First let me say that I've been a long-time visitor to this message board, and I'm really grateful for this community. I made an account to share my experience with others who are also suffering from this cursed affliction. After living with a chronic AF for over 2 years I finally decided to go through with surgery and had the dreaded LIS done on Friday morning (2/18/11). I have to admit, my fissure wasn't really so horrible most of the time — though some days I'd call in sick from all the pain. I had learned to manage my discomfort levels pretty well through diet, fiber supplements, my biffy, baths, and physical inactivity. Despite being manageable, my AF was definitely affecting my quality of life. It took a major toll on my fitness, willingness to travel, and love life. I'm going back to school this fall, so I decided it's time to take serious action.
Just a little background — I'm a 30-year-old guy, and I've been vegan for about 10 years. I work an office job. About a year ago I tried nitroglycerin, and it didn't seem to do anything for me. Last fall my doctor told me that I had developed a "skin bridge" across the fissure that would need to be surgically removed, so botox wasn't really an option. Prior to the surgery I did a sigmoidoscopy, and everything else seemed okay. My doctor didn't require me to take any laxatives or enemas the day before the LIS. I thought this seemed odd, but I was happy to comply.
Day 1: The surgery itself was actually not so bad, since I was out cold. When I woke up, I just felt pretty numb down there. I came home, took a long nap, ate some dinner, and went back to bed. I was able to walk around my apartment and didn't really feel much pain at all.
Day 2: I kept eating a fairly normal diet (though very high in fiber). About mid-day I started feeling kind of bloated, but my digestive system wasn't yet awake enough to move things along. Before bed I felt like I was going to burst from gas build up, so I sat on the toilet and nothing came out except my gauze packing. I experienced an unbearable amount of gas pain, but I couldn't even pass gas. It seemed like there was a thick turd blocking the exit. I had a hard time falling asleep from the gas pain.
Day 3: The gas bubbles continued to grow in my gut. Sitting on the toilet that morning yielded nothing tangible, and the sharp, stabbing gas pain was relentless. I was really worried that I was constipated and would have to visit the ER to clear out the backup. I got paranoid about putting more food in my body, so I nearly stopped eating. I took some MOM and laid in bed talking to the advice nurse for a while. I eventually figured out that if I laid on my back with my legs up on the wall, I could leak a little gas out, but it wasn't helping much. The advice nurse told me that he had once had a LIS done too, and it took him 7 days before his first BM. The thought of 4 more days seemed like a death sentence. That afternoon I couldn't take it anymore. Never in my life had I experienced this kind of pain. I felt trapped inside the pain and was getting claustrophobic. I went into the bathroom on a mission. I tried not to strain, but it was stuck. It was halfway in and halfway out and not willing to move either direction. Thankfully I had some latex gloves nearby and managed to coax it out. It was a pretty dark scene. I swear it was like giving birth (I don't know how you ladies do it!). The stool was a little thick at the start, but the rest was just chocolate slime. I was so relieved that I started laughing to myself! I felt some slight stinging pain at the surgery site but not so bad. An hour in the tub, and I felt almost no pain. My mood picked up instantly, and I resumed eating.
Day 4: I pooped in the morning. It was pretty uneventful, if not for a little blood. All day I ate high-fiber meals plus two doses of Citrucel and two docusate tablets (morning & night). Before bed I felt the urge again, so I sat down and pooped a little more. There was some blood, but nothing scary. And very little pain to speak of.
Day 5 (today): I woke up and had to poop pretty urgently this morning. I was surprised since I had just pooped about an hour before bed. This morning's BM was fairly robust but passed quickly and easily with a little blood at the beginning only. I did notice that a stitch had come loose. It was tangled in my butt hair. I wonder if it had popped loose (I didn't feel anything) or if it had already dissolved enough to come out. I couldn't tell from looking at it. Later in the afternoon, I was laying in bed and farted. It felt wet. I hopped up and went to the bathroom to check it out, and sure enough, there was blood. You know your life is in a weird place when farting blood isn't that big of a surprise. I sat down on the toilet and cleaned myself up. Then I changed the pad in my undies and decided to make a snack. I felt more gas coming on, but I told myself not to fear it. This time I was standing in the kitchen. I relaxed and let it slip out ... blood again! This happened to me two more times throughout the day. I'm trying not to freak out about the blood, but I'm wondering if this is okay. I don't feel cold or weak or light-headed or anything. It's hard to quantify the amount of blood, but it's definitely enough to splat around the toilet bowl and turn the water into cranberry juice. I keep having to pass gas (probably from all this fiber), but I'm worried that each time I do it's opening a wound. Did anybody else here experience much bleeding when not pooping? Could this have something to do with the stitch I lost? I called my doctor and left a message, but he didn't call back and now it's after office hours. I'll call him again in the morning if it's still an issue.
And that's where I'm at right now. I feel like I've been through the worst of it. Now it's just a matter of being diligent about my diet and keeping an eye on my backside. I'll try to keep you guys updated over the coming days.

