Hi Guys,
I am currently recovering from LIS, 16 days post op and though I have had decent luck with the BM's - I was wondering if someone can shed some light on what foods are generally found good for making sure BM's are ideal.
What are the foods that you would eat as part of your so called "fissure diet"?
Additionally, I have read on here the supplements people take to help the healing and some of the main ones I noticed were Vit. A,E,C,B12, Magnesium. Though I dont take anything right now because my recovery isnt going as smooth as Id like I am starting to think about these. Although my doctors dont recommended anything :roll:

After I had my fissurectomy, when asked about my diet, the doctor's response was "you may eat anything". I didn't like what he said coz eating anything and everything got me to see him in the first place. Also, vitamins are not recommended by doctors because the levels in the body have to be checked before any patient starts popping these pills in the mouth. I had hard time checking my magnesium levels, because at the lab that was something new and out of the ordinary. Well, I knew that magnesium relaxes muscles and so, that became an important element for my check. I dealt with fissure for a year. I religiously ate vegetables, and drank water crazily. It took time to realize that dark leafy vegetables and raw salads are actually hard on your tummy. Of course, doctor then confirmed this statement after my fissure got bigger. Doctor recommended clear Metamucil which actually caused more damage since it was fortified with calcium. It absolutely put off my muscle reflexes. So I quit which then made me realize that my fiber intake was falling short (even though vegetables only) over the recommended 25-30 g (for an average female weighing 120 pounds). This is when I switched to CAN food (Health Valley Organic Vegetable soup, Dr.McDougalls's garden vegetable soup or Progresso Homestyle high in fiber Minestrome soup) to record my actual intake on dietary fiber. I added average size broccoli florets 2 or 4 (cooked) to the soup. All this did the trick. I started going smoothly twice, sometimes three times with no pain. Apart from these CANs, I had brown rice pancakes, fruits such as naval oranges, grapes, strawberries, and honey dew melon. You may have this diet for two months at least. Diet (2 months), not pushing or lifting heavy things (2 months), retraining bowels with no spasms (forever) are the only elements that one needs to worry for fissures. I just introduced a new snack over the so-very boring diet, "Terra Sweet Potato chips". Thank you Jesus. I was missing my chips.
I had abused my anal skin with prescription creams and otc hemm. creams so much before and after the surgery that my rectum would get inflamed with just one tiny spasm that lasted for merely 2 seconds or a bulky stool. To avoid hard and bulk stools, I thought of consuming olive oil with my food. It is the best oil with no cardio damage. Also it helps in lowering gas formation so less wind problems. Now back to your question on diet, ...well, I recommend you to eat light vegetables that are used in soups. Have fruits that have lots of Vit A, E, & C. Having supplements to cover vitamin deficiency would be too dangerous. For example, too much of Vitamin C can create kidney stones. Remember, vitamins through supplements are absorbed completely by the body while vitamins through food when taken, excess gets thrown out by the body. I took zinc supplement three days and on the fourth day I fell and the whole room was spinning. I knew that excess zinc might have caused it coz that was the only new thing I had started then. Oh, another thing that you should consider is to introduce one food item to your tummy and wait for two days. I hope you know that the transit time for the poop is 16-20 hours. This is the only way to keep a thorough check on what goes in and how well it is coming out. Good luck on your diet and supplements. I apologize for this lengthy reply.

I've been on a pretty high-plant, low-animal diet for the past four months (with this fissure having gone on for about six and a half now). I try to keep lots of apples and pears in the mix for fiber, and when I eat grains I try to keep them whole. I'm lucky on that last one, because I actually seem to like brown rice, whole wheat bread and pasta, etc. more than the refined stuff. Beans are a total life-saver in my experience. I've also been making lots of stock, in the hopes that the extra nutrients from the broth are helping with my healing process. I don't take supplements because they're pretty expensive, and I think with the schedule I have that I can afford to get most of what I need from home cooking, though I do use milk of magnesia daily because it's a wonder for keeping things easy to pass.
I've seen lots of info on what to eat to make an AF get better, and a good bit of it has been conflicting, but the thing I see consistently is to eat real foods - keep the fast food to a minimum, try to replace the refined with whole, etc. I've actually helped put together a class on healthy eating for those on a budget, so if anybody here ever has questions, I'd be more than game to share what I do know. It can take a bit of time to get used to, but if you know some neat tips and tricks, you can actually eat better for less.

