Hello everyone. This has been a really helpful forum and I too have decided to share my own experience. Its been a long road for me. Not the worst fissure I guess, having read some of the truly horrific stories, but painful nonetheless.
I'm a 30 year old Male and first had my fissure about 5 years ago. Standard symptoms daily for weeks: Exceedingly painful BMs with slight amounts of fresh red blood seen in the stools. Had enough. Went to see my family physician and was correctly diagnosed with a posterior (6 o clock) anal fissure. Standard treatment - Dietary modification, GTN ointment and stool softener (over here we have Lactulose instead of Miralax). Fissure healed. Ecstatic. But recurred months later. Cycle of healing and tearing went on for over 2 years. Damn fissure just wouldn't go away! Had enough. Went to see the colorectal surgeon. Had a Lateral Internal Sphincterotomy (under GA). Proclaimed LIS as the gold standard for chronic anal fissure. Intra op findings were chronic anal fissure, exposing internal anal sphincter muscle. No sentinel pile. Anyway, post op and recovery were thankfully uneventful and the fissure completely healed in 6 weeks. No problem with the BMs till 6 months ago (i.e pretty much symptom free for 3 years after LIS) when fissure symptoms resurfaced. Went back to the same Colorectal Surgeon and he replied that it was ''exceedingly rare'' for an anal fissure to develop after LIS. Took a look and did a rectal examination with a proctoscope (literally died with the pain)! Imagine a metalpiece shoved up the ass in full sphincter spasm. It was so bad the scope couldn't go the full length and examination had to be half completed only. Told me couldnt see any fissures at all, but presence of piles. Prescribed me medication for piles and antibiotics for possible early perianal abscess. Wow. Took a week to complete all medication. Couldn't say symptoms subsided fully. Had enough. Embarked on quest to get better myself. Really watched diet, plenty of water, adequate fibre and all. Really got better. Happy. Till 3 weeks ago. Re Tore it after a large BM, accompanied by copious amounts of blood. This time was really bad. Avoided going to the toilet for 4 days straight with a liquid fast. Totally demoralised. Had enough. Went to see another doctor. And was given shots of Botox. This was 5 days ago. Currently feeling better, lesser spasms, lesser painful BOs, lesser bleeding. Will give update as I go along. Really considering a repeat LIS if this shit goes on. Enough is enough.
In summary, chronic anal fissure of 5 years. Treated with GTN ointment, LIS (once), Botoxed (once).
Thanks for reading and I sincerely wish everyone on this forum recovers completely.