Hey Davo,
I'm glad to see your LIS has been uneventful thus far. That's great news to hear. I am curious, what is the post-op diet that your CRS recommended and how long are you suppose to keep it up?
I ask because Im curious incase my diltiazem ointment doesnt work and I'll need LIS in the future.Second, I am currently dealing with a chronic fissure (anterior) that doesn't bother me at all except about once a month when things come out alittle hard and retear it. But even then I'm lucky that it isnt too painful and only bleeds slightly.
So Im trying to treat it as though I'm recovering from the operation and see how much it will heal or how permanent it will heal. I have curently upped my fiber intake, use the diltiazem ointment 3 times a day, and take a 1/2 dose of Mira a night for the last 2 weeks.

Hi Jax,
Good question!
What you must remember is that LIS does not repair the fissure. LIS actually relaxes the sphincter muscle which ultimately prevents the sphincter from spasming (this is the main cause of none healing fissures).
So basically once you have had LIS surgery you still need to heal the fissure and therefore you must keep up the fissure diet with lots of water, fibre and soft foods.
Once the fissure had fully healed then you can start incorporating normal foods back into your diet however it is still advisable to be cautious as a freshly healed wound can still be quite weak.
What diet are you currently following? Are you keeping things soft? Are you drinking lots of water?
With regards to healing times post-LIS this can be very variable depending upon the individual, my CRS said i could heal my fissure in 10-14 days however that was specific to me and not a comment in general. I think in general you should be looking at 2-4 weeks healing time however if there are other factors such as fissurectomy or hemorrhoids, etc. then healing can be prolonged even further
Davo

Ohh Sweet
You really are struggling with this soreness you poor thing!
Let me know how you get on - hopefully its just something silly and we can have a joint healing party!
Davo

Davo wrote:Ohh Sweet
You really are struggling with this soreness you poor thing!
Let me know how you get on - hopefully its just something silly and we can have a joint healing party!
Davo

Hi, Davo -
Just got back from the doc's office and got an encouraging report. This doc is a new crs (new to me, I mean), whom I really, really like. He's a folksy guy - very nice and seems to know his stuff. He's the guy I saw last week, too - in light of the fact that my other crs is overseas.
Okay - so, he took a very thorough look at me and said that things look good. He said my fissure area (including the fissurectomy) is 90% healed. The soreness I'm feeling is just tender skin, apparently just from not quite being healed enough, just yet. He looked fairly far back in there - and said that he did see some redness, but that the redness is the tender skin. He said that managing my bm's - to about the diameter of a large thumb size - is what I need to keep doing. He also said I should stay on the fiber supplements indefinitely. He can't see any evidence of where I bled (two weeks' ago) -- so, I assume this is all just a matter of giving myself time to toughen up down below.
The doc said that in some patients, the sphincter is smaller and tighter, which makes those people more prone to have a contracting sphincter. The LIS loosens that up - but everything still has to be managed with proper diet/bms. --- Actually, I don't feel half bad today -- so, for me, I just need a bit more time. The doc said to take half a valium and some Advil during the day, if I feel soreness.
So, my pizza-loving buddy, that is how my visit went today. If I can knock this soreness out and heal, I should be okay. . . . The big question is - Pepperoni or Canadian bacon?

Thats great Sweet,
I am glad you are well on your way now and its just a bit of tenderness causing you the discomfort. Hopefully with just a bit of patience you can heal this last little bit and have a pain free life.
Its probably a good idea to keep up with the fibre intake as your CRS suggested - my doctor said to me that if i maintain my current fibre intake i will reap the benefits in twenty years time from now.
As for the pizza suggestion.... NEITHER!!! I don't do Pepperoni and we cant get Canadian bacon here in the UK. Dominos do a Tandoori hot which is better than life itself however i am quite flexible when it comes to pizza providing it does not have Pepperoni!! Actually i am currently planning a pizza and Peroni lunch on my wedding day in Italy to keep the guests happy before evening dinner
Davo

Davo wrote:Thats great Sweet,
I am glad you are well on your way now and its just a bit of tenderness causing you the discomfort. Hopefully with just a bit of patience you can heal this last little bit and have a pain free life.
Its probably a good idea to keep up with the fibre intake as your CRS suggested - my doctor said to me that if i maintain my current fibre intake i will reap the benefits in twenty years time from now.
As for the pizza suggestion.... NEITHER!!! I don't do Pepperoni and we cant get Canadian bacon here in the UK. Dominos do a Tandoori hot which is better than life itself however i am quite flexible when it comes to pizza providing it does not have Pepperoni!! Actually i am currently planning a pizza and Peroni lunch on my wedding day in Italy to keep the guests happy before evening dinner
Davo

Will you have a "groom's" cake? My son, who's getting married in November, will be having a "groom's" cake. I'd like for it to be in the shape of an armadillo, with red cake inside -- but my son is on a certain diet, which is called the "caveman" diet, or some such thing. So, he does not consume sugar (nor do I, now).
I actually don't care for pepperoni, either -- it's a bit spicy, IMO. However, I love Canadian bacon (it's really just ham) and pineapple - or just plain cheese will do, too. --- Ya know, as long as my backside is happy, I'm happy. lol
Now, I have to ask . . . what is Peroni? I guess I should google it . . .

