I had LIS in 2004 for a fissure. Did well until this past year. Had another small fissure that Ive trying to heal conservatively per my CRS. I saw him last 6 weeks ago. Thought I was out of the woods as I have been taking a dose of miralax daily and having BMs with no pain. Then last Friday I had my annual physical with my internist which include the ole prostate exam with the finger up the butt. He said he would be gentle and not fire up my fissure issue. It seemed to go well, the next two days I was fine, but then two days ago I had a BM that was a bit drier and firmer and I could feel that slight twinge in my anal area and the last couple days its been obvious that things have gotten all fired up again. I see my CRS again today, but Im wondering what my options are at this point. A year of TLC has not fully resolved the issue. WHat I would call mild stress to the area has caused things to go south again. I can't keep poking ointment up my butt the rest of my life I dont think. Am I looking at a second sphincterotomy? Do they really work a second time? The last thing I want is incontinence, I'm still to young and active for that. Sick n tired of this. Any suggestions or opinions???

Pokey

I have not had the LIS yet, but certainly been on the endless circuit of ointment up the butt all the time - so I feel you buddy, stay strong.

A solution that's discussed quite a bit in the forum is dilation. Have you looked into that?

Saw my CRS today. He says the fissure is healing but it tore a little bit from the recent trauma discussed above. Keep doing what I'm doing and hopefully will not need any surgery. I asked if I did need anything more advanced what would he do. He said dilitation and or possibly removing the skin in the anal area that has the scar tissue but his preference is to keep me out of the OR. So I'm to keep up the Miralax and the calmoseptine and hope for the best.

Ach - I hope things improve!!!

I was told by my surgeon (and it seems logical to me) that if after LIS the sphincter tone is still to high (or returns to a high tone years later, as can happen), then a second LIS (on the opposite side) is indicated.

So one thing would be to see if the sphincter tone is tight, at least then you would know if that's contributing.

I also find that all the creams etc can make the skin a little weak - I've used vitamin e oil often to help with this.

Yes he said things are tighter than normal down there even after having aLIS in 2004. But he did not think another LIS would be the recommended "cure".