I have my surgery scheduled for this Monday which is a couple days away. I’ve had anal fissure twice now and each episode has been really bad. The first one occurred in April 2020 and the second one is happening to me right now. I am about six weeks in and the last episode lasted between six and eight weeks. The pain has been so unbelievably bad after each bowel movement which I do once a day in the morning. The muscle spasms are definitely the hardest part and they last for 3 to 4 hours each day and it’s excruciating. It’s impossible to focus at work and it’s really negatively affecting my performance. I cannot think straight when in pain.

I am using the nitroglycerin cream, MiraLAX, baby wipes with no additives, sitz bath, and Vaseline. I have use the Vaseline for several days after a post I read here with someone who had good results healing the fissure that way. The pain cream never worked for me and just made things worse. I’ve been trying pelvic floor stretches and sometimes they make the spasms better but they don’t go away. I have been absolutely miserable during this time and it’s hard to describe to people that haven’t been through it. Tell me the fissure feels like someone is taking a metal wire brush and pulling it in and out of my butt continuously!

Does anyone have advice for the surgery? Do you think I need pain medication or can I just use
Tylenol? I’m not supposed to take ibuprofen because of another condition I have. I am nervous about taking pain medication because I’ve never taken any and I’m worried about addiction factor. Plus my doc says they can cause constipation.

Is the post op pain as bad as the fissure and spasms? I feel like after that anything should be better by comparison.

Hi!
I haven't had LIS, but according to all the million papers and forums I've read, they give you painkillers.
If you can't take ibuprofen, you can ask for options. Tylenol might be one of them, but doctors know best. Just avoid opiates because they can give you constipation.
I'm really sorry that nitro didn't work for you, but I think you will be great and cured faster with LIS!
Please write your experience afterwards.

Yeah I definitely want to avoid the constipation from the painkillers. I wonder if using the Miralax and continuing with the high fiber diet will help counteract that. The nitro works better the first couple treatments but then doesn’t seem to be as effective with subsequent applications.

I’m really not that nervous about this surgery because I can’t imagine being in more pain than I already am. Maybe I’m taking it too lightly. My doctor said that the chances of this fixing the problem is much greater than not. He did say that they do not cut the muscle enough in cases where the procedure doesn’t work as well. Hopefully they get it right on the first try!
I was a bit freaked out at first reading the horror stories here, but as one poster mentioned, there are more likely to be horror stories and unsuccessful posts about problematic surgeries than successful ones. I will provide some updates post op.

"I’m really not that nervous about this surgery because I can’t imagine being in more pain than I already am."

BINGO!!!

You figured it out! I refused painkillers post surgery as I knew there was no chance the pain could be worse (it wasn't even close) during recovery. You can always get them if you need them later. Do more sitz baths which is what I did. My one year LIS anniversary is this month. I haven't looked back. Life is so good again.

Here's the big question. Why are you getting the fissures in the first place? Stress can be a likely culprit. I had major stress at my job that likely caused all my anal problems (it was a pain the A$$!). I left in January 2016 and have been really content (working remote from home or on long vacations is the best!). You might need to consider a job or career change. If you don't address the cause, it could come back. But that's just a theory. I have had a couple of minor fissures since my LIS but they were taken care of within a day without any pain or issues.

Rich44 wrote:"I’m really not that nervous about this surgery because I can’t imagine being in more pain than I already am."

BINGO!!!

You figured it out! I refused painkillers post surgery as I knew there was no chance the pain could be worse (it wasn't even close) during recovery. You can always get them if you need them later. Do more sitz baths which is what I did. My one year LIS anniversary is this month. I haven't looked back. Life is so good again.

Here's the big question. Why are you getting the fissures in the first place? Stress can be a likely culprit. I had major stress at my job that likely caused all my anal problems (it was a pain the A$$!). I left in January 2016 and have been really content (working remote from home or on long vacations is the best!). You might need to consider a job or career change. If you don't address the cause, it could come back. But that's just a theory. I have had a couple of minor fissures since my LIS but they were taken care of within a day without any pain or issues.

I’m not sure of the cause exactly but can remember at the start of each fissure a painful BM that was hard to push out and I started to bleed. It’s a possibility that stress had something to do with both long term fissures as there were stressful circumstances going on at the start of each.

I’m up late the night before surgery hoping that I won’t have to endure anymore 8-12 hour days of excruciating pain after tomorrow. I forgot to mention that I am getting a few skin tags removed as well while I am there.

