Ok, so I have another question that has come to mind that I would like some feedback on. From those who've had LIS, I would like to know how, if at all, it affected your bm's. And more specifically, did it make have a bm easier in terms of the muscles being relaxed and reducing straining. I was thinking today about what my expectations will be once having LIS and aside from the obvious, which is that it would cure my fissure disease, I would also expect that it would make my bm's consistently easy each day. Right now, my biggest problem is that I DO NOT have easy bowel movements, even with the fiber, water and miralax combo. My stool is consistently soft, but because of the issues that have have with lack of pelvic floor muscle coordination and very spastic/tight rectal muscles, my rectum doesn't relax properly to make bm's easy to pass with no strain. This is something that I would be expecting to be relieved by LIS, but I don't know if this is unrealistic. Thanks in advance.

just going to jump in on this even though I haven't had LIS but do have pelvic floor dysfunction that affects the muscular coordination for BMs. To the extent that LIS should help will depend on the degree to which your dysfunction is being caused by a tight or spasming internal anal sphincter, and the extent that it is being caused by other muscles such as levator ani in the pelvic floor. That being said, your pelvic floor dysfunction has likely only been made worse by the fissure and its effect on the internal anal sphincter, so in this regard, assuming your fissure heals with the surgery, BMs should become at least somewhat easier as your surgical site and your fissure heal.
Before you had a fissure were you struggling with this problem with passing BMs?

Well, I actually do have spastic levator muscles as that was one of the first things that my old CRS told me during an exam several years ago. I have since been told that I have pudendal neuralgia, hypertonicity in the anal canal and pelvic floor dyssynergia as well. I did have an anorectal manometry test done and that is where my GI doctor labeled me with the dyssynergia, which means that my sphincter muscle does not relax as it should when I feel the need to have a bm. But, he did not say that I had a high anal resting pressure, so that confused me some.
The bm problems were under control, for the most part, up until I developed my first fissure and then it all went downhill from there. I think that the more obsessed I became with my bm's and the more things I tried to do to correct it, the worse things got. I actually wish that I had not ever started taking Miralax or changing my diet so drastically. I also worry that I used steroid ointments too frequently and have done permanent damage to the rectal tissue that has led to the fissures and has caused this latest one not to heal. Maybe I'm just overthinking this whole thing.

It's hard not to over think this stuff when you are suffering, and when your case is made more complicated with coexisting problems. Your situation sounds at least somewhat similar to someone else I know who through anal manometry was told he did not have high anal resting pressure, but was told he had stenosis and dyssynergia. His surgeon would not perform LIS on him for his fissure because he didnt think it would help, and in his case his doctor thought it might worsen the already existing problems. It doesn't mean his surgeon was right or wrong, and it doesn't mean LIS is right or wrong for you either. It just goes to show there is so much variability and so much that is unknown, even among doctors, that it's no wonder we as the patient end up tied up in knots over the decision.
I wouldn't worry too much about permanent damage to the rectal tissue from steroid use. It will take awhile, but over the long haul most people find their skin recovers.
You are right though. The power of the mind is not to be underestimated. The more focused on the problem we become the more we get stressed and enter a vicious cycle and the problem just gets worse. I think it's really important to put other things into our minds and work as hard as we can on that aspect, because it really is the greatest area in which we can exert powerful influence over the body.
Above all, don't be hard on yourself. This is a problem with a very high degree of difficulty for anyone. The last thing any of us needs to do is lose patience with ourselves. Trust yourself and your intuition and your body.

I guess there is no guarantee with this type of surgery and having underlying pelvic floor problems makes it even that much more risky. I've seen two different CRS' here in town and one said that he would never do LIS because the risk of incontinence is too great and with my "sensitive bottom", as he puts it, it could cause me even more problems. The other CRS said that if he actually saw a fissure, he would recommend the surgery even with my underlying issues, but he has never actually seen me with a fissure. But, he only examines externally and says that he can see about 90% of fissures by "vigorously spreading the buttocks apart". This of course is not something you want to hear when you're going to the butt doctor in alot of pain. Anyway, he never sees anything, so that has been a dead end for me. This is why I've had to consult out of state. The out of state doc who I've only emailed with, said that even with my history he would recommend LIS and said that the pelvic floor dysfunction and fissures are two separate issues that are independent of one another and need to be treated separately. He said that LIS would be just as effective for someone with my underlying issues as someone without. So, I agree with you, recommendations vary greatly depending on who you talk to.

Hello everyone, I just had my first BM after LIS just an hour ago...some soreness but not anywhere near the pain of my BM with fissure..Alot of "pat" clean up with moist baby wipes and no bathtub per my doc due to the stiches for my removed tag...Also no blood, just alot of oversoftened poo. Yucks....Packed my butt again and laying on my side relaxing..After 72 hours since my last BM and 48 hours since my LIS, I am glad that is over..I know the follwing BMs will be just as anxious but some of my worrying is slowly subsiding...Cheers Al

Fantastic! Sounds like it wasn't too bad. That gives me hope.

You will be fine, just remember, no forcing, and let it drop...=) You will do great!