New guy with questions

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New guy with questions

Postby Josepagan » 20 Jan 2016, 08:23

Great to see all the good info here! I am mid 50s and dealing with AF for 8 weeks. Scheduled for fissurectomy next week, trying to confirm whether to do this or try more aggressive alternatives first. If this doesn't work, doc says there is a different surgery which i guess is LIS ?

I was given suppositories for 2 weeks, then 2 weeks of 0.4% nitroglycerin; no help. Admittedly I was not as consistent with sitz baths, but neither of two docs mentioned diet, other ointments or other options. SHOULD I DO THE FISSURECTOMY? Very painful for 1-2 hours after BM so suspect yes.

Sorry to be so long-winded. Any thoughts greatly appreciated! ! My problem caused by life long IBS, antidepressant and excessive straining. Thanks
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Re: New guy with questions

Postby Savaici » 20 Jan 2016, 09:05

Hi and welcome. The usual time period for using nitro is six weeks, and according to the literature the chance of healing is approximately 60 % if in the acute stage, which is just about where yours is. However, you have to be consistent with it (three times a day at least) and also Sitz Baths are a great help too... All to bring blood flow to the area which is what the anal fissure needs to heal.

Basically diet is good, but it is not truly going to change things, and common sense will tell you not to eat spicy food etc., and go easy on junk food. And not overdo the fibre.

If after that you feel that it's not working, go with the LIS. It is regarded as the 'gold standard' treatment. Most of our members heal with this, the majority, in fact.

There is a great search on here(not the one on the right, but top, between FAQ and Portal) where you can search by topic.

Whatever you decide, we are here, and feel free to be as long-winded as you like!!
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Re: New guy with questions

Postby Josepagan » 20 Jan 2016, 17:26

Thanks so much for detailed response! I failed to mention severe headaches from the nitro, and feel certain i couldnt do 3 a day unless I was off from work. So it seems i have to either go through with fissurectomy, which i have read is discouraged, or find a new doctor fast and do LIS. Thanks!
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Re: New guy with questions

Postby FissureFL » 21 Jan 2016, 23:39

Hi Jose...because you've only had your fissure for 8 weeks you might want to give the less invasive treatments more of a chance to work. It can take several weeks to feel better. When I first went to the doctor about my fissure (I had had it for many, many months) it took a couple of months to really "heal". There are other creams besides nitro that don't have the same severe side effects. My doc prescribed diltiazem cream which worked well, along with sitz baths and keeping the stool soft.

As for the fissurectomy, I had one this past April and it was the best decision I've ever made. I dealt with my fissure off and on for over 5 years. I would go many months with no issue but because it was chronic, it kept coming back. When it reappeared this last time, it would not go away and was worse than ever. My doctor suggested a fissurectomy which I was very scared of because I've read so many horror stories but I trusted my doctor. She told me that she prefers this procedure over LIS because there is no risk of incontinence (granted, LIS is small risk for this). I also had skin tag removal which I'd read so many terrible things about. Almost every post that mentions it says to not ever do it!! Anyhow, I can say with all honesty the worst part of the entire surgical and recovery experience was the nausea I had for two days post-op. The pain was NOTHING compared to the fissure pain and I never took any of the narcotics prescribed to me. I only took a couple of the heavy duty NSAIDS the first two days after surgery and then just aleve.

Both LIS and fissurectomy have very high success rates and a lot of times they are performed together. You have to remember that the majority of these surgeries are performed uneventfully and without complications. Point is, you'll find that the horror stories are disproportionately represented online so try not to overwhelm yourself with fear.
Good luck!!
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Re: New guy with questions

Postby Josepagan » 25 Jan 2016, 18:07

Thank you, that is encouraging. Right, it only makes sense that people drawn to this site may be those who have had less luck with AF treatment. Unfortunately, if i can't get IBS under control i cannot imagine that this wil not be a life long problem. Fissurectomy Wednesday, can't wait. Thanks
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Re: New guy with questions

Postby FissureFL » 01 Feb 2016, 19:01

Good luck! I hope all went well with surgery!!
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Re: New guy with questions

Postby Josepagan » 01 Feb 2016, 19:09

Thanks. I think recovery is as expected since a lot of pain and a little blood. 10 BMs last 3 days!! I think my IBS combined with constipating effects of Vicodin, then lots of fruit and fiber have me really screwed up. My 5 days is up tomorrow but no way am i going to work. Thank you
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