The thing I am most afraid of is a new fissure or my current fissure being stretched and made worse when the surgeon opens up the anal cavity. I was examined last week and even when he pulled each cheek apart to examine the fissure I felt it tear more and the pain got worse for a few days.

I had my surgery today. The worst part was waiting to go into surgery at 1:30 and dealing with the pain and spasms for hours before. They gave me a muscle relaxer before going in and some Tylenol which helped some.

I got general anesthesia and a mix of sedatives before going into the OR. I woke up with no pain at all and was able to sit without having to wiggle around and constantly adjust myself. I started feeling a bit sore and the incision cut around 7-8 pm and I am just a little uncomfortable now at 11pm. I have been taking Tylenol and no painkillers yet. I was prescribed Oxycodone.

I am of course not looking forward to first BM tomorrow because I don’t know what to expect. I’m just hoping my spasms don’t come back!

Hi Crypto. I hope you’re doing ok! Well done for going through the surgery - how does it feel to be on the other side? I hope your first day is been comfortable.
I am having lis and tag removal in just under a month and feeling very nervous about it but figure if I’m going to be in pain (which I am every damn day) then it should at least be a healing pain.
Can I ask how long you had the fissure for? And did you just have lis or anything else at the same time?
Sending you lots of healing luck!!

Conifer wrote:Hi Crypto. I hope you’re doing ok! Well done for going through the surgery - how does it feel to be on the other side? I hope your first day is been comfortable.
I am having lis and tag removal in just under a month and feeling very nervous about it but figure if I’m going to be in pain (which I am every damn day) then it should at least be a healing pain.
Can I ask how long you had the fissure for? And did you just have lis or anything else at the same time?
Sending you lots of healing luck!!

Hello, I’m doing well on day 2 and have had only minor pain compared to before. I can definitely feel the muscle has been cut although it’s not that bad. I’ve just been taking Tylenol and no Oxy yet. I had this fissure start around the end of August and it’s gotten worse over that time. I just had the LIS and skin tag removal. I wonder if they can get you in faster? My doctor saw how bad my pain was and got me in under a week. That was good because I didn’t have a lot of time to worry and anticipate it.

Depending on which position they put you in during surgery, will depend on which airway they use for general anesthesia. If they put your legs in the stirrups, you get a mouth piece for oxygen. If that have you lay down on your stomach they put in an airway tube. I had the mask and the stirrups which was nice because I don’t like those airway tubes. I have to say I don’t regret it so far and this is the first day I have not been in tremendous pain.

I’m so pleased to hear this. It must be such a relief for you. I hope this continues for you. I guess you haven’t had your first bm yet as you didn’t mention it. I hope it all goes well.

And my CRS is hugely busy at the moment so looking at a 6-8 week wait regardless so getting in in a month is good. The NHS is on its knees just now with wait times and everyone is going private (which is what I am doing). Feeling a bit nervous though as I looked at mine yesterday for first time using a mirror and it’s really big - like an open sore. I think the sentinel pile is causing it the problem as it’s kind of connected to it so hoping once that goes and the muscle is relaxed things will ease. My pain fluctuates from a 4/5 -10 out of 10 all day every day so figure can’t be much worse than this.

Please keep updating on your recovery as I will interested to follow and see how you’re doing

Conifer wrote:I’m so pleased to hear this. It must be such a relief for you. I hope this continues for you. I guess you haven’t had your first bm yet as you didn’t mention it. I hope it all goes well.

And my CRS is hugely busy at the moment so looking at a 6-8 week wait regardless so getting in in a month is good. The NHS is on its knees just now with wait times and everyone is going private (which is what I am doing). Feeling a bit nervous though as I looked at mine yesterday for first time using a mirror and it’s really big - like an open sore. I think the sentinel pile is causing it the problem as it’s kind of connected to it so hoping once that goes and the muscle is relaxed things will ease. My pain fluctuates from a 4/5 -10 out of 10 all day every day so figure can’t be much worse than this.

Please keep updating on your recovery as I will interested to follow and see how you’re doing

My first and second BM was uneventful. I felt a little discomfort the first and almost nothing for the second. The Miralax and the doculax combined is working great. I do not even feel my fissure after the surgery. The other thing I have noticed is before the surgery when the muscle was real tight it was hard to pass gas. Now it’s super easy and doesn’t hurt.

Which country are you in? Do you have a national healthcare system?