I know this may be a bit premature since I'm still healing from my LIS from 5 months ago, but I'm doing really well so I'll go ahead...
HISTORY
I didn't realize this until recently, but I think I initially got my fissure about 8 years ago during a constipation/straining incident. I say this because my more recent massive fissure pain came on suddenly with no real reason, and I've had "butt problems" for that whole time.
Back then, I experienced some pretty bad pain and a little blood but it seemed to clear up after a few weeks. But after that, I had increasing hemorrhoid problems and "itchy butt" problems. And in the couple of years leading up to the bad problems, I would occasionally have massive butt muscle cramps during sex. These increased in frequency over that time. Additionally, in the couple of months before the big problems, the itchiness increased significantly. These symptoms have all gone away completely since my LIS.
THE WORST OF IT
When the horrible fissure pain hit (Edit: about two years ago), it had all the earmarks of a bad acute fissure. Passing stool was like passing glass, and the massive muscle cramps lasted all day, peaking about 4 hours after a BM. It took me a couple of weeks to get to see the Gastronterologist (GI).
GIs suck, by the way. That is the most important lesson that I've learned: GIs don't really know how to treat fissures. Neither of the two GIs that I went to even gave me a visual exam. If you get referred to a GI, please try to get a referral to a Colo-Rectal Surgeon (CRS) instead. Had I done that, I probably would've saved myself a years' worth of pain and suffering.
The first GI prescribed me analpram, but didn't tell me not to use the applicator. Analpram is not bad, but putting the stuff inside is apparently a no-no and probably ended up making my fissure worse (while masking the pain). A week or so after I quit using it, my butt muscle went into overdrive to the point of making it difficult to have a BM without lubrication. The second GI was never even sure that I had a fissure, and spent a lot of time prescribing me stupid worthless medicine. For about a year, the only thing that kept my fissure from being completely intolerable was using Prep H suppositories every night to make passing stool easier.
MY AWESOME CRS
My GI finally decided to send me to a CRS. Since the CRS that she usually refers people to wasn't on my insurance, I was able to do a little research on the ones that were and make my own choice. I have to say that I did an excellent job. My CRS has probably been the best doctor that I've ever had. She examined me and instantly knew that I needed an LIS, and scheduled me for surgery the next week.
She was overly optimistic about recovery time, as all CRS's seem to be. It took almost three weeks for me to be able to leave the house, and I've only been mostly pain-free for about 4 weeks now. That has been partly because of two healing issues: a really persistent granuloma that formed around my LIS site, and the fact that my fissurectomy site didn't seem to want to completely heal. After four months and many appointments (and uncomfortable exams), the granuloma was finally done away with with a combination of cauterization (silver nitrate), cutting, and scraping. The final touch was cauterization of what remained of the fissure, which hurt like hell for a few days but has definitely allowed for better healing.
NOW AND THE FUTURE
I still occasionally get some pain down there, so I don't really expect to be completely healed anytime soon. Luckily, my CRS says that the muscle strength down there in now "normal," so I shouldn't have incontinence problems. However, I still get a little bit of sticky drainage. I'm not exactly sure what that's about.
I'll probably stick closely to my current diet, at least until the end of the year. I've achieved consistently soft stool with a combination of a high fiber intake (35-40 grams) and lots of water (at least a gallon), and extreme moderation of alcohol and caffeine intake (Edit: I forgot to mention the colace and benefiber). The things that seemed to help most are my breakfast of raisin bran and yogurt and my afternoon apple.
I'm hoping to quit taking baths every morning soon, though, since they take a bit of time. I'll probably continue with the post-BM sitz baths for awhile, though. I don't know when I'll feel comfortable "cleaning up" by wiping only.

Hi William, I'm sorry it's taking so long to heal for you but I think the fissurectomy is hardest to recover from. I'm three weeks out from LIS, still healing but I feel like I have my life back at least. The day the burning stopped was exactly what I strove for but really didn't expect. I don't know how we live like this for so long! I know a week is hell but I did a year! There's people on here that had them for many years...we're a tougher lot than we give ourselves credit for, I think. Well, I'm glad you're feeling better and I know with time you'll have that sucker healed, keep up the diet though, I've been sneaking in some beef but I'm also having the apples and oatmeal, I'm not willing to take any big chances!

Thanks so much, William, for sharing your story. You are really helping a lot of people. You sure went through a heckuva lot! I'm sorry you're still having some pain and I really hope that stops very soon. I have no doubt you will heal, even though it's taking a long time. I'm rooting for you! Please keep us posted about how you are doing.

hi william,
i am happy to hear that your granuloma seems to have been resolved. i can't imagine what that was like and i think you are the first on the AF board to have reported this post-op side-effect, if we can call it that.
in any event, we have similar length of time in suffering and i really hope that we are able to look back on it and realize that the suffering, although totally unpleasurable and unbearable at times, that we can thank God that it wasn't anything worse as i am sure there are even worse things than this. if we have an amount of suffering to bear in the world and this experience helps us to "work off" some of that, then my seven to eight years of mental anguish, fear, and pain will have been accepted and offered up to the heavens.
i wish you continued healing.

Hi William,
Thanks for sharing your story, and I wish you all the best as you continue to heal. I was curious about something you wrote, that your CRS said that the muscle strength was back to "normal". Does that mean that when they perform the LIS, and cut the inner sphincter muscle, that it eventually grows back together, creating the possibility of yet another fissure (or the same fissure) forming because of involuntary muscle contractions? Maybe I misunderstood -- perhaps she meant that after cutting the muscle, she has created an environment that is more normal than it was prior to the LIS. I sure hope so -- I don't want my fissure to come back! :(

MattMecham wrote:I was curious about something you wrote, that your CRS said that the muscle strength was back to "normal".

I think she meant normal compared to the average person. She said that she would expect to see "normal" values if she tested it with a [some machine that tests butt muscle tone that I can't remember the name of]. Perhaps I was a tight-a$$ before my fissure and the LIS brought me down to normal(?)

Elphie wrote:I'm three weeks out from LIS, still healing but I feel like I have my life back at least. The day the burning stopped was exactly what I strove for but really didn't expect.

Glad to hear that you're doing well! Hopefully your recovery will be quicker than mine.

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I had simillar problem...
I first went to my PCP who told me that I have hemorrhoids.
I was like what??? I never had anything stick out of my anus..
Anyway, I listened to him and treated it with warm bath, stool softner etc etc...
Of course that did not work.
So I went back to my PCP and he did another visual exam but still says it's hemorrhoids. After another month without any improvement I got fed up.
So I demanded my PCP to refer me to a specialist. And this CRS only took a quick glimpse at my wound and said it's anal fissure.
So yes, it's really important to see right kind of a doctor.

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That looks suspiciously like SPAM to me. Hawk your cheesy goods elsewhere, please. If I am mistaken, then I apologize.