Hi All,

It is nice to find a place where this topic can be discussed. I have had hemorrhoid issues for a few years but about 3 months ago now I got the gift of anal fissure. It took me about 6 weeks to go the doctor as I'm one of those people who do not care for the doctor but the pain was flat out unbearable and I had no choice.

I was diagnosed with 2 large internal hemorrhoids and an anal fissure. I was issued the standard stuff I have seen others talk about on the forum along with Fiber and stool softner recomendation. I have had 2 doctor visits since then and while it has not healed I have been able to get the symptoms more bearable but the problem is still there.

I have about 1 bad day a week now but I am sick and tired of worrying which day it will be. The doctor has pretty much told me there is nothing else he can do and he does not think the fissure will heal and he strongly reccomends surgery.

I guess this is my question. I am 3 months into what I would guess is now a chronic fissure, what are the chances this will heal on it's own or do is it more feasible to try and knock out the fissure and the roids at one time under the knife.

As I understand it just because you have the surgery doesn't mean that you won't have another tear the next time you have a hard bowel movement.

This sucks I just want my life back without my butt being the center of it!!

Sorry you have joined us here. It's nice that things are getting better. If you have seen improvement but the fissure will not completely heal I would recommend Botox before LIS. IF the Botox doesn't work you can always have the surgery. I would also recommend that if you decide on Botox get a large dose, I would say over 50 units. Studies have shown people have more success with higher doses. I had three injections totaling 68 units, 30 on each side and 18 in the fissure. That was 3 months ago. My follow up a couple of weeks ago the doctor said the fissure was not completely healed but I do not have any pain, only minor discomfort. As for the internal hemmies I would leave them alone. They usually do not cause any pain, and do you really want a doctor to cut you in the area of a fissure. Not a good idea in my opinion. Good luck keep us posted.

Thanks for the advice Apes.

While searching the net I see botox mentioned but my CRS has not even brought that up as an alternative to surgery. It's just frustrating as I am a pretty active person and while intense pain is happening less frequently the discomfort is always there after a bm.

I may give it until the end of the year and see what progress it makes on it's own and then look to surgery or maybe even get a second opinion and explore what botox can do. My job is really busy the last quarter of the year and it would be tough to take off from work the 2 to 3 weeks the doctor is talking about after surgery. I'll be honest I don't look forward to needles or scaples being used anywhere in that region for any reason :).

it sounds like things are moving in the right direction. Did the CRS give you any creams, Nitro or Nifedpine? those are the first things you should be using before botox or surgery.

I got the Nitro and creams and have been using the Nitro but the cream actually caused me more pain than anything else.