Thanks a lot for the quick replies Mabs and Ozark! There is some really good information there, much appreciated.
I keep hearing about milk of magnesia, Im going to have to give this a try. I dont really struggle from constipation, I do go every day but for some reason on some days have to still strain a bit, so its not the constipation may be my "passage" is too narrow.....
Ozark, Im all ears for what you have to say, honestly anybody suffering or even having recovered will be required to make lifestyle changes so we could all benefit from what you have to say...
Mabs - How long ago was your surgery? Are you fully recovered now? Is fissurectomy the same thing as the LIS? Also, assuming you are recovered, how long did it take before you were fully over it and how much time did you need off work? Im currently 15 days post op and no where close to where I thought Id be, I had the LIS. I still have the pain the same way I did before, my life was actually better before the surgery because the nitro used to give me a lot of relief temporarily and I used to apply it 5-6 times a day!!
And I love those chips too, I an avid label reader on all food items and I have to say so far these are the best health wise and also taste really good. I like the veggie chips better than the sweet potato though :D
Also, are you sure the transit time is upto 20 hours? So what I eat now will come out tomorrow around the same time? I thought it gets digested within 2-3 hours, but the elimination depends on how well your digestive system works :roll:
And my doc recommended metamucil clear as well, Ive been on it a few months now but havent noticed any damage, I think it does help me. Additionally, oats are a really good source of soluble fiber as a replacement for metamucil clear.

no, fissurectomy is different. LIS is all about your sphincter muscle. However, there are two sphincter muscles. I bet you know that already. Well, i wasn't aware of that. The doctor can take care of the internal one but not the external one. This is why you feel like you were better off before LIS. I thought that too when I had the botox and a fissurectomy. Due to botox my internal sphincter muscle/s was/were put to rest (temporarily). However, my external sphincter muscle was left as is. This is the muscle that we have to relax on our own while moving our BMs. I am sure you know that too. No doctor can target this because of fear of incontinence. It would result in wearing diapers. Imagine a numb butt-hole ??? (bad idea). The fact of the matter is that I never had problems with my internal sphincter before the surgery. I had this trick to relax it by touching/slightly pressing under the tail-bone during BMs. This is a chinese medicine trick that always works. Well, like i said, I was not aware that there were two spincters, internal and external. The doctor never explained that he would be able to target "only" the internal s/muscles. The botox made it worse and gave me a sense of fullness all the time because the poop would get collected (due to relaxed I/Spincter muscles) and until I had my BM, the sense of fullness never went away. The worse was when I ate my next meal, it pushed more matter into my sigmoid and I would have this fullness feeling back.
Well, to answer your question on how long did i take to heal... it took me 6 weeks to have a stress-free toilet visit. I had used both icepacks and sitz bath. Ice pack just makes you feel good and forget the pain temporarily. Ice pack is good if you have hemms with fissures. Hemms tend to shrink with ice-packs. However, it is the sitz bath (especially immediately after a BM) that helps a lot. Walking a bit helps but lying down all day will give that area some time to heal. Try lying down on your side. You will be healed in six weeks.
In my case, in the fifth week, the soreness of the botox started going away which in turn made the feeling of fullness go away. The pain after BM which lasted exactly four hours everyday, also subsided. But the rectum remained inflamed and swollen (at the six o'clock and 12 o'clock position). The swelling went down during the night. No, the passage never gets narrower once you have the surgery. It, as a matter of fact, expands.
Metamucil works and does the job of bulking very well which further helps in eliminating the bowels completely (another important factor because the old bowel left behind can become hard the next day). But the focus is not just that. Our external s/muscle also should be relaxed. Metamucil doesn't do that. It gives the pressure to go but we contract our butt hole so tightly that this pressure, the weight, and a closed exit,... all can contributing factors for developing a tear.
Yes, 16-20 hours is the best transit time to have. Anything before and after that can cause either diarrhea or constipation. Constipation is the term used both for irregularity and incomplete bowels. So going regularly like in your case but having an incomplete BM (either due to fear, or pain..in my case, hormones) is termed as constipation too in a broader sense. You know when your bowels are complete.. there's this little stuff pushed out after your so-called "sausage like poop". It accompanies with a little wind and you get the feeling.. ah it is all out ! If your poop has a consistency of so-called "mushy" , then try using a food blender and pulse-grind your food for 2 seconds. It will help the tummy to digest it better and your poop will have that desired length without breaking. Remember to eat slowly coz your saliva is important.
I had my surgery on March 21st. It will be two months almost. Yes, i am completely healed because fissurectomy does heal the fissure no matter how many times you have spasms or contractions after the surgery. The surgery targets the fissure to heal it completely. If your bowel habits are bad after the surgery, you may have a new fissure but the old one is definitely put to rest.
I quit work because I didn't want to deal with work stress. I know some people would not be able to do this. But this is the same type of thinking that upgraded my fissure stage from acute to chronic. We all know, this is the worst kind of illness. You can't sit, stand, walk, lie down or work comfortably. If you notice, a butt can feel the pressure in everything you do which also means that babying this part of our body is actually a necessity.
Ok, now let me tell you the ordeal on creams. My skin thinned out by applying so many creams so much so that before my surgery I even asked my doctor to renew my skin ! (hahahha). I used syringes to apply ointments, pushed hemm tubes to get the medicine inside or lubricate the area for an easy poop transit. No no no no... wrong wrong wrong.. worse ideas... stop all that. That skin is tender and important and no doctor can repair that. All that can cause trauma. I stopped everything and I am now using A&D ointment. First I used EV coconut oil, that just made my skin dry.. even more. (My most expensive cream so far used is Anamantle ..300 $ with insurance :-((( ). I have even used olive oil. Well it worked, but didn't stay on all the time. Thus, after reading this forum, I read someone using A&D with no side effects. And the idea that vitamin A&D actually helps in reparing and relaxing, made this the best substitute for Nitro (my first cream) and Diltezem (my second cream).
Yes, after two months I will now be getting back to work. This illness is something that can strike back the moment you forget your past ordeal :-) .. I will take care of my diet forever because a lot of damage is done to my butt-hole already. I can't risk it anymore because I am 45 and healing is not as speedy as it use to be. There is another ordeal yet on the way... Menopause !
Don't worry, I know you will start feeling better in your fourth week. Endure a bit more. I will pray for your speedy recovery.