Hi Anthony - welcome here and thanks for your writing about your LIS experience! It's useful to hear everyone's experiences. I think it sounds like a good idea to call your CRS today, since you think you've lost a stitch and you have blood. Some of the LISers here can probably chime in to say whether they had bleeding or not some days after.
Also, just wondering if you are getting too much fiber - which isn't a good thing either. Though, from what I have read, after a surgery, your stomach and all related activities are bound to be whacko for some days.... If you are on or have had some painkillers, that will make you a bit constipated, and then if you are getting over the recommended amount of fiber, then that might make for difficult BM ???
Hope you will get back on track soon, and hope you can get a lot of good info here!

Hi Anthony,
Sounds like you're doing well, getting that first BM to come out is the worst, personally I was quite scared about doing it so that's why I couldn't go, I soon realised that just letting it happen was the best thing and really uneventful.
You might be having too much fibre if the stools are bigger than average, it's tricky to get the right amount and most of us (me) still struggle with BM's from time to time, as for the blood when farting I wouldn't worry too much about it, it's normal to bleed for a while after LIS, even if you've popped a stitch which I did in the beginning you should still be ok.
Stay vigilant over your ass, keep to a strict diet and drink plenty of water and remember you're only 5 days post-op, lots of weird sensations will follow regarding the sphincter including spasms which won't be like pre-LIS but strange all the same, you may experience pinching like feelings and burning/stinging which are all normal.
Good Luck and keep us posted.

Hi Anthony- I had LIS the day before you. I haven't had much bleeding at all since the first day, but sounds like I've had more pain with BMs. I had achieved a pretty good regimen of soft poops with a fairly small dose of Miralax before LIS (after about a year) and since the advice of the nurses and Dr's post op instructions all emphasized the fiber and Colace, I have been doing all three since last Thursday. I have not had your problem with the poop, although I almost did on Saturday. I thought I was going to have the "giving birth" episode repeated that started this whole nightmare to begin with! I remembered that some on here squat to go and I tried that and it was amazing how much came out and how easily and pain free. Since then, I've had regular BMs. In fact, I'm now up to going pretty much any time I eat anything, I have to have a BM. I was being so careful because I actually have been still indulging in an occasional Vicodin and didn't want trouble of the constipation kind. Today, I realized that I am pretty much where I was several months ago where I was doing too much fiber and it really gave me a lot of gas and frequency.
I guess my main points are:
- everyone seems to really have a different course after surgery
-I would definitely call the Dr. because of the bleeding and your thinking a stitch came out- better safe than sorry!
-If you have really upped your fiber, but you haven't been drinking as much water (like 8-10 glasses, mimimum) that fiber could really be backfiring on you! Colace can also backfire if not combined with quite a bit of water.
- My Dr. said that if sudden bleeding happened, to sit on a towel wrapped package of frozen peas (the bag kind, not a box) for 10 to 15 minutes and that if the bleeding didn't stop , to call them. I was supposed to use the peas to apply to the area twice the first day and can still use it for comfort if it helps. I actually did use them again yesterday(not sitting, but lying down and putting them against my backside. I think the sitting on them was a cold + pressure = stops bleeding thing)
Hope some of this helps and that you are feeling some better.

Thanks for your thoughts and tips. It's really great to have such a sympathetic and knowledgable group to help work these issues out.
Day 6: I had a small, fairly loose and somewhat bloody BM in the morning, took a bath, and then had to go again. The second time my stool was much more solid, but not too firm, and there was hardly any blood. I think you guys were all correct about overdoing the fiber. I got back on track with my normal diet, and the loose watery gas has disappeared. Oh, and I spoke to a nurse in the afternoon and she said that it's not uncommon to lose a stitch like that. She said that the CRS used a series of "interrupted sutures." Apparently there are multiple discrete sutures reinforcing one another in there, so if one pops or comes unravelled, the others will still stay in to keep the wound closed. She also told me that the type of sutures used are meant to be permanent — they won't dissolve over time. Instead they'll just become a part of my body. Strange. The rest of the day was fairly uneventful. I took a long nap and went for a short walk (about 5 blocks or so). It was raining, so I walked a little fast, and that wore me out a bit. At the end of the day I had a small BM with almost no blood. That was really encouraging.
Day 7 (today): What a week it's been! I'm happy to say that today has been really good so far. I had a nice, medium-sized BM this morning that was soft but pretty solid. It just slipped right out — and there was no visible blood. It was almost enjoyable! I hope this is a sign of things to come. I took a long bath afterwards. Now it's a few hours later and I feel a mild, burning presence down there, but not enough to call "pain." It's funny: for me there hasn't been much pain at all from the surgery site. I haven't needed to take any painkillers for the past few days. All my major pain and discomfort has come from digestive complications rather than the wound itself.
Anyway, thanks again for all the advice and encouragement — you guys are awesome! It's been a week since my LIS, and I feel like I'm finally on the right track. Things are starting to look up!

Day 8: I got out of the apartment quite a bit today. I had lunch with some friends, and went shopping at the mall. I felt a little discomfort throughout the day, but nothing worse than my chronic fissure was causing me before the surgery. Walking around all day made me pretty tired, but other than that, I felt really good. It seems like I'm back to a manageable level of discomfort, and as long as I take it easy, everything should just keep improving from here.