I had the classic chronic fissure symptoms since January. I had tried all of the conservative measures to heal it - coconut oil, proctofoam, anucort (I don't recommend the last 2 - I felt better but it made my anoderm very fragile), miralax and nifedpine. I came close to healing but it always came back worse it seemed. I was misdiagnosed by 5 different doctors as having everything from hemorrhoids to ingrown hairs. I had lost 10 pounds due to my restricted diet and I was getting desperate.
In June my general surgeon suspected anal fissures. I've never had a scope, I've only had digital exams. He referred me to a wonderful experienced CRS a few hours away. He diagnosed a posterior anal fissure due to the symptoms and recommended LIS and fissurectomy. I was devastated. I did not want to have surgery but I had run out of options.
I was beyond stressed out on surgery day. I was sitting in preop in tears. My surgeon made me feel a little better by telling me that the worst part of the procedure was the enema I had to take right before surgery. And he was right! That was the last time I felt the fissure pain. I walked to the surgery room and they had me lay face up on the table and then I was out. I had the general laryngeal mask anesthesia. I guess that's when they put a tube in your throat but I was out so I had no idea.
Turns out I had 2 fissures. An anterior and a left lateral fissure. The fissurectomy consisted of cauterizing both fissures to remove the chronic fissure and create an acute fissure. Then they performed the LIS to loosen my sphicter which was VERY tight and stitched it up.
My surgery was at 2 and I was on my way home by 4. I had no pain until the next morning but it was minimal and NOTHING compared to the fissure pain.  The LIS site hurt if I moved too much for about 5 days. On day 6 I didn't feel it at all. I didn't feel the fissure site until about the 4th day. And I only felt it when I had a bm.
My first bm was about 2 days after surgery. Unfortunately I had too many stool softeners so I had bad diarrhea for the first 4 days. I had bleeding and discharge for about 2 days and that was it. I guess it's normal to have discharge and bleeding for a few weeks though.
I was prescribed Norco for the pain but I tried to use ibuprofin instead. I felt the pain really wasn't bad enough for the Norco. Well my body told me I was wrong. I developed a fever on the second day. I thought it was much too soon to develop an infection. My husband called my CRS and a nurse told him it was because I wasn't taking the pain meds and my body was reacting to the pain. So I started taking the meds and sure enough the next day I was fine.
It took about 3 weeks for the pain to go away with my bm. I would get a slight pinch and burning pain at the fissure site. But I kept up with the stool softeners and healthy eating and sure enouh the pain started going away. Now I only have a slight burning/itching feeling during bm's.
I took miralax religiously since April. I recently stopped taking that and started taking 250 mg of magnesium oxide. It works much better for me. It seemed like my body was getting used to the miralax and it wasn't as effective as it used to be.
I had my 4 week checkup with my CRS and I was told that I am healed! The site looks a little raw but I have had tremendous healing in such a short time. I was told that since I don't smoke I healed much faster. I pretty much can eat anything. I still stick to my 2-3 liters of water and fiber but I can eat pizza or ice cream or whatever I want now. :)
If you are considering surgery please don't be afraid. Just make sure you have an experienced CRS. The pain is nothing compared to the fissure pain. It breaks my heart to see anyone suffering. The only thing I regret is not having this surgery sooner. I finally have my life back! :D
Thank you everyone for posting your stories. You have given me hope in the darkest days of my fissure. You help so many people more than you know! I hope you are all having a better day!

So happy to hear you are all healed, resume! Awesome news! :D You are incredibly brave to have gone through with it. I am also considering it if I can't heal on my own within the year. I am definitely scared out of my mind about getting it, though.
How much fissure pain did you have before the operation? Did you have bleeding and pain with bowel movements? Was recovery really difficult? I think the recovery scares me more than anything.

Thanks Luka! I know exactly how you feel. I was terrified too!
Before the surgery I only had pain with bowel movements and the pain ranged anywhere from a 3 to a 7 out of 10. After the bm the pain would be gone. I also bled a little maybe once every few weeks before the surgery. It wasn't much.. just a little blood in the tp when I wiped. I dreaded going to the bathroom!
The recovery was better than I expected. The pain was worse with the fissure than with recovery. It was very manageable with pain meds. I took maybe 1 or 2 Norco's a day for the first week.. even when I didn't need it because of the fever. The bowel movements were much better too because the LIS loosened up the sphincter. I never had spasms, my sphincter was just really tight all the time.
I really hope you can heal on your own! I tried for 7 months! Please don't be afraid of the surgery if you do decide to go through with it. I know.. easier said than done! It was seriously one of the best decisions I have made. And no matter what just keep in mind that there is light at the end of the tunnel! :D

Thanks for the reply, resume. Again, I'm so happy to hear you're healed and that recovery was not too bad for you. I just keep hearing horror stories about the recovery being worse than the fissure in some cases, so that frightens me a lot. I know others have tried to not take the heavy pain meds during recovery due to fear of constipation, but I heard it's best to keep on top of the pain at all times. I would guess a stool softener and good diet would combat the constipation side effect.
Did you use the enema at the hospital or at home? That scares me too. Never had to use an enema before. I know some surgeons don't even require it with LIS, but others do.