mabs wrote:no, fissurectomy is different. LIS is all about your sphincter muscle. However, there are two sphincter muscles. I bet you know that already. Well, i wasn't aware of that. The doctor can take care of the internal one but not the external one. This is why you feel like you were better off before LIS. I thought that too when I had the botox and a fissurectomy. Due to botox my internal sphincter muscle/s was/were put to rest (temporarily). However, my external sphincter muscle was left as is. This is the muscle that we have to relax on our own while moving our BMs. I am sure you know that too. No doctor can target this because of fear of incontinence. It would result in wearing diapers. Imagine a numb butt-hole ??? (bad idea). The fact of the matter is that I never had problems with my internal sphincter before the surgery. I had this trick to relax it by touching/slightly pressing under the tail-bone during BMs. This is a chinese medicine trick that always works. Well, like i said, I was not aware that there were two spincters, internal and external. The doctor never explained that he would be able to target "only" the internal s/muscles. The botox made it worse and gave me a sense of fullness all the time because the poop would get collected (due to relaxed I/Spincter muscles) and until I had my BM, the sense of fullness never went away. The worse was when I ate my next meal, it pushed more matter into my sigmoid and I would have this fullness feeling back.
Well, to answer your question on how long did i take to heal... it took me 6 weeks to have a stress-free toilet visit. I had used both icepacks and sitz bath. Ice pack just makes you feel good and forget the pain temporarily. Ice pack is good if you have hemms with fissures. Hemms tend to shrink with ice-packs. However, it is the sitz bath (especially immediately after a BM) that helps a lot. Walking a bit helps but lying down all day will give that area some time to heal. Try lying down on your side. You will be healed in six weeks.
In my case, in the fifth week, the soreness of the botox started going away which in turn made the feeling of fullness go away. The pain after BM which lasted exactly four hours everyday, also subsided. But the rectum remained inflamed and swollen (at the six o'clock and 12 o'clock position). The swelling went down during the night. No, the passage never gets narrower once you have the surgery. It, as a matter of fact, expands.
Metamucil works and does the job of bulking very well which further helps in eliminating the bowels completely (another important factor because the old bowel left behind can become hard the next day). But the focus is not just that. Our external s/muscle also should be relaxed. Metamucil doesn't do that. It gives the pressure to go but we contract our butt hole so tightly that this pressure, the weight, and a closed exit,... all can contributing factors for developing a tear.
Yes, 16-20 hours is the best transit time to have. Anything before and after that can cause either diarrhea or constipation. Constipation is the term used both for irregularity and incomplete bowels. So going regularly like in your case but having an incomplete BM (either due to fear, or pain..in my case, hormones) is termed as constipation too in a broader sense. You know when your bowels are complete.. there's this little stuff pushed out after your so-called "sausage like poop". It accompanies with a little wind and you get the feeling.. ah it is all out ! If your poop has a consistency of so-called "mushy" , then try using a food blender and pulse-grind your food for 2 seconds. It will help the tummy to digest it better and your poop will have that desired length without breaking. Remember to eat slowly coz your saliva is important.
I had my surgery on March 21st. It will be two months almost. Yes, i am completely healed because fissurectomy does heal the fissure no matter how many times you have spasms or contractions after the surgery. The surgery targets the fissure to heal it completely. If your bowel habits are bad after the surgery, you may have a new fissure but the old one is definitely put to rest.
I quit work because I didn't want to deal with work stress. I know some people would not be able to do this. But this is the same type of thinking that upgraded my fissure stage from acute to chronic. We all know, this is the worst kind of illness. You can't sit, stand, walk, lie down or work comfortably. If you notice, a butt can feel the pressure in everything you do which also means that babying this part of our body is actually a necessity.
Ok, now let me tell you the ordeal on creams. My skin thinned out by applying so many creams so much so that before my surgery I even asked my doctor to renew my skin ! (hahahha). I used syringes to apply ointments, pushed hemm tubes to get the medicine inside or lubricate the area for an easy poop transit. No no no no... wrong wrong wrong.. worse ideas... stop all that. That skin is tender and important and no doctor can repair that. All that can cause trauma. I stopped everything and I am now using A&D ointment. First I used EV coconut oil, that just made my skin dry.. even more. (My most expensive cream so far used is Anamantle ..300 $ with insurance :-((( ). I have even used olive oil. Well it worked, but didn't stay on all the time. Thus, after reading this forum, I read someone using A&D with no side effects. And the idea that vitamin A&D actually helps in reparing and relaxing, made this the best substitute for Nitro (my first cream) and Diltezem (my second cream).
Yes, after two months I will now be getting back to work. This illness is something that can strike back the moment you forget your past ordeal :-) .. I will take care of my diet forever because a lot of damage is done to my butt-hole already. I can't risk it anymore because I am 45 and healing is not as speedy as it use to be. There is another ordeal yet on the way... Menopause !
Don't worry, I know you will start feeling better in your fourth week. Endure a bit more. I will pray for your speedy recovery.

