Hi everyone,
I've had fissures on and off for over 3 years now. I manage my symptoms with daily Miralax, colace, fiber supplements and nitroglycerine cream. I've had botox twice (the last time was three months ago).
Overall, I'm better than I used to be. During the first 2 years or so of my fissure I often had bad pain after BM that would last for hours. For the past few months, things have been somewhat (but not completely) better. Pain after BM varies from none to moderate, and usually (but not always) goes away pretty quickly. So, I'm somewhat better, but still have some pain and bleeding sometimes. My life still revolves around achieving perfect stools. Although, I must say, things are not as bad as they used to be. On my last physical exam a week ago I was told that I have just one small fissure (where I used to have more and bigger).
I've seen three different CRS, and all say that LIS is the only thing that can help. One of the three says that it's really up to me, since my symptoms are mild enough to live with, and that there is some risk of reduced continence of some sort with the surgery which I can avoid by not having it. The other two just recommend the surgery in a very matter-of-fact way and say that it's very unlikely there will be any problems.
I have LIS scheduled for this coming Friday (I made the appoinment about a month ago during a stretch of more painful BMs) but am now having major doubts about going through with it. From reading this forum, I have the impression that usually people go for the surgery because of intense, incapacitating pain. That's not my case right now--I have intermittent, mild to moderate pain. Am I crazy to be considering surgery? Thanks in advance to anyone who can help!

Hey Mr.Fissure.
I just wanted to say IMO surgery is the best thing.I had LIS and skin tag removed and it's been the best decision I made. Wish I would have done it sooner.
Many people have good fissure days before their LIS surgery and have doubts, but you have to make the decision if this is something that you want to keep trying to heal on your on or just get it over and have the surgery which gives you the best shot at healing.
To answer your question , I'd think you were crazy if you didn't after 3 years,LOL.... But then again I've had a really good out come w/ LIS.
This is the way I looked at it when I wanted to back out:
If a doctor told me I had a 90% chance or more of having a better life after having any other surgery -would I do it?! My answer was yes.
Did I want to keep riding the rollercoaster w/ highs and lows of the home remedy game or do a surgery that they have been doing for eternity, because it works. My answer was yes again.
I kept telling myself the numbers are high w/ this surgery being a success and if everyone who had it had a terrible outcome and it didn't work then they wouldn't keep doing it and the success rate wouldn't be so high.
If people were all pooping on themselves after this surgery and not healing I truly don't believe they would still be doing it.
I had a surgery post on here but cancelled my page. It's under guest now but it was lis/skin tag removal on October 19th 2010.
I planned on not being back but when I read post in here it kills me not to respond because I know the fears and worries that come with this and It wasn't worth all I let it do to me. Like I said I wish I would have done it sooner:)
Take care.

Your story almost sounds like what I lived with for ~5 years. I got my first fissure in 2005. I got it healed to a point of some days I didn't even know it was there. But it was there since I had drainage and some days it would hurt like heck. All dealing with the number and consistency of BM. But it was never bad enough to side line me from my normal life activities.
I kick myself everyday for not going in for surgery sooner - 1 year of suffering probably should have been my limit. I lived for so many years letting the fissure control my regiment - diet, sitz baths, etc.
I was terrified about the incontinence issue - the main thing that kept me from surgery. It is very rare. Just make sure you get an experienced seasoned CRS and you should be fine. And my CRS told me the people that have issues already have some issue going on with the sphincter muscle - and they won't even offer the LIS if they thought incontinence was going to happen.
What pushed me over the edge was getting another fissure. I found I have an underlying issue(IBD) causing my fissures but they still treat them aggressively with the LIS when they are chronic. Plus the LIS now helps me heal them faster when I get a new one(happens rarely).
In the end though you need to feel good about your decision. Good luck.

mrfissure, if you're crazy then most of us were crazy before surgery :) I swear most of us, myself included, felt GREAT in the days leading up to LIS hahaha.
One a fissure is chronic, the level of pain tends to become much more tolerable. A lot of us put up with it for a while before pulling the trigger and taking the surgical plunge because the problem would never fully go away. I did that for a year before finally doing it and others have waited even longer.
I tend to agree with all of your surgeons: if the fissure has been around for a long time, then LIS is probably the only thing that will fully heal it. And it's unlikely that you'll have any serious problems afterward. Ultimately it is indeed up to you, though, and it'd probably be possible to simply live with the fissure too if you're leery of surgery. Sometimes they can develop complications like fistulas, but that isn't too common. Still, it's worth bearing in mind that there's risk either way.
If you have surgery scheduled then it's probably the right thing to do. I actually canceled my surgery two days before and then had it put back on the schedule lol. So it's normal to wonder if it's the right call. A lot of us wondered the same thing and most of us are happy that we followed through.

