In August of 2011 I had my first experience with an anal fissure. I live in Chicago, I am a 45 year old male, and fortunately have access to good medical care. After a few months of topical treatments such as Nitroglycerin, Levsin and Nephedipeine not working I decided to have LIS surgery in November 2011 at the recommendation of my colorectal surgeon. I was extremely nervous about the procedure, so nervous I actually backed out of the surgery that day and opted to have Botox injections instead. The first Botox injection was initially successful and gave me relief for almost 1 year.
The next November 2012 I was back in my colorectal surgeons office with the same symptoms I had the year before. This time the plan was to have LIS surgery and I went through with it. However when I woke up expecting to have the LIS performed my surgeon opted for an internal Hemorrhoidectomy. My surgeon did not find a fissure while I was under so he opted to remove my Hemorrhoids. His thought was the Hemorrhoids were causing the spasms in my sphincter. He was wrong and I suffered with spasms for more than 9 months until I eventually developed another small fissure. At this point I should have seen a pelvic floor therapist; please read on to see why.
In August 2013 I again took the easy way out and I opted for Botox because I was still scared of the surgery and I thought my sphincter had loosened some since my first Botox injection plus I got a year of relief from my first Botox injection so maybe another Botox injection would cure. I was wrong, the Botox wasn't as effective the second time and I should have opted for the LIS instead of the Botox. The second Botox injection was my third time being put under and my second Botox injection only lasted about 5 months before my sphincter started going into spasm again along with external Hemorrhoids. I was in pain and I was so upset I felt like giving up.
I saw my colorectal surgeon a couple days later after the spasms started and I had LIS surgery a day later on January 17, 2014. Those of you afraid of the LIS surgery please don't be. The LIS surgery was a breeze compared to what I was experiencing pain wise. I had five fantastic days right after the surgery. Unfortunately on day 6 my sphincter started spasms again and I was back to taking Levsin and Nephedipeine. I didn't think I would ever be normal again. Things did start to get better after about three months and were really good for about 6 months. I was still using Nephedipeine once or twice daily but I was living my life until November 4, 2014.
On November 4, 2014 I went to bed feeling fine and was awakened in the middle of the night in pain and sphincter spasms; talk about depressing. I went back to see my colorectal surgeon in a panic and I was distraught. He said he didn't feel there was anything more he could do for me and referred me to a pelvic floor therapist in the hospital. I thought I was screwed to be quite honest. What could a therapist do for me that a surgeon couldn't.
Well I am happy to say after only ten weeks of therapy, one time per week I am feeling about 95%!!!!!! I am feeling better than I have felt in years!!! I can sit for hours, go to the gym and eat whatever I want. I still take fiber a couple of times a day but my life is back. When my pelvic floor therapist first saw me she said one side of my pelvic floor was much tighter than the other. My therapist showed me how to do about 6-7 different kinds of stretching and breathing exercises and used her finger to massage different areas in my colon internally. In my case I think my muscles were causing the fissures as opposed to the fissure causing the spasms.
I used this forum many times looking for peoples experiences that might help me so I had to comeback and post my success story and mention how much a pelvic floor therapist helped me out. Pelvic Floor therapists are a god send!!! If spasms are your problem I would highly recommend you get assessed by a pelvic floor therapist. My insurance covered the therapy in the United States.
2 Botox Injections
1 Internal Hemorrhoidectomy
1 Lateral Internal Sphincterectomy
1 GREAT PELVIC FLOOR THERAPIST!!!!