Hey guys,

23 year old male here. Underwent an open wound surgery for Pilonidal Sinus a year and a half back. Just recovered since it was quite a deep wound.

Noticed burning around my anal area around 2 months back. Around a month back, realized it's a fissure and took all possible measures (fibrous food, diet control barring any medication) to help it heal. It did respond well for 4 days, but one hard stool and symptoms recurred.

I visited the doctor who gave me stool softeners and a gel to apply on the affected area. The gel only worsened the burning and pain, but the softener worked. Been 5-6 days now and I am much better. Just a bit of itching and irritation but no persistent burning. Only bothers me if I sit upright for prolonged periods. However, a few questions linger in my mind:

- How high is the recurrence rate assuming I heal completely? I do seem to have some pelvic floor muscle tension which has gone undiagnosed for very long now

- Assuming I am off the stool softeners, what can I do to ensure prevent a hard stool doesn't reopen the fissure again?

- Under what circumstances (genuinely hope this doesn't happen since I have already been under the knife once!) will a surgery need to be done?

- How much does pelvic floor tension contribute to this? I have had this issue for 8-10 years now honestly but this is the first time I am suffering from a fissure

Also, how much time does it generally take for a fissure to heal completely?

Boy oh Boy, this is a LATE response to your question and I hope it finds you healed and well again. I visited this site in 2015ish and after my fissure healed fully (~ Jan 2017), I left it and never looked back again. This is how I feel most do with this site unfortunately. I had reoccurring fissures for years until finally a had a VERY large one from a huge hard bowel movement. The spasms lasted FOREVER! I did find value in this site, as a fissure sucks and is kind of private subject hard to talk with others openly about. I too was sole searching forever! All doctors wanted to perform SX but I relentlessly held on and it did finally heal. There was only one surgeon that told me due to my age (at the time was 44-45) he WOULD NOT touch me with a knife. The reason was incontinence. Most people he said experience that after Sx. I took that to heart and ran with it. Fighting to just ease the pain and use stool softeners and sitz baths. Eventually dilatation through a pelvic floor therapist. She help me learn how to fight the spasms. They were daunting!

"Reoccurrence rate": for me it reoccurred until the big fissure in 2014. Then after doing my protocol, it hasn't come back again...Thankfully!

"Assuming your off stool...": I was on stool softeners for sever years until it healed and continued for several months later as well. Once the fissure heals you have to watch your diet and pay attention to your body.

"Under what circumstances": Hopefully never. If you are young (ie under 60) you should do whatever you can to prevent the knife!! Typically this causes incontinence.

"How much time does it take..": That depends on how bad the fissure is. Spasms with a fissure are very debilitating and may take some time to overcome. Mine actually took me over 2 years! Most people don't have that much time off work or able to function with it. I was determined to NOT have Sx, so I endured what I had to until it healed. Go see a Pelvic Floor Therapist, and one that specializes in anal fissures.

thank you for your update and for the hope that natural healing is possible !

I saw few surgeons telling the same- that anal surgery is a very bad idea!