Hi all. I was just starting to feel a bit better again. I didn't have pain during BMs just some spasm afterwards. I actually left the house to run a few errands even! But ever since I saw my CRS for a checkup I feel that both fissures are open again. It didn't really hurt that much when he checked but each day has gotten worse since. I feel the dreaded sharp pains during BMs even though they are soft Today I feel like a hot poker it being shoved up my butt! It is even throbbing and I haven't had that for months! I am so depressed I just don't feel like I can start all over again with this. I had a LIS booked for this coming Thursday as I also have an appointment to see my pelvic pain Doctor the following Friday. After reading all the scary post-LIS posts on here I thought I would try the botox again. The truth is though it seems that botoxing my pelvic floor only made the fissures worse (in fact, I got the second one shortly after) but yet botoxing my internal sphincter gave me bad urgency and aggravated my pelvic floor and I had to poop all day. I thought getting it in both would be the answer but I don't want to take all my support and continence away. I just don't know what to do. Even if the botox works it never lasts long enough for things to completely heal What should I do?

msimon, I'm really sad to read your post. I don't really know what is best, but since you've had so much botox in the past, wouldn't it be better to go for LIS at this point? It does sound as though pain is always going to set off your spasms, and the LIS ought to fix that. It's still the most effective treatment for fissures, by far. Hang on in there til Thursday. Can you talk to your pelvic pain Dr before then? They might be able to reassure you?
I hope you feel better, msimon, and I'm hoping and praying you can make the right decision for yourself.

Thanks Scientist. Well, today I bled. A streak all the way down my first BM. I haven't bled in months. I must have jinxed it by telling my CRS that. This fissure-business has made me superstitious. Could my CRS have damaged things in there but it didn't hurt at the time? Can't believe this! Well, I don't know what to do. Weird thing is that I am not that spastic today but sure feel like I need to BM alot. Usually the day after a retear is much worse spasm-wise. Has anyone ever gotten that gotta go feeling from a spasm? Don't think I emptied though as I was so anxious with the blood and all and I was very loose which is often tough to empty.

So my decision is either to try more pelvic floor botox or the LIS. I think the real trouble for me is while having a BM the muscles do not cooperate (probably the pelvic floor but maybe the sphincter also). I wish there was a way I could tell what needs to be loosened. With surgery being permanent I cannot afford to be wrong

Sorry for the ramble

I'm sorry you've had such a bad setback. When I went for my second opinion, she definitely made things worse for me. The poking and prodding caused my spasms to worsen. When they were at their worst I felt like I needed to have a BM all the time, too. I'm sorry I don't really have any advice, just hugs and support.

Give LIS a try! It eliminated my fissure, and although the first few weeks were rough, it was worth it. I think I was only out of work for less than a week and actually didn't use any pain meds. I used more pain meds when I had botox with a tag removal!

Thanks Guys. Your kind words are at just the right time. I would have tried the LIS long ago if I didn't have such a wonky pelvic floor/external sphincter. When I had botox into the internal sphincter I had to poop all day and my muscles would go crazy and try to hold it in even when it was "safe" to do so (and I sure didn't have much time to get to the toilet). This was not good for healing and not good for the psyche. But when I injected the pelvic floor with botox I tore a new fissure I seem to need to weaken both but then I feel to weak to even walk around! If only there was some way to know how it would go...

MM, the weird thing is that it didn't hurt all that much when he pryed but each day has been worse since. Weird.

msimon wrote:MM, the weird thing is that it didn't hurt all that much when he pryed but each day has been worse since. Weird.

It was the same for me.

Hey there, new to the forum. Just wanted to say i am waiting on LIS surgery approval from my insurance. Possibly in the next 2 weeks.
Im interested to know if it is the permanent fix the surgeon said it would be. Anyone know? Ive been dealing with fissures the past 3 months and its getting tiresome. Cant sleep, cant work, cant please my wife without pain in the aftermath. Im 34 and have a gardening business that is suffering because im not there. Need insight. Anyone?

Hi Suavecito. Welcome to the forum. There is no shortage of success stories on here following LIS. They do, however, have a large range in recovery times and pain afterwards, etc. You say you have been suffering for 3 month, what have you tried in that time (ointments to relax the muscle-nifedipine, nitroglycerine, diltiazem; stool softeners)?

Msimon, I havent been able to work since august due to burning, itching, inflamation, and pain. I went to the e.r. twice in september because i couldnt take the physical pain and inflamation anymore. I couldnt pass stool from the spasming anal sphincter and blinding pain. I didnt know what it was like to be constipated. I had no idea what was wrong. I had never had any health issues before so this was foreign to me.
First e.r. visit was useless. They tested, poked, and proded and said "youre constipated", take this suppository and see a GI dr as soon as possible. With no insurance, soonest appointment was 3 months away. I went back to the e.r. a week later because the suppositories were not working. They did blood work, ct scan, injected dye into my veins for the ct scan, i drank a half gallon of liquid solution for the xrays, and they poked my butthole. They said there were no signs of internal bleeding or hemorrhoids so i had to see a GI dr for a colonoscopy.
Immediately following that e.r. visit, I called the GI dr office where i had an appt in 3 months and demanded to be seen. I was given an appt the following morning. The colonoscopy was done 2 weeks later in late september (30th) and they found the fissures, 2 polyps, and diverticulosis. Biopsy results (Oct 8th) found polyps to be benign and follow up visit with the surgeon resulted in recommendation of another surgery to do LIS (lateral interior sphincterotomy). I was referred to another surgeon for that surgery and i saw him October 21st. According to this next surgeon, this surgery will "permanently" fix the interior sphincter muscle. The fissure causes the interior sphincter muscle to spasm and close in order to protect you from the pain of the fissure. This spasm also causes the blood flow to the fissures to stop and impedes the healing process. I am waiting on authorization from insurance to approve the surgery and i will be scheduling that soon.
My question now. Has anyone had this done and is it the permanent fix the surgeon said it would be? The surgeon said, you can live with and treat the flare-ups or solve the problem altogether. I dont want to put myself through surgery if I dont have to but i also dont want to live with this all my life.
Thanks