea tree oil/vitamin E cream on the fissure (been doing this everyday for about 2 weeks now) and it has reduced the frequency of bleeding from 4-5 times a week to about 2 times per week. Despite this, there has been no visible reduction in the size of the fissure. I eat a good diet, no read meat, lots of stool softening salad and fruits, and no sweets, sodas, or fast food.
Should I call up the surgeon and try and get the LIS? Or should I try some other forms of treatment first? I'm worried that this thing will get severe, and I'm too damn young to be waddling around like a fool worried about the vicious nonhealing wound in my anus.
Any advice for me??
Thanks

It is a bummer that you are dealing with this at your age. The steroid cream will do very little for a fissure. Seems like that is the main thing GP's will prescribe.
I would say going to the CRS would be worth it since you have had the fissure for so long. The CRS will be able to evaluate if it is worth trying conservative treatments - ointments specifically for fissures, botox, etc. or if surgery makes sense.
Good luck.

Hey there,
Sorry you have a fissure but welcome to the forum. You are very young and I'm sure it's frustrating going through this. Unfortunately fissures can happen to any age group! They suck!
You are right about your fissure being chronic after a year and the likely hood of you healing it without surgery is very slim. You could try one of the ointments that are for fissures like diltiazem, nitroglycerin, etc... that you can get from a CRS. They are less likely to do anything but keep you more comfortable once a fissure becomes chronic.
I had LIS in October of 2010 and did very well. I am actually kind of pro-LIS because It gave me my life back... So I would say get the surgery since it's been a year already. That's just my opinion though :)

Thanks for the quick response guys.
My main issue with the surgery is the risk of incontinence and the fact that I would have to get it done over the summer because I'm in university now. Imagine having fecal incontinence starting when you're 19...! Not an appealing idea. I'm sure that I could get the surgery and be ok afterwards, but still, its a scary thought. I've never been under the knife before, and was hoping to not have to be for a long long time.
How fast was your recovery dawn?
If I did get the surgery it would be in early May, and I'll be traveling for the bulk of June and July so I can't be immobile.
If the fissure is benign and not getting worse is it all right to leave it there? My doctor told me that the risk of infection was super super low, that I would essentially have to go out of my way to get infected.

If you do have surgery make sure you seek out a well qualified CRS. The incontinence risk is very low and almost non existent with a surgeon that knows what they are doing. Also, I was told men have a lower risk also because the amount of muscle. The incontinence risk is what kept me from a LIS for years. I wish I would have done mine earlier.....
Letting it go isn't good. You will continue to build scar tissue which can cause stenosis of the anal canal. Skin tags/sentinel pile can develop which are painful as hell. I know right now you mention that is just bleeds. But it could move into the realm of being very painful in just one morning. The pain and spasms caused by a fissure can be debilitating.
Remember that going to a CRS doesn't automatically mean surgery. The choice is always yours and the CRS will help layout the options for treatment.

So sorry that you have to join this club at such a young age. Hope you will be able to see a good CRS.
By the way, I think that I have read here that hydrocortisones (steroids), if used over a longer time, can thin the skin and this isn't good for healing an AF (but maybe a more knowledgeable person than myself can chime in on this, since I'm not 100% sure...)

Hello and welcome,
You've gotten good advice already. The steroid cream is just junk and I don't know why so many general practitioners love to prescribe it. I was given the same thing the first time I complained. My advice is, throw it away. It won't help and it might hurt.
You should seek out a CRS definitely, especially since your wound never seems to close on it's own. You're going to need some help, and they are the only doctors who really know about the right types of ointments to prescribe.
Pauls is right, you don't want to let this go. I have, and I'm pretty sure I've got the big buildup of scar tissue that he mentioned. Now I'm certain I'm going to need the surgery and there may be more work involved than just the LIS. Botox might be an option for you and it's one that carries no risk of permanent incontinence.
Dawn's right too--fissures do suck--but this is a great place to vent about them and everyone here is so caring and understanding. When I got my first fissure I was only 28 and I lived in total denial for a long time. But it would heal up and go into remission for long periods, and every time it did, I thought I'd never see the little b****rd again. Then one day it came back, and it brought friends.
My point being, these things will get worse given the chance. Don't let the fear of incontinence stop you from doing something about this. I think the incontinence risk from LIS is probably overexaggerated.
Good luck to you!

nalad.ouch wrote:Thanks for the quick response guys.
My main issue with the surgery is the risk of incontinence and the fact that I would have to get it done over the summer because I'm in university now. Imagine having fecal incontinence starting when you're 19...! Not an appealing idea. I'm sure that I could get the surgery and be ok afterwards, but still, its a scary thought. I've never been under the knife before, and was hoping to not have to be for a long long time.
How fast was your recovery dawn?
If I did get the surgery it would be in early May, and I'll be traveling for the bulk of June and July so I can't be immobile.
If the fissure is benign and not getting worse is it all right to leave it there? My doctor told me that the risk of infection was super super low, that I would essentially have to go out of my way to get infected.

Hey there,
As Paul said you need to look for a well qualified CRS . That's the most important thing!!
Recovery times vary from person to person with this surgery. I had a skin tag removed with my LIS that formed because of the fissure, So it took me about 6 weeks before I wasn't sore at all down there. Most people who have straight LIS and have a pretty good recovery are able to go back to work at about 2 weeks on the average( from what I've read and the people I know personally). Some are quicker and some take longer...
I think if I hadn't had the tag removed, I would have definitely fit in the 2- 3 weeks felt like it never happened category....
The best advice I can give anyone is to pamper your butt for those two weeks, even if you feel like you could run a marathon! The surgery was really nothing for me. Living with the fissure was the hard part!
ps...
if it makes you feel any better, I know someone who was just a few years older than you who had LIS and he's fine. He fell into the 2 week recovery category :)

Thanks for all your replies again.
I guess I would have to devote a whole month to the recovery process then, so this would have to be done over the summer for sure. When you say 2 weeks to recover do you mean bed ridden for 2 weeks?
Another thing that worried me stiff was whether or not the fissure could be linked to some other sort of bowel disease, I spent so much time worrying about what was going on inside of me. I'm too young to be worried about a more sinister disease being the root of my fissure I hope.
I go to university out of my home state, so I'll have to schedule a CRS appointment well in advanced. I guess sooner is always better than later.

I personally laid around for 2 weeks because I wanted to give myself the best shot at healing with as few set backs as possible. I wouldn't say you'll have to lay in the bed for the whole 2 weeks but the less time you spend on your bottom would be the best. It's pretty swollen down there after the surgery.
As for the bowel disease, that's probably not the case. I know a million things go through your mind and you worry when something like this happens. I just knew I had colon cancer or something just because I seen blood from the fissure. Don't let your mind wonder. Fisssures are pretty common and that's probably all you got:)