When my surgeon told me I had to have the surgery I tried to avoid the scary stories. It is possible for things to go wrong but I think as long as you have an experienced CRS and follow the outpatient instructions the benefits outweigh the risks.
I used the enema at the hospital and it was not fun. The application wasn't bad but the bowel movement was quite painful! I had a fissurectomy too so maybe that's why I had to do it. One of my fissures was pretty far up.
Are you using any of the creams - nifedipine or nitro?

Did you get an exam with an anoscope before getting the surgery? My CRS couldn't even do that because I was so tight (probably due to being so nervous) and was in too much pain. My fissure is inside and I can see the beginning of it somewhat if I'm looser, but you can't see anything on the outside. I wish I could get a better look at it, but I can't and I'm scared of getting a scope because it might make it worse.
I'm currently taking Diltiazem. I have been using it since January. I keep using it because it seems to help the spasms, especially when they are the worst, and at least promotes some blood flow to the region. I haven't tried nifedipine or nitro. My CRS said they don't use nitro because of the awful headaches it causes.
Sorry for all the questions. I'm just trying to mentally prepare myself if/when I need to go the surgery route. And I agree, I think most people just post the horror stories online, which are probably quite rare with this procedure under an experienced CRS. I just like to look up peoples' experiences so I know what to expect should I need to do it.

You can ask me anything. I'm happy to help if I can. :) No I never had a scope for the same reasons as you... too tight and painful. I don't blame you for not wanting one. To be honest no one saw the fissure until I was in surgery.
I was on nifedipine. I think it's similar to diltiazem, isn't it? It helped me a lot too but whenever I went off of it the fissures got worse.
How long have you had your fissure Luka? Has it been almost a year?

I've had the fissure since last December. I developed it around Christmas and it was excruciating pain. It completely ruined my Christmas and I almost ended up in the ER. The pain eased over time with self-care and Diltiazem, but I still get flare-ups (not nearly as bad as the beginning, but still painful) and even when I don't have much pain, it still feels weird and I can tell it's still there. I told myself when I was first diagnosed that I would give this a year to heal on my own, but if it doesn't, I will research and plan for getting the surgery.
I'm going in to see a CRS again in a month (the wait list is long for this CRS since he's so popular). I'm scared about what he will say or do. I definitely don't want a scope in there. The last CRS I saw didn't do it, but this person is new to me (the CRS my doctor originally referred me to that is the most experienced one at the practice our of the 3 CRSs there). I don't think most surgeons will do the scope if you're in pain and too tight, though. I keep reading you should find the most experienced CRS to do surgery. I just hope he will be understanding and not cold like so many surgeons are out there. How did you like your CRS?

Your story is so similar to mine. I developed mine about a week after Christmas. It sounds like you're doing a lot better than you were. I've read many stories where people heal naturally in about a year or so. So there's still hope! :)
I had to wait 6 weeks to see my CRS. He was very nice and answered all my questions. He made me feel very comfortable with getting the surgery. I'm sure you will be in good hands with this CRS. I doubt he will make you get the scope if you don't want it. Funny thing is I wanted to have the scope no matter how much it hurt because I wanted to know for sure I had a fissure. But my CRS didn't want to make me suffer any more than I was.
I'm so excited for you to see the CRS. If anything he will offer advice and information about your situation that will hopefully make things better for you. I know it's scary not knowing what's next but it sounds like he's a good surgeon and this is definitely a step in the right direction whether or not you have surgery. :)

Thank you for the encouragement, resume. :)  I am still hoping to heal this without surgery. I know others on this forum have with time, patience, and a super strict diet. It's just discouraging sometimes because I'm doing everything I need to do to heal this, yet I still get flare-ups for absolutely no reason.
Weird thing is that I didn't develop the fissure from constipation. I honestly have no idea how I developed it. Did you get yours through having constipation? I rarely ever get constipated, so that obviously wasn't the cause in my case. It could have been loose bowel movements from all the stress I had, but I'm really not sure. I know in some cases there's no clear cause of the fissure.
I'm so happy you found an understanding and nice CRS. They can be hard to find, from what I've read. I REALLY hope mine will be like that. I suffer from depression and an anxiety disorder, so I couldn't deal with a CRS that didn't care and just wanted to treat me like a guinea pig.
Thanks again for answering all my questions. :) You've been a great help and I'm so happy you're healed and don't have to deal with this anymore.