Hi Mr F
Yes as much as I would love to say that relaxation and mindfulness could cure a fissure...I have completed a hypnotherapy course and am starting a psychology degree...I think the best it could achieve is making you less stressed and hopefully thus relaxing your sphincter muscles.
I don't know I'm sure Botox must work or the NHS wouldn't really offer it as it's more expensive than the LIS think it's all dependant on the size of the fissure and your sphincter tone.
Good luck when you have your op I'm sure you will keep us updated on your progress.
Yes he's a great CRS and a truly nice man and I'm glad he's not just gone...your nearly healed women deal with it...lol

Thanks, mpb.

That's good to hear...and yep, I'll be sure to keep you posted on progress.

Cheers for lending an ear and your sound advice today...
Mr F

Hi MPB and MF,

I've been away from the forum for a little while and was feeling a little better but tore the fissure again yesterday. I was starting to think maybe I could avoid having the LIS, but I think it's more wishful thinking than anything else. I'm sure you know how it goes - when you're feeling a bit better you don't want to put yourself through it, but when it flares up again you want to have it done.

As I wrote a little while ago, I saw my CRS in January and pretty much bullied her into agreeing to do the LIS. It's a shame it had to come to that as I think I may have slightly soured our relationship with the arguing (not in an aggressive way, I might add). I haven't had the date for operation yet, but I know when it arrives I'll be focusing on it most of the time as the date gets nearer. As MPB has said to me, don't gauge everything by some of the difficulties some of the members have had on here with their LIS ops, as a lot of people stop posting as it's a complete success. You still worry that you'll be in that small percentage of problem cases, though.

I have to face the fact that unless I have less sphincter pressure, I'm always liable to tear at some point, even if I stayed fissure free for a while. For instance, this morning I bled again after a very full slightly bulky motion. I'm not spasming, but it feels sore and angry. There doesn't seem to be very much correlation between the food and the BM a lot of the time. I can eat something quite innocuous and I'll really suffer the next day.

My CRS wasn't super thrilled that I'd given up wholemeal bread and pear skins in favour of white bread and skinless pears and she also said I was having a low dose of Movicol (Miralax). That's all very well, but when I do up the roughage and the stool softeners, it sends me to the loo 3-4 times a day, producing stools with lots of residue - not pretty! I must admit I did something a bit stupid when I felt the fissure was clearing up and started eating biscuits and chocolate and snacking too much. I do eat free from biscuits, but I guess it's still dry. I also had several squares of Galaxy chocolate, rather than my usual Caramac (caramel bar - not really chocolate).

Mr F. Don't let your family decide what is best for you. I'm sure they're advising you out of love, but you know what you need and it's probably time to be selfish. My wife is very supportive and is happy with whatever I want to do. How I'll explain this to my 6-year-old daughter after the op if I'm incapacitated, I really don't know. It's not so much embarrassment, but I don't want her to worry about Daddy and get ideas it could happen to her. Awkward. Mr F., you say you're in your late 40s, I'm in my mid-50s, so I also don't want life to pass me by, especially with a young child. That damn thing is such life inhibitor - I love your 'do-it-anyway' attitude MPB. I just hope your situation rights itself in the medium to long term. If not, bully your GP and your CRS into the colostomy! At least with Crohns you have a fighting chance should this not give you what you need.

Huge hugs to everyone on this forum. We're all heroes in our own way. I can honestly I'd rather lose a finger and be cured of this wretched thing...and I'm a musician lol!

Hey banjo buddy - I'm in a similar situation as you - I have thankfully not re-torn my fissure yet, but my resting pressure is very very high and I'm in constant pain. Thinking also the LI S may be the way to go. Like you, my bm's are difficult to control - doesn't seem to matter what I eat.

Just so you know, I am trying pelvic floor physiotherapy to try and relax things down there - sadly it hasn't helped too much but I also have daily diarrhea so that me be why. It might be worth a shot to see a pelvic floor physiotherapist for an opinion on the surgery, even if to just confirm it is the right step to take.

Keep us all updated on your progress - these stupid things do indeed suck big time. It has changed my life, and not at all in a good way.

GG

Hi GG,

Funnily enough my CRS pretty much told me that my pelvic floor was messed up and out of sync with the sphincter. What I did a couple of years ago was biofeedback breathing techniques, suggested by my CRS. It does help a bit, but it's hard to get it to function 100% properly when you're tense sitting on the loo. I also use an IKEA footstool to raise my legs up. I guess it all helps a bit, but probably not quite enough to get shot of the AF and dodgy bowels. Like a few on here, I also have IBS and a high sphincter pressure of 120.

When I saw my CRS last month I kept on about a colostomy and she told me in no uncertain terms that she couldn't recommend it on medical grounds. Her analogy was it was sledgehammer to crack a nut. This is pretty much the mantra of all GPs and consultants that I've come across. It's a shame they see it from a purely medical point of view and not a life inhibiting one. After all, I believe not all colostomies have to be permanent, so they don't even have to worry about that aspect. My CRS warned me about things like hernias, but surely that's your choice. Having had a hernia and an operation for it, I'd happily have another of those rather than the AF any day. Sure it's painful, but in a different way.

