Hello!
I am new to this forum. I`m Lars a 28 year old male from Norway who has had a fissure since sep/oct 2007. My bum nightmare started in 2003 march when i had an outbreak off internal hemmies and a perinal abcess. The hemmies got treated with rubber band and the abcess developed into a fistula. The fistula didn`t botter me at all except for some draining but no pain. The doctor "blasted" the fistula open and let it grow from the inside out. I had a big hole in my ass but very little pain. After a month i was completly healed :)
Time went by and i continued to having internal hemmies. I think i have had rubber band treatment about 10 times. Complety fine after a day or 2.
But then in september disaster struck.. I thought i had once again gotten hemmies. But by the time a got an appointment with a CRS the hemmies where gonne. The crs said that i had av very tight tight anal muscle, something at i totaly agreed on. Agreed that i should have an operaton to make the muscle less tighter(LIS). By the time i waited to get the opertation i developed a chronic anal fissure. Finaly got an appoinment to see a CRS at another hoispital. He said that we should try Botox. I then got a botex injection in my ass. This was i november. Time went by an i was in terrible pain. Pain 24/7. Checkup in january was not good. I still had a very big fissure. The CRS suggested a second round with botox(dobbel dose) and a fissurectomy. It was a different CRS who operated me and he said if the fissure doesn`t heal up now we will just perform LIS and the fissure will heal. Fine i thought :) Checkup in march. The fissure had not healed and i was still in terrible pain. Then the CRS said that he didn`t know what else to do... I then got very sad and angry since the other CRS had said a totaly different thing! I wanted to have the lis operation. The crs said that it wouldn`t help me since didn`t have spasm by the day he inspected me. I find this very strange since i feel real tight down there. He more pain i have the more it thightens it feels like...
I have an appointment with the CRS who did the second round with botox(dobbel dose) and a fissurectomy tomorrow. I hope he agress with me on the LIS operation. Or else i don`t know what to do..... I am refusing to live like this the rest of my life. I have lost a lot of pounds since september and can`t work out.
What does spasm pain feel like? I feel like a knife has been stuck in my butt... I also have to push hard to fart. I didn`t have to do this before the fissure.
Any advice to a troublesome mind?
PS: I`m not so good at writing english but i am hoping to make myself understandable :)

sorry you're suffering! i'm sure you know this by now, but are you keeping your stool extra soft and going everyday?? it might help to take some kind of supplement or stool softener - miralax, milk of magnesia, colace, etc. Warm baths or heating pads can help with the pain too. Also, over the counter meds are good and not constipating.
i never had the spasm pain that everyone else describes, so i'm not really sure what that's like. for me it's burning, stinging, and sharp pain - basically HELL all day long after a bm.
Even though it feels like forever, it hasn't been that long for you and i'm surprised your dr is already giving up. he seems really insensitive. i hope the other surgeon agrees to at least give you the option of LIS. it's intended to make your sphincter muscle looser, so it should definitely help heal the fissure. a lot of people have success with it! in the meantime, try all the conservative measures to help you deal with the pain. this is a horrible thing to have to live with everyday and we have to figure out ways to cope with it until something can help us heal. i'm glad you've found this forum!

Lars! Your English is great-totally understandable so no worries about that!
Gosh, I feel your pain. Your story is so sad but you've come to the right place. We have all dealt with doctors, pain, treatments etc. One thing I wanted to ask is if you had used any of the ointments that are typically prescribed for AF like nitroglycerin or diltiazem (anoheal) or nefidipine. These are all blood pressure meds that are compounded into a petroleum base and when applied to the anus it causes it to relax so that more blood flow results and increased healing. I used diltiazem for 4 months plus took 3 baths a day and that was what got me over the hump.

I too have dealt with hemorrhoids. I just had a hemorrhoidectomy done in January that didn't heal properly and ended up abscessing and then turning into a fistula requiring another surgery end of March.

For me when I get a spasm, it does indeed feel like a knife in the bum, though not cutting, more like a pole or large stick.

