Hi Gang! I have been on this forum before...tried healing without surgery but three years later decided to try something after having periodic relapses (increasing in frequency). I am one week out from fissurectomy with botox. The surgeon is very well respected locally and I'm just hoping this might allow my fissure to heal.

My question is how to manage the lack of control with flatulance. This seems especially pesky after dinner (no particularly offending food). I already take one Prilosec a day for GERD. Any suggestions? I'm returning to the work place and I'm somewhat concerned about this as well as urgency. I'm thinking I'll just skip lunch, which can trigger an urge (or gas).

Just to pass along to others....I took off one full week from work (surgery on Monday) and wish I had the rest of this week to regain normal energy and figure this stuff out. I will have had about 10 days out of the office when I return. I meet with clients and my work is sedentary.

Any tips are appreciated!

First of all...love your handle. It's perfect!

Welcome back. Wish I had some advice but have none as I have not been through the surgery. Hopefully someone will chime in.

I am very very curious about your journey. I am 13/14 months in to this experience and wondering where this will go...will it resolve with or without surgery. No idea. I am wondering how you decided to finally go for surgery, how often and how bad were your set backs?

Would love to know how you are feeling and how the fissure and your rear end in general are feeling.

Thanks for sharing your story...and I hope you get some info from someone more knowledgeable than myself.

Only thought...play some music at your desk or bring in a fan to create some white noise and freshen the air if needed.

All best - Canadabum

Thanks for your reply. I will be posting in more detail about my journey once I am beyond surviving day to day! In short, I had some level of bleeding and pain/discomfort on about a monthly basis. I consulted a surgeon a year ago and decided to post-pone LIS. After increasing relapses (more than once monthly, weekly minor relapses) I decided to go ahead. The surgeon confirmed my own thinking...that the scar tissue was counterproductive to healing ('I can see the edges are curled in'). The symptoms impacted all areas of my life....work, walking/exercise, going to the bathroom (!!), so that is what finally pushed me over to try surgery. It hasn't been a quick fix but I don't believe there was such a thing for my chronic AF.....hopefully, one day.....I'll be thinking of something else!

I may try your strategies...at least in some situations!

I wish you well with your own struggles with this very bad condition!

This is an update. Post botox and fissurectomy (10 days post) I am experiencing urgency after eating. I can be half-way through a meal or 10 to 20 minutes after and I had better get to the bathroom. Near miss today after eating a small non-gas producing dinner. Some incontinence before I could get situated.! This is really a drag and makes me more anxious about returning to the office tomorrow. I wish more people had posted to give advice. Feeling I need to run out and buy some Depends!! I'll call into the surgeon's office to see if they have any advice.

Encouragement needed!!!

Sorry to hear of your distress but the reality is, I don't know that there is much you can do to change this situation. Botox injections are something we have absolutely no control over. The botox will weaken your internal anal sphincter and the sole function of this muscle is continence. There is not really any other muscle that quite does this job either. The up-side is that when there are incontinence issues, they are usually short-lived as it seems some other muscles must rebalance and make up for the loss somewhat. If they do not, take heart that botox is temporary and at least the side effects will not be forever, like it is with LIS.

I have had botox many times and found the whole experience humbling. I learned to come to think of those things as just bodily functions everyone has. I did have some depends on hand when I got my LIS as I was prepared for the worst. Sometimes that is what it takes to heal these damn things. Are you at least having some symptom relief? Do you think you are healing?

Thank you so much for your response! After an episode of urgency/incontinence last evening I went to choir practice (warned the director I might disappear with no notice) and then had a full day of work today (exhausted). It was so, so difficult to trust my body. I didn't have/wear Depends but I am planning to get some in case. I just checked every hour to see if I needed to go (which I did twice during the day). It has been really stressful.

You asked about relief from symptoms.....my BM's have been basically pain-free....slightly uncomfortable but not the pain (I assume due to spasm) of days/weeks/months past. The area is still sore from surgery and definitely an issue with trying to clean up after a BM. So some positive effects along with very disconcerting 'side effects.'

Just trying to remain hopeful.

Thanks again for your kind reply!

You are very welcome. I'm so glad to hear you are carrying on with life, even with your fears. I became a recluse for a long while as I dealt with these issues and feel like I lost so much time (life is already so short!).

There is no shame in all this. We are all human and we all poop and fart. This all has given me perspective. If it comes to Depends, so be it. It's short-term.

That's great that you are having a relief from the pain. A strange trade-off, I know, but a necessary one. That spasm is what was preventing the healing so this is very good news.

Your botox effects should peak at about a month. I always noticed the biggest difference around the 2 week mark, but everyone is different. Keep us posted on how you are doing.