31 y/o male. Considering surgery but scared

Going on 7 years of anal fissure...

Are you having, or have you had a Lateral Internal Sphincterotomy (LIS)? Please share your experiences here, or ask any questions.

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31 y/o male. Considering surgery but scared

Postby RushJet » 05 Nov 2014, 15:40

Ok, so I've been lurking here a couple weeks now and figured I would post and see what everyone has to say...

I am a 31 year old male and I have struggled with anal fissures since getting my first one in 2008. Out of nowhere, there it was. Since then I have had them more often than not. Using the restroom can be agony, but I am generally alright when I am not using the toilet. My doctor has thrown everything at me. Ointments that didn't work and caused extreme itching. Laxatives, fiber supplements, Botox injection... you name it. She checked me for Crohn's, did a colonoscopy, etc. My fissures are not in the typical locations, so she was concerned that they were indicative of something else going on. All results have come back negative. Apparently I am just cursed.

I am now, according to her, a candidate for LIS. I definitely want this situation resolved. I am self-conscious of my multiple and often-inflamed skin tags, and hate the anxiety of using the bathroom. A lot of you here say you are in constant pain, miss work, have spasms that last hours, etc. etc. I don't really have that. What I do have is a good amount of blood while defecating. The pain during this is sometimes manageable, but is often excruciation during bad flare ups. For the past six months or so I have had one major fissure on my right side, and a couple minor ones in some other locations. None of them seem to have any intention of healing. However, if they ever do, you can bet they will be back or return in a different location. I get tastes of relief once in a while and I think I am in the clear. Then the bleeding will return and I'll be back to square one.

Here is the thing that has me hung up: I am a musician. I tour. I play shows. I lift heavy equipment and perform on stage. My biggest concern is that something could go wrong with the surgery and put my passion and livelihood on the line. As of right now, and as of the past 6 or so years, using the restroom is hell, but aside from inflamed skin tags and some nagging soreness, I can generally live my life. I have read some horror stories about people living with fissures and I feel that, in spite of how long I have suffered, I don't have it as bad as some others.

I don't want to make the problem worse, but I am also ready to leave these issues behind if LIS surgery is the answer. After I had the Botox injection (which did not help me heal at all), I felt like I was going to wet my pants with every cough, laugh, or sneeze. This was a strange side effect, according to the doctor, and not one I would look forward to experiencing again on a permanent basis.

Sorry for the long post, but it's nice to find a community of people facing these same issues. Any thoughts, advice, or words of encouragement would be helpful. I am also in a position right now where my insurance would cover the surgery, so that is yet another reason why now might be the time to take care of this. I'm just kind of at a loss here. Are there others out there who have had fissures without a constant debilitating amount of constant pain who have had LIS and are back to normal?

Thank you.
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Re: 31 y/o male. Considering surgery but scared

Postby Scientist2516 » 05 Nov 2014, 16:55

Hi Rushjet,
welcome to the forum
:wel:
Sorry you have to be here.

Yeah, 6 years is a long time to have been struggling with this. LIS is scary no doubt about it, and while it's still the most effective treatment, there are risks from incontinence to infections. Probably the skill of your surgeon is a really important consideration. Don't be afraid to grill your surgeon about her success rate, infection rate and number of LISs she's done.

You've had a lot of tests done. Did you have your anal resting pressure tested? Apparently that's the best indicator of whether LIS is right for you. Not all surgeons do that test, but in your case, since you have atypical fissures and no clear cause for them, testing your ARP might be a good idea.

Have you tried a heat pad or hot water bottle to soothe your pain. It works wonders for me, and even aids in healing a flare-up. As a travelling musician you probably spend a lot of time in a car or bus, and sitting on a quarter full, not-to-hot hot water bottle can make that more tolerable. I take mine to bed and put it under my bottom while I sleep.

Good luck!
Nifedipine/lidocaine, no help
Diltiazem, effective, but caused major rash
Nitroglycerine, effective.
Topical estrogen for final healing.
Gentle heat to bottom - pain relief, muscle relaxant
Kondremul mineral oil
Time - lots of time.
Status - Healed!
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Re: 31 y/o male. Considering surgery but scared

Postby RushJet » 05 Nov 2014, 21:04

Yup. I have had the test and I had a high resting pressure. The doctor told me that it was indicative of a spasm related to anal fissure.
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Re: 31 y/o male. Considering surgery but scared

Postby Scientist2516 » 05 Nov 2014, 21:48

It sounds like LIS is the way to go then. I really hope it goes well. There's lots of advice here about how to prep for LIS, what to expect and how to cope afterwards during recovery.
If it seems like a lot of people had a bad experience, remember that people are here because they are suffering. The ones who recover easily tend to drift away from the forum and go back to their normal lives.
Keep us posted. Ask any questions you want to.
Nifedipine/lidocaine, no help
Diltiazem, effective, but caused major rash
Nitroglycerine, effective.
Topical estrogen for final healing.
Gentle heat to bottom - pain relief, muscle relaxant
Kondremul mineral oil
Time - lots of time.
Status - Healed!
User avatar
Scientist2516
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Re: 31 y/o male. Considering surgery but scared

Postby suavecito » 05 Nov 2014, 22:05

Hey RushJet. Im 34 y/o in similar situation. I just havent had as long of a battle as you. I do have pain and havent worked my gardening job in 2 months because of it. I too am a lis candidate and waiting for insurance authorization. I just started (yesterday) using an oil concentrate i bought on amazon to see if i can clear this up naturally. Its called forces of nature fissure control. I noticed it stopped itching real quick but im still hurting from the spasms and lack of sleep from the discomfort. I domt know if this stuff works but im willing to try. I used "burt's bees beeswax lip balm" because someone on this forum said it would help. That was the most blinding, burning pain i have ever felt in my life. I dont recommend that at all. Im just trying stuff to see if it works until the dr calls to schedule the lis. If none of these help, i think im going in for it. The success rate is in the 94-96% and i feel like the surgeon is the most important factor in the decision. Like scientist said, dont be scared to grill the surgeon on their ability and success rate. After all, you will deal with this for the rest of your life. Good luck.
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Re: 31 y/o male. Considering surgery but scared

Postby RushJet » 06 Nov 2014, 15:02

Well, my surgery is now scheduled for next Friday. I have a big enough gap in events where I feel like the sooner I do this the better. I'll keep you guys posted on how it goes as best as I can. Wish me luck!
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Re: 31 y/o male. Considering surgery but scared

Postby Savaici » 06 Nov 2014, 15:28

Good luck with it Rush! Let us know how it goes.
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