Ham and Pineapple - now you're talking pizza porn again...... ohhhh wonderful. I may have to give in this weekend and get my first pizza in a long time.
Peroni is Italian beer! It goes hand in hand with pizza!

Oh for goodness sake you two!
Sweet
Sounds as if you have had the conversation I had last week. Not quite healed on the fissurectomy site so still pain to be expected. Keep everything soft'n'smooth (which isn't a new type of ice cream), keep up the water & fibre intake.
I thought I'd be clever yesterday and not have my early ibuprofen with my tea & toast. This was a mistake as the pain did kick in quite quickly. It did ease off very soon after I was sensible. Got to listen to my body still.
Davo
I'm glad to see that you too are listening to your body. When did we all get so sensible? Oh that's right it was about the time we were all going to shut our hands in the door to take our minds off the pain in our bums.
Oh, oh I have to report the consumption of a couple of glasses of wine at the weekend - with no ill effects. So I'll be listening to my body on that score next weekend

Happy healing

lindwe wrote:Oh for goodness sake you two!
Sweet
Sounds as if you have had the conversation I had last week. Not quite healed on the fissurectomy site so still pain to be expected. Keep everything soft'n'smooth (which isn't a new type of ice cream), keep up the water & fibre intake.
I thought I'd be clever yesterday and not have my early ibuprofen with my tea & toast. This was a mistake as the pain did kick in quite quickly. It did ease off very soon after I was sensible. Got to listen to my body still.
Davo
I'm glad to see that you too are listening to your body. When did we all get so sensible? Oh that's right it was about the time we were all going to shut our hands in the door to take our minds off the pain in our bums.
Oh, oh I have to report the consumption of a couple of glasses of wine at the weekend - with no ill effects. So I'll be listening to my body on that score next weekend

Happy healing

Hi, lindwe -- So true! - We have to be mindful that things are still tender and have to be managed. My doc said today that I will have to be on some type of fiber (Metamucil, Konsyl, etc.) for the rest of my life. No prob - I just mix it with water, drink it quickly, and it's not bad at all. I also eat Fiber One cereal in the morning - and prunes at night. The doc also said that I might should cut the prunes out, if my stools get too bulky. It's a fine balance to keep, that's for sure. He actually asked me about my stool size - and I showed him (about 1 1/2" in diameter - sorry, TMI I know!) and he said that the stools need to be a bit smaller, and that I should cut out a little of the fiber.
Well. Anyhow, I hope you're feeling better. We just have to be careful and keep at it - the ibuprofen, etc. My doc said to split a Valium in half and take it during the day, if need be.

Davo wrote:Hi Jax,
Good question!
What you must remember is that LIS does not repair the fissure. LIS actually relaxes the sphincter muscle which ultimately prevents the sphincter from spasming (this is the main cause of none healing fissures).
So basically once you have had LIS surgery you still need to heal the fissure and therefore you must keep up the fissure diet with lots of water, fibre and soft foods.
Once the fissure had fully healed then you can start incorporating normal foods back into your diet however it is still advisable to be cautious as a freshly healed wound can still be quite weak.
What diet are you currently following? Are you keeping things soft? Are you drinking lots of water?
With regards to healing times post-LIS this can be very variable depending upon the individual, my CRS said i could heal my fissure in 10-14 days however that was specific to me and not a comment in general. I think in general you should be looking at 2-4 weeks healing time however if there are other factors such as fissurectomy or hemorrhoids, etc. then healing can be prolonged even further
Davo

Davo,
So i understand that the sphincter resting pressure goes down after surgury to allow the fissure to heal. I am using the diltiazem ointment cureently, which is suppose to do the same thing, so is the only difference is that the ointment doesn't lower it as much? And when everything is healed from the LIS, will the resting pressure be forever lower, or will it return to where it was pre-op?
I'm hoping that since I assume my fissure isn't too big or deep, (based on verry slight pain, very little bleeding, and only about once a month for last 7 months) a slight lowering of the resting pressure may be enough to heal it fully. It was considered healed in December by my proctologist, only to have it bleed few weeks later. I also didn't have the diltiazem ointment until 2 weeks ago. I wish my first proctologist has prescribed this on day1 rather than using suppositories and antifungal cream.
I am currently just being concious of what I'm eating, staying away from chips, fried foods, and breads...etc. I make sure to eat items with fiber, oatmeal or yogurt in the morning, I'll have a plate of salad for lunch or I'll atleast get something from the cafeteria that has a side or 2 of vegetables. For dinner I eat brown rice, a meat dish, and side of vegetables. On top of this I drink 6-8 glasses of water a day, I add about 6g worth or fiber from either metamucil or KONSYL, and for the last 2 weeks I drink a 1/2 dose of Miralax before I sleep.
Stools are still formed, not like toothpaste, but fairly easy to pass. I still have to push a bit, but nothing major in my opinion.
I guess Im asking all these questions because Im afraid of the LIS esp since the recovery seems like it will be worse than what Im going thru now since my case seems mild compared to most people on here. I have a followup appt with my new CRS to see if the ointment helped on April 17th. If not he says its either botox or LIS and he doesn't recommend botox. If I do need LIS, I wonder if he can make the incision smaller since my fissure doesnt seem too bad to speed up recovery and minimize the pain! :(