Hi there... so glad to find this wonderful site to help us sufferers cope with this embarrassing problem.
I've been dealing with a fissure for 2 weeks now. The main issue is the 5-6 hours of pain after every bowel movement. Almost unbearable. I've never experienced anything like this before although I've dealt with hemorrhoids for most of my life.
It wasn't until yesterday, however, that I was able to get in to see a colorectal surgeon. After researching various surgeons, I found one that had a lot of good reviews online. When I met with him yesterday he confirmed I had a fissure (I'd suspected it based on my research of symptoms). He prescribed me diltiazem which I got at the compounding pharmacy and also lidocaine to apply before bowel movements. The diltiazem has helped with spasms.
He told me this only works in about 25% of people so he suggested scheduling surgery as it takes about 2 weeks out to schedule a spot so I'm going to schedule a surgery on Monday. He said if it heals in the meantime we can cancel the surgery. I guess it's an LIS, however he told me he doesn't cut it quite the same way (laterally I guess) as was on the diagram he showed me. He said it's a smaller more vertical incision. He said he's done 1600 of these. I asked about incontinence and he said none of his patients have never had a problem with it.
I also have vicodin for pain that my PCP prescribed earlier in the week for pain, however I am trying to avoid taking that due to the constipation it can cause. I'm taking MiraLAX and trying to regulate my bowel movements, but it's either real loose and more often... or less often and hard. Ugh. I want loose and less often.
I've been eating considerably less than I normally do and have lost some weight. When I do eat, I find myself wanting comfort foods rather than probably the things that are best for me. I don't know if it matters too much as long as they are loose.
My boss has been fairly understanding... the first week I worked from home a few days and the second week I had vacation already scheduled so I took it and stayed home. I'm going to talk to him tomorrow and look into working from home the coming week so I can best treat this. I'm hoping the spasms continue to be on the mild side because if the pain is at it's worst, there's no way I can continue to work if I have a bowel movement. I'm wondering if any of you have had to go on short term disability with a fissure and/or how receptive your employer was to this. If you did work with this, how did you manage to treat this if having a bowel movement at work?
Thanks everyone.
G.

Hey Asswipe, i'm new here too, just discovered the site yesterday :) so glad to have found this place too!
it's good that your boss is so understanding about the issues, i think it's hard to convey just how painful a fissure is to someone who has never had one, so it's excellent that he is being empathetic.
the constant soreness can be coped with i think, but the sharp, sudden white-hot stabbing pains are so bad that it's impossible to concentrate on anything. so to avoid this kind of pain at work i got into the habit of having a BM when i got home from work, at least then it doesn't affect my work life. at one point i used to have a BM before bed. i'd find that i could go to sleep before the spasms started and due to the body being relaxed during sleep i would avoid pain altogether. but i had a few bad episodes where i woke up in pain, so i stopped that.
i find that eating less isn't a good idea, you end up having irregular BMs and often they take longer to pass through you, causing harder stools. so just eat as normal but make sure you have lots of fruit, veg and fiber (and fluids!). i'm also guilty of wanting comfort foods, i think it's because it's one of the only pleasures you can still indulge in with a fissure. it's probably fine in moderation, but don't overdo it!
definitely don't take any vicodin, regardless how tempting they are to ease the pain - they will only cause you more pain in the end! i think this is the worst part of having a fissure, all of the stronger painkillers are completely out of bounds due to the nature of the illness. ibuprofen and paracetamol are all i ever take.
i'm surprised you've been scheduled for surgery so soon, your fissure can only be classed as acute as it's only been two weeks and the usual approach is to try topical creams first along with warm baths and change in diet. personally, i'd avoid the surgery until i'd tried more conservative approaches - but maybe that's just me, one of the more experienced members here will probably offer better advice on that front, as i've had my fissure for over 3 years and i'm still avoiding surgery (though i'm finally going to look into it this coming week!)
Hope i've been of help, and wish you the best of luck with your fissure!

Thanks for the info.
However, I can't imagine dealing with this for 3 years given the pain I've been in. Perhaps mine is worse than some. He did say it was large I believe.
I'd rather get the problem fixed and move on with my life!

Hey Asswipe! Welcome! I'm sorry you have a fissure, but it's really great that you are getting the proper treatment so soon into your ordeal. That's really the key! Since you've only had the fissure for two weeks, the Diltiazem may very well work. I wasn't clear about whether that you will try the Dilt for only 2 weeks? Some folks would prefer to give the Dilt a bit longer, so I understand Sorebum's reservations. But other folks think like you and just want the dern thing fixed! It also depends on how the fissure is affecting you life. For some folks, the fissure is not excruciatingly painful, and they are able to live with it for quite a while. For others, like me, the pain was extreme and debilitating, so I wanted surgery as soon as possible, even though it scared the heck out of me.
The only thing I would be concerned about with waiting a very long time (like years) is the possibility that scar tissues can develop, which would have to be removed during the LIS as well so that the fissure will heal; or that it will get infected; or that it will heal into a fistula. Once the fissure is a few years old, it will definitely not heal without surgery (or maybe botox). That is not to pressure you at all, Sorebum - surgery is a personal decision and as long as your are ok and your doc says you're good, then you should do what you are comfortable doing.
I agree with Sorebum about the painkillers. I also took ibuprofen, along with extra-strength Robaxecet, which is a muscle relaxant. That really helped. I also agree that you should eat - I lost so much weight that I looked scary, but that actually made my recovery more challenging because I wasn't healthy going into the surgery. As long as you've got good stool softeners, and your diet is fissure-friendly and healthy, you will be fine. :D