Fellow Forum Members,
I had a spinctorotomy operation 3 years ago and this solved the problem with the painful muscle spasms. My doctor said the fissure would heal itself after the spinctorotomy operation. It's now been 3 years later and this demonic fissure is still causing me all kinds of pain when it splits open. It's a serious stinging pain that is bad but compared to the muscle spasms I had 3 years ago not that bad.

My question is simple. What options do I have to make this fissure permanently heal? I was told the spinctorotomy operation was going to make the muscle spasm pain and fissure pain go away. The reality is only the muscle spasm pain was fixed but the fissure pain lingers.

I'm meeting my doctor soon. What should I tell him to prescribe to me? Any opinion will be greatly appreciated.

Hi Matrix. I am not as knowledgeable as some on here but here is what I think:

Have you tried using some of the ointments that promote blood flow (Nifedipine, Nitroglycerine or Diltiazem)?

How are your stools (are they consistently soft)? Do you think you heal and retear or is it always the same?

Do you have a posterior fissure? Do you have any other issues such a pelvic floor muscle dysfunction?

Why do you think you are not healing?

My understanding is that when the LIS doen't work, advancement flap surgery is tried. There are a few on here that have had it done and would know a lot more than me. Hope your Doctor is able to provide you with some helpful information.

msimon,

Thanks for your post

The only prescription the doctor gave me after the spinctorotomy operation was a tube of compounded medication that reads "Diltiazem 2%, Bethanechol 0.1% PLO Gel". So to answer your question, I have not yet tried Nifedipine, Nitroglycerine. I have only tried Diltiazem. I went through 2 tubes of the compound medication gel and the fissure was in check for the first year after the operation. However, it's now 3 years later and it's come back with a vengeance. From what I have noticed the fissure is in a viscous cycle of healing and retearing. for the past two years. Due to no insurance I have not seen my doctor in these last two years and therefore have been without prescription medication. But due to the strong discomfort I'm paying him out of my own pocket to see if I could get stronger medication because this fissure stings like crazy when humidity is high down there. It makes one want to scratch the hell out of it.

As long is this fissure exists I don't think I'm fully healed. In short, I honestly think the spinctorotomy operation as 50% successful . To answer your question it's a posterior fissure located at 12 O'clock right before the anal entry point . I don't think I have pelvic floor muscle dysfunction because I seem to be have complete bowel evacuation. However, I do have days where I have some constipation.

My personal opinion is the sedentary lifestyle I have is what is preventing the fissure from healing. I'm forced to sit down all day at work. I'm sure this doesn't help.

I will be seeing my doctor soon. I plan to ask him about Botox, Nifedipine, Nitroglycerine and Flap Surgery.