LIS didnt work CRS suggests fissurectomy advice wanted plse

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LIS didnt work CRS suggests fissurectomy advice wanted plse

Postby jillywilly » 17 Apr 2013, 10:05

I've had a chronic fissure for 18 months now & have posted on here about my previous treatments, none of which have so far worked!! Rectogesic & anoheal creams didnt help then I had botox in june 2012 the effect was very short lived only 6 weeks of relief so i had a LIS performed in Nov 2012 again no relief from that so now CRS says rather than risking incontinence by doing 2nd LIS he wants to do a fissurectomy & at the same time another dose of botox & skin tag removal, can anyone who has had this advise me of the following:-
1. How likely is it to work given that nothing has so far!
2. How long is the recovery likely to be? (it took me 2 & half weeks to recovery from LIS although the fissure pain continued as it had pre op)
Iam really dreading the thought of more surgery but at the same time i need something to stop the terrible pain i have after every BM as its totally ruining my life!!
Any advice would be most gratefully received.
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Re: LIS didnt work CRS suggests fissurectomy advice wanted plse

Postby Savaici » 22 Apr 2013, 11:57

Hi Jill,
So sorry that none of the treatment that you have had so far seems to have totally sorted you out. And so sorry that you continue to have pain.
I don't know if it's feasible, but have you considered getting a second opinion by going private? There is an exceptionally good surgeon who Davo saw in London, and you might like to look at his posts.
I can't really offer you any advice on LIS or Botox, only suggest that you do a search (which you probably have already done) for other members' results of which there are many. And you have your results yourself. And hopefully someone else will come in with some ideas for you.
Thinking of you and wish you the very best. Image
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Re: LIS didnt work CRS suggests fissurectomy advice wanted plse

Postby suzyljank » 22 Apr 2013, 15:36

Hi, I'm so sorry you're having such a hard time. My LIS didn't work either. If your resting pressure is still really high even after LIS my question would be how would a fissurectomy help. It would remove the fissure but in order for you to heal you'd need your bottom to be relaxed enough for blood flow to return to the area so you can heal. Maybe your doctor would do a second LIS plus the fissurectomy, that might help. Are you able to pass a normal sized bm or is it really thin? I agree with Savaici, maybe a second opinion would be a good idea. Whatever you decide I wish you all the best. Suzy
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Re: LIS didnt work CRS suggests fissurectomy advice wanted plse

Postby thisfissurecankissmybutt » 22 Apr 2013, 18:45

Have you considered standardized anal dilation? My CRS is not a fan of it usually, but he said it may be appropriate in certain situations. If your anal resting pressure is really high, standardized anal dilation may be just what you need to stretch the muscle and loosen the sphincter. It might be worth checking into.
Good luck!
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Re: LIS didnt work CRS suggests fissurectomy advice wanted plse

Postby Fernie1 » 22 Apr 2013, 22:58

So sorry about your pain..I too had an LIS that did not work and waiting until after June to see if crs wants to do a second LIS. I have read in this forum of two exams you can have done to see if you can have a second LIS..one is called a monometry test and the other is an endoanal ultrasound. I think a second opinion will set you at ease and will let you know of other options. I'm on my 4th crs..it can take a while before u find the right one. Wishing you a speedy healing..and prompt relief from pain.
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Re: LIS didnt work CRS suggests fissurectomy advice wanted plse

Postby owmybum » 23 Apr 2013, 02:35

Hi jilly
I am in the uk, and I am on my 3rd crs! I am now seeing the one Sav mentioned, that treated Davo.
You have to feel happy with the treatment proposed, and confident in the crs performing your surgery.
My new crs. Has suggested I have a fissurectomy with Botox. If that fails then it would be advancement flap.
I am different from most on here though as I don't have an elevated anal resting pressure. My fissure was a result of hem banding and skin tag removal.
I think another shot of Botox along with a fissurectomy to remove scar tissue is a sensible way to go before going in for a second LIS. Why are they removing the skin tags? Do they cause you pain?? If they don't, my advice to you would be to leave them well alone!!!
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Re: LIS didnt work CRS suggests fissurectomy advice wanted plse

Postby cuzzy » 26 Apr 2013, 15:48

ok 2 questions this might sound silly but how far in do you go with the diltiazem cream i dont know if im using it properly and the second is is it usual to have the blood streak even after using the cream for 3 weeks that is what makes me think im not doing it right thx
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Re: LIS didnt work CRS suggests fissurectomy advice wanted plse

Postby jillywilly » 26 Apr 2013, 16:17

Personally I insert the cream as far as I comfortably can with my index finger & as far as bleeding goes I still get bleeding after a bm on regular occasions & I've been using anoheal (diltizem) every day for 3 months!! I know that my fissure isn't healing though so that's why I'm now contemplating further surgery. If its only been 3 weeks I would suggest you persevere with the cream for at least 3 more weeks.
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Re: LIS didnt work CRS suggests fissurectomy advice wanted plse

Postby Guest » 27 Apr 2013, 08:50

If you are bleeding that could mean two possibilities. Your diet is not producing soft bms or your skin has become very sensitive. Using cream for a long period sometimes makes the skin very thin and therefore prone to tears. Apply olive oil to repair it and use Diltizem only if there is inflammation. Take vitamin E capsule every day. Beware of calcium, protein and iron intake. Instead of cereals, try eating homemade breakfast. Cereals are fortified with vitamins and minerals that may cause stools to dry. Drink every hour a medium glass of water (9 glasses at least). Have sitz bath after every BM for 20-30 minutes. You should have at least two BMs everyday because the longer your stomach holds your BM the harder it will get. If not, have a stool softner such as Miralax and check your fiber intake (25 g Women and 40 g Men). Please do not have fiber supplements. They just swell with no nutrients. Use fruits and cooked vegetables as your fiber therapy. This is the only way to help you have a complete BM because whatever stays back will become hard next day and the friction will cause the tear. Have a heavy breakfast so by 10 am you will have another BM because of your heavy breakfast intake. While going try to touch and press just below your tailbone so that you are free from spasm and your sphincture muscle stays relaxed and open. Sit only when you get a strong reflex. If not, drink a big glass of water. This will develop in pressure that will lead to a strong feeling to go. I am mentioning these tricks because this is the only way to prevent any more tears. You can have 10 fissurectomies but if your bowels are not trained, the tears will keep coming. Now to answer your two questions. Yes, fissurectomy is a good solution for healing that big nasty cut. Sitz bath, creams, diet and water can only help small tears. The big ones need surgery. It will take you around three weeks to heal from a fissurectomy given that you stick to the recommended diet faithfully. A diet that has Vitamin A, C, E and magnesium in abundance. Having said that, fissurectomy takes care of your existing fissures. The surgery will heal it no matter what. You will be free from that nasty tear once and for all. :-)
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