I will be interested to hear what the doctor says about the LIS. I don't know why the other one dismissed that as a possibility. Seems like it could be warranted in your case.

I don't know if you have had a chance to look around much here but we have tons of threads with people who have gone through the same process as you in trying to figure it out.

Take care.

Lars,
I have only been in the group for about a month, so others are more knowledgeable to respond to you. I do think that I have had spasms and for me it feels like a very bad toothache in the butt. I don't know if that is a good description or not. I am currently using a cream which is helping me. I think one of the greatest things about this group (besides all of the good sharing of experiences/advice) is knowing that you are not alone. I have suffered with butt probs for a few years and only could talk to my husband and my mother about it. My mother had a fissure removed over 40 years ago and she is now almost 83 years old. Maybe it is genetic!
My Mayo CRS doc told me that fissures occur often in young adult males if this is any consolation for you. I hope that you find a treatment/solution to your problem. I think you can do a lot for yourself with diet and drinking lots of water. I am also concentrating on mind/spirit techniques as I feel that we are not only our physical bodies. I don't know that I gave you any good advice or not. It saddens me to see so many young people with problems such as yours, but evidently age is no barrier to such difficulties. Wishing you improved health.
Cheryl K.

Hello everybody.
Thanks for the advice and replyes :)
Lecia: I have tried the nitroglycerin for about a month. But it gave me bad headache so i had to quit. This was before my first round of botox. It didn`t see to make any differense.
I don`t know if diltiazem (anoheal) or nefidipine is availeble in Norway... I think it is just botox and nitroglycerin who is used.
Yes my CRS is very insensitive. I just hope the other CRS approves with me... I can`t force them to perform the LIS.. I need a doctor to belives this operation can cure me :)
Together with the shap pain i also have a constant "dull" pain. When I have a good fissure day and the sharp pain isn`t present the "dull" pain is always there.
My stools are soft and i go to twice a day so no problem there.

Lars,
I should have specified that I use the diltiazem cream and have been on it for a few weeks.
Cheryl K.

Hello cherylk
I to have been trying mind/spirit techniques. I go to a healer and and have been trying "reiki". The funny thing is that after they are done with me i no longer have the knife/sharp pain! Just the "dull pain" and the feeling that something sits in the anus(maybe it is a skin tag, hemmie og the fissure itself, i don`t know). This last until i go and have a BM. Then the knife/sharp comes back. I am thinking that maybe this is the spasm pain but it is relived by mind/spirit techniques until next bm. Does this sound natural to all of you?

I don't know that everyone can agree on what a spasm feels like but to me it is more of a involuntary clenching of the anal muscles. The pain could be experienced in different ways though.

Anoheal is available in the UK if that is ever an option for you. It doesn't have the side effects of headaches like the nitro.

I use alternative medicine to help control my pain like cranial-sacral, myofascial release and chiropractic. I am going to try accupuncture this Summer.

Lars,
This is such a small world! I am a Reiki Master although I do not practice on people. You reaction is not surprising as the MIND is very strong indeed. How we think we feel has a great bearing on how we do feel. I will try to send you long distance (very long distance in this instance) healing energy, which is very similar, I feel, to saying a prayer for another person. I still find it hard to understand why so many people who have no digestive problems develop fissures and other rectal ailments. Because I have IBS I guess I think most rectal problems arise in persons that have similar problems to mine. To improved health and well being,
Cheryl K.

Hi Lars,
Welcome.
Sorry to hear you are still in pain. The drs in Norway sound much like the drs in the US unfortunately.
Spasm=tightness of the sphincter. The tightness may be intermittent like twitching, but for me it was constant 24/7 clenching. The LIS definitely fixed that problem and immediately reduced the burning pain by about 80%. If you are having to push hard to fart or poo or if your anus is permanently tight, then your sphincter is in spasm.
I had botox too and that did nothing much to stop the spasm. I was too far gone by the time I got it.
Feel free to read more posts and show yourself around the board.
Chris