I shared this story as a story of hope. A story with a happy ending. Although it was awful along the way. And almost everything that could have gone wrong did go wrong. And as an aside was not too long ago that I was up all-night reading forums like this. And I really think a post like this would have made me feel better.

As an interesting aside I think I have especially good insight into the medical system. I am a surgeon.

My fissure story began in July of 2021. I went on a backpacking trip to California. I got super dehydrated and had a traumatic bowel movement. That's where it all began. I subsisted for approximately 18 months. I would have a traumatic episode. I would get fanatical about my diet. Eat ungodly amounts of fiber drink incredible amounts of water and it would heal. And then it would recur. The cycle occurred about every three months.

Eventually it got to the point that it changed fundamentally who I was. I lost approximately 40 lbs. I didn't do the things I wanted to do with friends or family. It completely consumed my life and who I was. I didn't travel. I didn't have fun. My career suffered. It was awful. I simply barely lived from traumatic bowel movement to traumatic bowel movement

I tried everything non operative you could think of. I tried the calcium channel blocker creams (diltiazem etc). They did not do anything for me. I had at least 3 rounds of Botox injections. This is one I would strongly recommend against. They did absolutely nothing for my symptoms or my disease course. Botox only created pain from the injection. And cost a lot of money.

Eventually I underwent surgery in January of 2023. Approximately 18 months after the initial traumatic event I underwent sphincterotomy. I went to a fellowship trained colorectal surgeon. However, the story is not happy and does not end well there. In retrospect all I can tell you is finding a good doctor is not as easy as you think. And I am a doctor! But it is so critically important. And it comes down to more than just training. There are certain inherent abilities and skills which need to be present in a surgeon and I hate to say that not all of them have those skills.

As a surgeon myself I see this. Some people are just better than others at what they do. And the surgeon that I initially found wasn't as good as the surgeon that I ended up with at the end. This is a cautionary tale. Ask the surgeon how many they've done. Read their online reviews. Try to be as informed of a consumer as possible when deciding who you're going to let cut on you. Bottom line is I made a mistake this forst go round.

The bottom line is my initial surgeon didn't do a good job. They did an inadequate sphincterotomy. They simply did not cut enough muscle. In doing so they simply created another fissure which was much worse than the initial fissure. The next three months were the worst of the entire endeavor. Instead of living with one fissure I was living with two. One traumatic and one iatrogenic. The pain was excruciating. I was depressed. I didn't want to go on. My head went to some pretty dark places.

I finally convinced my initial surgeon to take me back and do an adequate sphincter release. Which they did. It was an amazing the difference. I had read on forums like this how well people did after sphincterotomy. And how they lived happy carefree lives. Which made it even harder to live with the situation after my first surgery when I was worse than before.

But after the second sphincterotomy it got much better. And it got better rapidly. But unfortunately, my story was not over there either. The pain had gone away. I was back to eating more normally. I was gaining weight.

About four months after my second sphincterotomy I developed a fistula. I think the fissure had been there for so long and as it healed sealed itself off with what they call a “keyhole” deformity. This resulted in an abscess which then evolved into a fistula. I went back to my surgeon. They blew me off. I literally had pus pouring out of my backside. And their recommendation was to simply soak in a bathtub. But as a surgeon I knew this wasn't right. And I eventually demanded that my surgeon to take me to the operating room. They relented and behold when they took me to the operating room they discovered the fistula they had been trying to ignore (either intentionally or more likely unintentionally).

They placed a Seton drain. I immediately felt better and over the ensuing weeks the infection cleared. But I knew it was time to switch surgeons. I knew it was time to find someone who would listen to my concerns and had the knowledge and skill to see me through to the finish line. I thank God that I found that surgeon. The second surgeon I went to was everything I'd hoped for. Everything I needed the first go round. They listened to me. They did a thorough exam. They didn't make excuses. They didn't try to convince me I was fine when I knew I wasn't. My first surgeon’s solution to everything was giving me as much valium as they could. I never even took that stuff. I hated it.

Regardless in December of 2023, 29 months after this ordeal began I went back in for my final surgery with this second surgeon. I had a fistulotomy. At the hands of this skilled surgeon everything was different. I had no pain after surgery. This was in contradistinction to all my previous operations where I suffered after the surgery or had some complication. Since this last surgery my recovery's been miraculous.

I am healthier now than I ever have been. Many of the habits I picked up as far as my diet have stuck with me. Yoga has been an outlet. I'm in the best physical condition of my life. I eat what I want. I travel. I work. I spend time with my family. I'm literally better than I was before this whole ordeal began. I appreciate feeling good, good health. I realize now these things are not a given and cannot be taken for granted. Time is precious .Which I hope will give whoever is reading this story new hope.

There is a light at the end of the tunnel. You can get through this! A couple of things I will say to you which I wish someone would have said to me early in this ordeal. Have the surgery. If your fissure becomes chronic and has been present for more than six weeks there's no question, have this sphincterotomy. Don't do Botox. Don't do creams. The surgery is the cure. And perhaps more importantly make sure you find a good surgeon. Just going to a colorectal surgeon isn't good enough. Ask them how many of they've done. Make sure you like them. Make sure they spend time with you and pay attention to your concerns.

I pray that you will one day be like I am now. I will never be the same after what I went through. But honestly it has changed me for the better. All I can say is hang in there. There is hope.

I'm happy to hear that things worked out so well for you in the end. I wouldn't agree that everyone should go directly to surgery though, because if a medical alternative works for them, it might be best to try that route first.

What an Ordeal! I feel for you,...literally. In short my anal fissure lasted two and a half years. Constantly living with pain is just so overwhelming. Various creams and 3 X unsuccessful botox injections, I too lost much weight and went in for a Sphincterotomy but came out with a Fistularotomy instead. Going to the toilet was agony for 4 days. I too suffered a deep depression as a result. Something I never experienced before. But thanks to a great surgeon I started on 20ml of Actilax every evening, no bread or cheese (particularly bad culprit) and eating more fruit and veg and making sure that whatever I ate had to be almost liquid before i swallowed. This was the cure! Never let your guard down though. LIfe is sooo good without anal pain. I hope you stay well and keep enjoying your pain free life.