HI folks,
Thanks for all the info you folks post. It has helped me a lot. I have been living with a fissure for two years now - two years where my life has pretty much been driven by this fissure. I'll keep this brief, and can expand on details later.
The fissure was not normal from the get go. No pain on defecation. Major butt pain all day that got worse as the day progressed, and was aggravated by vibrations + sitting - like planes.
I tried Nitro, Nifedipine, and other topical ointments. Naadda.
I then looked into Botox. I am a health researcher, so I know how to read the literature, and figured out dosages, and location (inner/exterior sphincter) - tried the Botox twice, and Naaadda.
So by now, it seems certain that this is a low sphincter tonicity fissure. Relaxing the sphincter with Botox is not ameliorating healing. There are, by the way, many more Women whose sphincters are like this. Low sphincter pressure.
That means, LIS will likely make me incontinent -as in oops, I caughed - incontent.
So I pushed until I found a colorectal surgeon who would do the only sensible thing - anal advancement flap. Well, I don't know how many he had done. The flap kind of worked, but the stitches popped open on one side,, and the flap moved.
So, only half of fissure was healed.
Meanwhile, spasms and everyday pain are OUT of this world. Spasms are moving down my legs, into my abdomen. I have to visit pain control docs to get special pain meds.
And even though healing from the flap surgery is by FAR the most painful thing i have ever done in my life, I did it again.
A second surgery was done to essentially, remove the remainder of the fissure, and cauterize the edges. Slash and burn the m*therf*cker!!!!
This did not work.
Sigh.
Many hundreds of hours of my reading these gruesome articles on fissures and fistulas later, I realized that there was one therapy I had not yet tried - hyperbaric oxygen therapy. There is one sad little article. But there it is. And it ought to work, since it targets the problem -- which in my case is not too much sphincter pressure, it's that the wound is ischemic and lacks vascularity.
So I locate an HBT clinic where they have the new machines - they have clear tops and you don't feel as claustrophobic. And they can put a monitor above your head so you can watch movies and pass the time. It was hard, but ok.
15 treatments, two hours at standard HBT pressure. That was the protocol I followed. It took about two weeks.
Two colorectal surgeons have confrmed that the fissure is gone.
OMG!!!!
I still have butt pain, and I am not sure why. It's not nearly as bad, and I am treating it as nerve related,and perhaps the spasms just persist AS IF the problem was still there. Maybe a person can have both Levator Ani + a fissure from hell. I will go to a pelvic floor release physio clinic and see if they have any bright ideas.
But basically, from my perspective, I am now cured.
Please message me if you want any details about any of this.
Cheers, Mary