How to escalate?

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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Re: How to escalate?

Postby chachacha » 16 Feb 2018, 17:49

I don't know if I would have done more than one, and it's amazing that you've had three!
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
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Re: How to escalate?

Postby patience_and_healing » 16 Feb 2018, 20:05

Hi Harper, if you're willing to reveal which state you live in then perhaps one of the forum members could suggest a doctor for you to visit. I'm personally not aware of how to get a committee to look into a case. It's also a good idea to get anal manometry done because after 3 LIS it should have reduced and based on that the doctor can decide future treatment. Ask your primary care for an effective non-constipating pain medicine as well.
8/16-12/16: Fissure due to antibiotics
5/17: Botox to sphincter, fissure healed
9/19: Trigger point injections and pudendal nerve block
11/19: Botox to pelvic floor
8/20: Botox to pelvic floor in new location.
On and off in pelvic physical therapy
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Re: How to escalate?

Postby Harper05 » 16 Feb 2018, 20:23

I am in Maryland, I will take all suggestions!!
I also had Botox in December and that didn’t work. I think I have asked about an anal mamotry before and he looked at me like I was crazy. But I will ask again, and for pain meds that are non binding. I’m currently looking into acupuncture.
I’m honestly lost at this point. The pain is severe and I feel like I have no answers.
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Re: How to escalate?

Postby Hopefull123 » 16 Feb 2018, 20:54

Just throwing some ideas to cover all possible issues
Have you had colonoscopy yo rule out colon cancer, anal cancer, inflammation, autoimmune disorder, crons, ibs, other GI issues
Have you gotten tested for yeast infection down there
Have you gotten a blood test for food intolerance which can cause inflamatipn
Have you tried gluten free, dairy free diet
Have you tried self dialation
Has the fissure healed
Is there scar tissue
Have you had pelvic floor physical therapy

These are things you can ask you doctor to run tests to go afyer the root cause. Sometimes we have to do the research and ask the doctors. I don't entirely trust them.
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Re: How to escalate?

Postby Harper05 » 16 Feb 2018, 21:12

I had a colonscopy 3 years ago. The last surgery my CRS tested the scar tissue for cancer and there was no signs of it. he doesn't think my fissure looks like chrons. I have had full blood work done.. nada.
I am a healthy mom in my 30s, i am very active, eat healthy- workout a lot.. you would never think i battle this issue everyday all day...
I have no tried GF or DF.. my doc says my diet has no effect on it? I am a VERY healthy eater.
self dialation, no?
Fissure has not healed.. still there.. and yes there is some scar tissue.. CRS has said fissure was about .6 inches.
have not done pelvi floor therapy - would that help??

Im desperate !!!!
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Re: How to escalate?

Postby Hopefull123 » 16 Feb 2018, 21:27

Believe it or not the most important aspect of healing a fissure is your diet. I suggest to rest gluten and dairy free, no rice, sugar, chocolate and other hardening foods. For 30 days all I ate was veggies, yams and meat, plus 500 mg of magnesium as a stool softener. This is essential not to stretch and keep tearing the wound everyday. Then when it heals a little, you need to address your muscle spasms. Obviously LIS did not work, but you can try pelvic floor therapy which teaches you how to relax yourself and your body muscles. Self dialation will get the muscles used to being stretched and not spasm. After your fissure heals, add psyllium husk to bulk up your stool and naturally stretch it everyday. But you need to close the wound. They should have done fissurectomy along with LIS to stitch the wound and clean up the scar tissue. Also coconut oil and castor oil suppositories help a lot as well as manuka honey inserted with a q tip. For additional info on these tips, read my previous posts because it's a lot of info.
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Re: How to escalate?

Postby Harper05 » 16 Feb 2018, 21:41

Oh wow!!! Thank you so much for this.
My diet is pretty much oats, peanut butter, vegetables, fruit and chicken.. I will cut anything out I need to if it means the AF will heal. I also drink coffee and cream.
I also take miralax and 2 colace.
Does pelvic floor therapy like physical therapy?
Thank you so much for all of this, did you do a lot of research when trying to heal your own AF?
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Re: How to escalate?

Postby Hopefull123 » 16 Feb 2018, 22:06

You can search by keywords here and get many posts related to pelvic floor therapy. They will lead you to the right exercises for your pelvic floor muscles, also there is biofeedback. Ask your doctor to assign you to a pelvic floor therapy and biofeedback. Search this keyword here to get info on how it's done.
I have experimented with sooooo many foods for 8 months healing and retaring every week because of a few bites of chocolate, cheese and bread, or yogurt. Many people also reported here that when they slip and eat a piece of pizza for example the next day the stool gets ever so slightly hard but that s enough to open the wound again. I ve read so many stories in different forums including in my country. I noted many similarities in diet trends, ointments and dialation and concluded that the best bet was a strict diet with absolutely no cheating for the first 30 days, then muscles treatment through dialation and stopping the laxatives so the stool can become firmer to get them used to being stretched. If you shield the muscles too long through laxatives they will never go back to its original state without being stretched in the proper way.
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Re: How to escalate?

Postby Hopefull123 » 16 Feb 2018, 22:12

One more thing, coffee is very acidic, in addition to your loose stools because of tje laxatives, the acid that goes out at the end will keep burning the wound and cause pain. I would suggest to stop the coffee for a while.
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Re: How to escalate?

Postby missy moo » 16 Feb 2018, 23:17

Just my 10cents worth coffee cream an any type of dairy can cause constipation for some people
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