This is a video of the doctor I plan on seeing at some point, she explains the procedure.

https://www.mydr.com.au/theBottomLine/v ... -dr-naseem

John there are two layers of muscle internal and external I believe and we control the external when we tried to prevent gas but the internal we don't control that's the bit that can always stay tight and that's the bit that's done that surgery on (internal) lateral sphincterotomy to permanently slightly relax it they surgeon only does a tiny cut it's a controlled cut and precise

Okaybum she's seems great it's a shame she's not in NZ I mite have to come to auz to get lis if one day I decide to bite the bullet and John she pretty much sums it all up if you want to take a natural stool softener try magnesium I'm take two capsules of magnesium oxide before bed every night it works great but I still need to not go crazy of bad foods I think my resent setback was from eatting pizza which for most is a no no and also having a few beers an a very late night that all mixed together caused me two days if hard stools so I'm back on track now I'm going to try really hard this year to eat right take my magnesium drink lots of water but not over do it get out for a walk everyday and get my second round of Botox this year sometime I would 100% recommend Botox before Botox a setback would cause me pain with bms and all day afterwards but since having Botox a bad BM causes pain or discomfort during bms for 2-3 days today is day 4 and my BM was painless so it was day one hard stool pain day two hard stool pain day three soft stool pain day four soft stool painless before Botox I would of been in pain for 10days so Botox has made setbacks short lived and pain discomfort during bms reduced drastically overall.

I take 150 mg. magnesium citrate every day + PEG + docusate sodium on nights when I take alcohol. I tried 200 mg. magnesium but it interfered with good sleep and there were strange effects as well.

There are plenty of people on this forum who complain that even after LIS they still had to keep taking softeners or laxatives and others who had re-occurence of the AF.
If I were a surgeon, which obviously I am not, I would never operate on someone who can handle the pain for a few weeks and try other methods during this time.
Finger dilation is not gross at all, you use latex gloves on which you cut all fingers and use one at a time. As opposed to anal dilators you can much better control the procedure with your finger.
And then, you have so many choices to try based on other people experience - maybe you find one which works for you. Example: Manuka honey, Dr Wheatgrass cream, zinc-oxide cream, coconut oil, Fissure control, etc, etc - plenty of choices to try. However, even this route has its risks: if you use creams/lotions for too long you might weaken the tissue strength and get fissures more easily. So you need to balance this as well. Start with one treatment, keen it for one month and see how it goes. Then stop for 2-3 months and try something else. It's a very long journey but you do not have to live with the stress of incontinence - remember, the older you get the more loose your muscles become, including the sphincter. A cut is a cut so if you do the surgery and feel good now this is no guarantee that when you get older you will not get incontinence.

Abu wrote:There are plenty of people on this forum who complain that even after LIS they still had to keep taking softeners or laxatives and others who had re-occurence of the AF.
If I were a surgeon, which obviously I am not, I would never operate on someone who can handle the pain for a few weeks and try other methods during this time.
Finger dilation is not gross at all, you use latex gloves on which you cut all fingers and use one at a time. As opposed to anal dilators you can much better control the procedure with your finger.
And then, you have so many choices to try based on other people experience - maybe you find one which works for you. Example: Manuka honey, Dr Wheatgrass cream, zinc-oxide cream, coconut oil, Fissure control, etc, etc - plenty of choices to try. However, even this route has its risks: if you use creams/lotions for too long you might weaken the tissue strength and get fissures more easily. So you need to balance this as well. Start with one treatment, keen it for one month and see how it goes. Then stop for 2-3 months and try something else. It's a very long journey but you do not have to live with the stress of incontinence - remember, the older you get the more loose your muscles become, including the sphincter. A cut is a cut so if you do the surgery and feel good now this is no guarantee that when you get older you will not get incontinence.

Thanks, I'll think about it. I like the idea of anal dilators as well; seems less gross than with finger. Right now even a finger wouldn't fit in. There are so many options available and none seem to work for everyone.

What do you mean by "a cut is a cut"; isn't an AF a cut anyway, with LIS or without?

AF is not a cut but a tear in the skin. An AF does not affect the muscle itself whereas an incision is done as deep as the muscle fibers go.
I will always regret taking the decision to surgically repair an inguinal hernia - this is also why I developed an AF in the first place as the antibiotics really wiped out my gut flora and made me constipated. Also, I have other symptoms which I will never get rid off - but this is not the place to discuss it. My point is, if you can try other methods do it or you may end up regretting all your life. If you already tried everything you can think of with no success then you can be at peace with yourself and try surgery as a last resort.
I still believe that medicine is advancing every single day and I am confident that in 5 or maybe 10 years from now new procedures or treatments will be availble for people suffering from this.
i have countless of example in other domains: look at knee or hip arthroscopy which were also considered "the gold standard" for more than a decade and now slowly but surely people realized that it is not the best option anymore, on the contrary.
Time will tell but if you want to keep your body intact, as God meant it to be, then you should do whatever it takes and go to any lengths to find relief and healing naturally.
Treat your body the way you want it to treat you and you will find the way to healing.

Abu how long have you had your fissure? And how log in did you start to find relief naturally?

I have it for 4 and a half years. The first 3 months were awful but I persevered and read about it for hours every day, trying to find solutions. After 3 months I slowly started to feel better but the fissure still acted once every few weeks. The first year it was like this, retears every few weeks but each subsequent one was smaller and easier than the previous ones. After the first year and a half I thought I healed and dropped my softeners completely, just like many people do. Big mistake. I suffered a retear which took weeks to subside.
Since then I take my softeners every single day and also drastically changed my diet to a healthy one. In the past 3 years I experienced setbacks only sporadically, once every 8 to 9 months and very minor ones. Minor means a drop of blood just once followed by no pain only small discomfort that day. That's it. I start with Manuka honey then for a few weeks just to ensure I do not develop a fistula as an AF, even small, can become infected.

And you only use magnesium citrate as a softener right?