GG, what do you eat to try to avoid tearing your fissure again? I was starting to vary my food a bit again, just to put on some weight. I was having spag bols, chunky chicken and a few other things. I don't think it was those that caused my relapse, but probably too much snacking. I've had a food fear for a long time now and was starting to get a little more confident and wham!

On a slightly different tack, I feel that although we have a number of options for dealing with AFs, the medical profession hasn't really come up with a great method of dealing with these damn things. What I can see in the future though is a total rethink about dealing with long term fissure problems. They can send you away with Botox injections, LIS and flap ops, ointments etc. but none of those actually address the fundamental issue of needing to use the loo and the associated possibilities for damage and pain. The only thing that really addresses that and lets the thing heal is a colostomy. Maybe they'll find a great healing solution or side effect free painkiller. Right now, I feel we're all at the mercy of a medical profession that really doesn't understand the consequences of a long term fissure and is more interested in protecting their own backs. Maybe a cynical view, but I've been down this road too often not to be cynical.

Hi Banjo n GG
I think the LIS would be a great option for you both such a majority of people recover so well after a few days they are back to normal after a few days.
My IBS is severe and not really controlled I want so much the week after the LIS that I don't think anything could have stopped the spasms. But the important thing is if I just go once I now have very little to no pain and even manage without GTN if I have a happy poop lol.
This is a sensitive area and if not given ideal conditions can take a while to heal.
As for a colostomy I wouldn't want one now with my pain as it is. It really can bring issues if it's own and many who have IBS have to get up 2/3 times a night every night due to gass. On good days I sleep straight through and wouldn't want to get up that often unless my pain was bad.
Yes I really think there should be something better lol

Hi MPB,

I'm glad you're seeing some success with your LIS. Ultimately, it doesn't matter if the progress is slow. The main thing is to get there in the end or at the very least have a more comfortable time of it than you had before.

My current fissure seems to be on the left and not at the anterior or posterior position. I know this can be a sign of Crohns, but I don't think it is that. All I know is that it's bled for the last three days and I think I'm going to have to go back to wholemeal bread, rather than white (grrrrr!). At the moment I'm not spasming really - maybe one or two brief spasms, but nothing persistant yet, although I know this can change.

I think my CRS is doing a closed LIS on me. She mentioned it takes a couple of minutes and is a quick procedure. She didn't mention stitches. I find it a lot easier to accept the surgery when the fissure is feeling rough than when I feel a bit better - it seems more justified.

Hi banjo
Yes I'm much better than I have been and do realise the importance of patience....I'm normally a very impatient person and if nothing else this fissure has made me be patient
I think for me at least the improvement will come when my bowel slows down...fingers crossed that happens sooner rather than later.
I had a closed LIS but I did have stitches so I think every surgeon has their own favourite way of doing things
The one thing I have had to accept is there will be no way I can return to how I was eating before the fissure...but hey ho
Agree with you that the more pain you are in the easier it is to accept the need for the op

Hi mpb and banjobuddy

Thanks for your messages and sorry I've not come back earlier. As it happens I've been having a better week and just trying to get on with life !

Sorry to hear you've re-tore your AF earlier this week, banjo, I know the feeling only too well, its so frustrating. Hoping its not as bad as first feared and you're on the mend again now...Do you have a date for your LIS?

As you both say, I think its only natural to feel like you need an LIS less when you seem to be making progress..! Saying that, I'm not taking anything for granted and still half expect the inevitable setback will be just around the corner...I've come to expect it now LOL.

I know my family want what's best for me, and to pave the wave for my likely eventual LIS, I had a good chat with my Dad this week, about why I feel I need an op. I think at the end of our conversation he understood a little better about how its impacted my quality of life in ways that aren't necessarily obvious at first glance, and says he'll talk to my Mum about it for me, so feeling pretty positive all in all.

MPB, sounds like you're continuing to make slow and steady progress, as you say, stay patient and I'm sure you'll get there in the end!

All the best
Mr F

Banjo buddy - I eat the low FODMAP diet for ibs. My digestive system has been out of control since I had a bug/antibiotics in December, but before that this is what i was mostly eating to keep things regular and soft:

- bananas
- peanut butter
- gluten free bread with 4 g soluble fibre/slice
- smoothies with iron vegan protein powder (all natural - great stuff, gentle on the tummy), banana, almond milk, maybe some strawberries and MIRALAX and METAMUCIL
- prunes in moderation if I was feeling backed up at all (rare)
- lots and lots of water

It took me a while to figure out a good dose of miralax and Metamucil. I started with a small dose in the evening and worked up until things were moving smoothly and it was effortless to go.

I had non stop diarrhea for a month from the bug, which no diet seemed to stop. Now I'm back on taking morphine for pain and I've swung the other way!!! Back to Metamucil and miralax for me. My system is so finicky - yours hopefully is a little less so!

mbp - how are you feeling?

I'm calling on Monday to book LIS! I'm actually looking forward to it lol!!