Literally at wits end...

Chronic fissure

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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Literally at wits end...

Postby TheWeez » 31 Jan 2022, 10:13

Hi all, not exactly sure where to turn at this point. I was diagnosed with a fissure in April of 2021 and had surgery the very next day to fix a fistula and got a Botox shot for the fissure which did not work. After many months of suffering, I saw another surgeon that ended up doing a LIS on 12/29/21. At my four week follow-up, the doc said the fissure appears to be healing normally and that I shouldn't be experiencing much, if any pain.

I'm still in just as much pain as I've been in since all this started last March and don't know what to do. Advil seems to be about the only thing that helps with the pain. Hot baths are great while I'm in the in the bath. Starting to feel like death would be better than waking up to the same pain every single day. As a network engineer, sitting down is kind of my life and I haven't been able to do that for almost a year. Been standing up or laying down while working. Even laying down is painful.

I'd love to hear from anyone who's dealt with anything similar as I feel like I'm out of answers.
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Re: Literally at wits end...

Postby Rich44 » 04 Feb 2022, 14:01

That's awful to hear. Where do you live?
Fissure June 2014 - Oct 2020
Botox, skin tag removed - Feb 2015
Levator Ani Sep 2014 - Feb 2016 (left job, cured!)
LIS, skin tags removed - Oct 2020
Fissure 100% healed - Nov 2020
Still healed as of March 2024
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Re: Literally at wits end...

Postby avfissue » 06 Feb 2022, 21:02

Sorry for your pain! I’m 5 weeks out from LIS surgery and still very sore and have pain with my BMs. I’m waiting until the 6 week point before making an appointment.
I bought a make up mirror with LED lights on both sides, I use it to examine everything closely and it has helped me wrap my mind around things and keep things cleaner. I’d recommend it
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Re: Literally at wits end...

Postby TheWeez » 17 Feb 2022, 14:49

Rich44 wrote:That's awful to hear. Where do you live?

Sorry for the delay, I live in Northern Virginia, about 40 miles west of Washington DC.
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Re: Literally at wits end...

Postby Rich44 » 21 Feb 2022, 14:13

TheWeez wrote:
Rich44 wrote:That's awful to hear. Where do you live?

Sorry for the delay, I live in Northern Virginia, about 40 miles west of Washington DC.
Did you have a colorectal surgeon or general surgeon do your LIS procedure?
Fissure June 2014 - Oct 2020
Botox, skin tag removed - Feb 2015
Levator Ani Sep 2014 - Feb 2016 (left job, cured!)
LIS, skin tags removed - Oct 2020
Fissure 100% healed - Nov 2020
Still healed as of March 2024
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Re: Literally at wits end...

Postby posertiermadness » 07 Mar 2022, 21:01

Sorry to hear you are still suffering. I have been at that point of wanting to die, but fortunately a friend genuinely asked how I was doing, pulled me out of it. Not been that low again.

Remember, LIS did not heal the fissure, just makes it easier to heal. It will take time and it will get better. I have not had LIS yet, but just had my second exploratory in a year… “Looks like it’s healing” but doesn’t feel that way. My CRS does not want to do LIS, but I have follow up in 6 weeks if it is no better I think it is time. 4 years is long enough! (8 with previous anterior).

You are on the right road. Hang in there!
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Re: Literally at wits end...

Postby Thissucks08 » 28 Mar 2022, 14:10

How are you feeling now? I am 8 weeks post op and still not 100 % healed. My fissure is still there, but now my pain is where my incision is. My CRS told me 3 weeks ago "the incision is struggling to heal". He put silver nitrate on it. I feel some improvement but am terrified I will have this pain for the rest of my life.
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Re: Literally at wits end...

Postby posertiermadness » 28 Mar 2022, 14:46

@Thissucks08 You will heal. I promise. Keep everything dry and clean.

Get a bidet bottle (Home Depot has them in a lovely purple :roll: ) so you don't have to wipe other than pat dry (Don't spray too hard or pull apart to much given the wound).

Stay active (within reason). Don't over sit, spend the day lying down, or stand all the time. Sadly, your body will listen to you: The less you do the more pain you will get from doing very little. You may have a bit more pain from upregulating activity, but you'll either be moving up or moving down (Don't do or continue the latter). Avoid any strenuous activity (i.e., lifting, quick moves, etc.)

Very important to stay calm and relaxed, doing some mindfulness and making sure you are relaxing all those small muscles that surround the muscle out of your control. You may actually get increased pain twinges when doing so from allowing more blood flow into the sphincter, but this will bring more healing. I do yoga everyday, stretching without over stretching the surrounding pelvic muscles.

Metamucil. Metamucil. It may sound counter-productive, but you don't want cow patty waste (no matter how much this is the preference almost all of us have unsuccessfully tried). It moves way too fast and tears rather than allowing the sphincter to slowly open for bulkier (yet soft formed 1/2" to 3/4") stools.

NEVER NEVER PUSH! For now (and maybe forever), you are better off having slow moving softies. You will literally feel full of $#!t. Remember, you have likely kept things soooo mushy that you are no longer used to the feeling of a full large colon. As long as things are still coming out and remain soft yet formed, it will keep coming.

A good night's sleep. The internal sphincter generally relaxes when you sleep. Get a good sleep each night. Not sure what to say about sleep meds (They can be quite counter-productive due to tolerance and some find it worsens gut issues). Don't sleep too much because then you will not sleep at night. Naps will also likely interfere with nighttime sleep, but I've had many a chronic pain patient (I'm in a different area than this) tell me that a quick nap resets their daytime pain (probably the muscles relaxing). I do find a quick nap can help me on those tight/bad days, but a poor/disturbed (kids startling) nap can make my pain worse.

All of the above is my recent (relaxed) regimen based on my experience and professional knowledge (Again, sphincters are not my professional area of expertise). It seems to be leading to slow healing, but something always comes up (e.g., replacing toilet, damaged flooring, etc.)...Argh!

Hang in there. You WILL heal. And you have had LIS, so way less chance of recurrence!
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Re: Literally at wits end...

Postby Rich44 » 28 Mar 2022, 14:53

Great post posertiermadness! I tell people the same things. I used a water bottle like a bidet for years until I simply added a bidet to my toilet which I absolutely love. Try to minimize stress and anxiety, relax and never push/strain on the toilet. Avoid stool softeners and make sure they have plenty of fiber.
Fissure June 2014 - Oct 2020
Botox, skin tag removed - Feb 2015
Levator Ani Sep 2014 - Feb 2016 (left job, cured!)
LIS, skin tags removed - Oct 2020
Fissure 100% healed - Nov 2020
Still healed as of March 2024
Rich44
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Re: Literally at wits end...

Postby posertiermadness » 28 Mar 2022, 15:03

Thanks @Rich44 Just a heads up for others. I personally find I have less control over the (too high) pressure and direction (yanking cheeks when shifting) of a toilet bidet as well as a hand-held easily carried in a "man-bag" when needed. :~)
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