Hey guys, thanks for your advice, I really appreciate it. This is the only place in the world outside of my CRS office where I can talk about this! So, the consensus seems to be that I should go ahead with it already....But I'm 3 days from surgery now and still not sure if I'm going to do it. I had several very good, pain-free days in a row. Today I had a little pinch and some blood on the tissue, but pain was mild and only a couple of minutes.
I don't know what to do!!!
My biggest fear is incontinence. Everyone seems to be saying not to worry about anything long-lasting. I have run across a few posts on another board, however, where people talk about how after LIS they had a lasting problem with slight leakage for several hours after each BM. One of the three CRS I consulted acknowledged this kind of thing. While that's not as bad as incontinence of stool, I guess, it still sounds horrible to me, and I think I'd rather stay with what I have now than trade it for that. If you don't mind my asking, have you experienced anything like this?
Another thing is that besides the fissure pain I get with BMs, I have other weird symptoms--itching, a kind of poking sensation, sometimes a feeling of tenseness and pressure, sometimes pain when passing gas. These symptoms come and go and don't seem to be related to BMs. The CRS say it's all fissure-related, and nothing more sinister. Did you guys have anything like that?
Does all that go away eventually after LIS? Do you ever get to where you stop thinking about your butt altogether?
Thanks so much in advance for your advice. You guys are great.

Hey there,
All the other symptoms that you mentioned are fissure related. I had all of them and yes they do go away with LIS.
Mr.Fissure, I can only say LIS has been great for me and I think about my butt much less than I did before having it. I'm 8 weeks post-op today so I guess with time from the way it's going that I won't be thinking about my butt much at all. I believe having a fissure takes a toll on you mentally and that will all go away in time.
I know your fears, I've been there...Lis was much better for me than having the fissure. Only you can really decide if you've had enough.
I got to a point where I said "what do I really have to loose? My life wasn't getting any better without LIS.
Are there days right now that you aren't thinking about your butt?Lol .... The answer for me before Lis would have been No.
You have to read the positive and remember that the majority go on to have success after LIS and never post on the internet.
I read some horrible stories before having my procedure and I truly believe some may have a harder time but there are some people on the net, just like in the real world who want to milk things dry. Some want to look like a war veteran or something for getting Lis...hahaha!
Don't get me wrong I believe that some have problems and other medical issues that make recovery worse, but I had to weigh it out and believe I'd be in the 90 something%....
Good Luck with your decision. I know how scary it is! It was so much easier than I expected and gave me instant relief from my fissure pain.

Hey MrFissure, yep, aside from the in-your-face severe pain that any fissure victim knows all too well, there can definitely be other weirdness. If you've had a thorough examination (meaning anything from anuscopy to sigmoidoscopy to colonoscopy) and everything looked clear, then I'd rest easy that it's "just" the fissure causing problems. Mine actually caused back and hip pain after it'd been around for a while.
The risk of incontinence is real, but is extremely rare if we're talking about permanent incontinence of any sort. Minor short-term issues aren't as rare.
And yep, just about all of the weird feelings do eventually go away after LIS, at least for the vast majority of people. I think once you've had a fissure, you'll always be a little hyper-aware of your butt, so I don't know if one can say that you'll ever completely stop thinking about it. But to get to the point where you no longer fear it and can go eat your favorite foods without being scared that you'll have to pay for it the next day is very feasible and should be the expected outcome after LIS.

So, here I am, still undecided. Surgery is scheduled for this Friday. Saw the CRS yesterday. She says that she can see the fissure. It's still there even though I haven't had much pain from it for the last week or so.
She says she does closed LIS. No stitches or packing, just a cut into a small segment of the sphincter. She said that recovery will be far less painful than recovery from abscess drainage which I had once, and that I'll be up and around, able to go back to work, etc. after one day. I told her that I've read about a lot of patients who experienced more problems and she insisted that the way she does it, it's a minor operation and that people start feeling better than they did before right away, from the first BM.
I'm wondering, what do you experienced LIS patients think about this? Is the technique she's talking about less invasive than what some people have? Could she possibly be correct about how easy the recovery is?
I'm really agonizing about whether to go ahead or not. What she says is so tempting. I've learned how to live with the fissure, and I manage it fairly well most of the time, but I'm always nervous that the next BM could tear me open, and diet, hydration, fibersupplements, stoolsofteners, sitzbaths and creams are a big focus in my daily life. It would be great to get rid of all that.
On the other hand, I'm not that bad off. It's been a long time since I had bad pain--it's just that I can't seem to get all the way to no pain no matter what I do. The CRS makes it sound like this surgery is virtually guaranteed to solve the problem with almost no risk of problems.
I'd like to delay making a decision, but now is a good time for me to do it because I have three weeks vacation over the holidays. If I don't do it now my next vacation is in six months. (although the CRS says I won't need any vacation time, just one day for recovery).
Another possibility would be to try botox again. I had it in June and in September, and while it didn't make my fissure go away, maybe it's the reason why my symptoms have been less than before? (My current CRS doesn't like botox, but I called the one who did it for me and the nurse said they can try it again if I want).
I have to decide this today. Please help!

I have to be honest: I'd agree that LIS is indeed virtually guaranteed to solve the problem, but I think the estimate of recovery in one day is a total load of bull. As in absolutely ridiculous. I had "closed limited" LIS with no stitches or packing either and recovery was not a day. Can it happen, sure, some people are back on their feet in just a day or two. Is it likely to happen, no way.
Surgeons always tell people they'll start feeling better the day after surgery. That's true if you're in sheer agony like those with an acute fissure. When my fissure was young and at its worst, LIS recovery would be far preferable. But when I had LIS, my fissure was already chronic and not causing me that many problems, and the truth is things felt worse after surgery than before. In the long run the surgery was worth it for sure though. "Feeling better the day after than you did before" can be true if you were in a ton of pain before surgery, but it doesn't mean recovery is one day.
Personally LIS seems like the right thing to do if you've had your fissure for a while. But please don't expect to just bounce right back the day afterward. Hope for it, and maybe you'll be one of the lucky ones. But I'd leave yourself some flex as far as when you return to normal activities.
I don't say any of this to scare you. But the estimate just seems so laughable that I think a dose of honesty is called for.

hi mr fissure,
i am in your exact same boat and almost same time length in dealing with a fissure - mine was born in 2004!
was so close to doing an LIS in 2008 but my CRS at the time was super conservative and we went ahead with a colonoscopy to rule out other things.
from 2008 thru now, i have had a completely different life than what i knew from 2004-2008 with that fissure. i was no longer scared to go to the toilet, still had constipation issues that aggrevated the area and skin tag and well, i seem to have retore/disturbed the chronic fissure that has been mostly pretty good for these last couple of years.
to be honest, i haven't had the pain like i did before colonoscopy and i just dealt with the saga of the skin tag.
**
i have a female CRS who also explained that she would be doing an LIS from a very invasive approach and well, it sounded good to me on Monday and i said, yes. let's get it on baby.
for the most part, i function well. on occasion yes i have ass issues and those are the days that i just ask myself, do i really want to go on like this every year. my left knee is already going bad so i don't need to add on to other out of order things - let's hope i don't need viagra anytime soon! LOL.
so, despite functioning at pretty good capacity - and i even did so on my worst fissure days since i completed 3 marathons under the fissure days and i never was given these creams everyone puts on - so never could tell you what a cream headache feels like!
even through today, i manage my diet solely via eating foods that are right for me - no extra oTC fibers, stool softners, etc. i do keep some Vicks Vapor Rub on hand for Laverne & Shirley.
from what i have seen around here, it seems that the body and the ass get into agreement and start to behave well before LIS and play games with our heads on "am i doing the right thing?"
**
my biggest question going into the procedure is that i am hoping that despite all the irritation, pain at times, and worry, that i sincerely don't want to have brought on a new level of worse pain that i will have to live with moving forward.
it's amazing at what my body has adjusted to but also i know it somehow is wiser in knowing that this isn't a way to continue moving forward. having the procedure at this time seemed like it was all effortless and right. i can't explain it. but there was some level of calm and no freaking out like there was in 2008.
normally, i am a happy ass. i like my ass.
i just want it to be healthy and recover from the skin tag and fissure that is there, both of which i could easily continue living with but allowing to challenge me from time to time.
it would be nice to not have those challenges any longer.
**
now i can ask my CRS on f/u visit if what she plans to do is the 'closed limited' and if so, the Neuro, I am happy cause I certainly hope it avoids having all that packing down there like a stuffed turkey.
**
good luck Mr Fissure.
again if you want to cancel, you can. now is a good time.
i know some people who have done this and they later eventually had it done.
you have to feel that it is right for you.
as scary as it can be and as there will be variables not quite resolved - how much time to recover, will this happen, will that happen....every one will have a different experience.
all i know going into it is that i don't expect to be 100% for about 1 year. i don't expect to heal overnight. i don't expect to send out my ass on modeling jobs in a month. and it won't be walking down no Milan runway in six months.
i do expect to be patient, keep up a good diet, and attempt best to not strain for whatever, especially after surgery.
i know you are double guessing yourself because you feel pretty good. i do too. and it is a thought that i do have in the back of my head. but i have had plenty of great days, more than i thought i ever could not doing the LIS, but i want MORE!
and i really hope that is not being greedy or selfish. it's good right now. but you know, it can be great.