Hey mabs thank you so much for the detailed reply. I appreciate the detail and you taking time out for fellow sufferers especially when you are past the agony!
Its funny how reading something encouraging just automatically makes me feel good, even if temporarily and then soon enough I slide back into pain and negativity land and all of a sudden life feels like a mess.
I really hope Im good to go in 6 weeks, 2.5 weeks as we speak. I have been lucky enough to have a good rapport at work and been able to take a long time off because of this.
I knew about the 2 muscles but didnt know that the doctors can only target one and yeah that trick about pressing, I tried but dont think it worked, may be Im doing it wrong. Is there anywhere on the internet I can read about it??
I also dont know how effective sitz baths are because I literally dont feel any difference :( whether I go right after BM or go later or dont go at all. Also, I find that on most days, my fissure pain which is now a combination of burning, pinching in various spots and knife edgy in various other spots just kind of stays all day after the BM in the morning. Still cant sit without discomfort, with discomfort may be an hour or hour and a half, that it! Lying on the side is magic though I dont know how this works but it does. I wil try the ice pack and see if that helps.
So about your surgery then how different is the fissurectomy from the LIS??
And about metamucil, the one I take isnt the regular psyllium husks, Im sure you know about the soluble vs insoluble fibre - so this one is the soluble fibre which supposedly helps making the poop soft as opposed to bulking. And you know the ahhh feeling, I havent had it in years :( I have IBS too so my BM's always leave me with the incomplete evacuation feeling and a lot of pain and bloating all the time!
Also, about the creams, its too bad you had to go through so many that it wore out the skin but honestly Id probably have ended up there if I hadnt gone through LIS. I really hope Im fixed up though coz otherwise Id have to go back to NTG!!
Whats this A&D cream? Never heard about it!
Anyways thanks again and do follow my story here - http://anal-fissure.org/t6602p15-surgery-done-now-can-i-have-my-life-back

Ok, i did go through your previous posts. You need to just give some more time to your healing process, coz in your case, a fissure is involved. I don't understand why your fissure is not healing. LIS should keep your s/muscles relaxed all the time which in turn should actually speed up the healing process of the fissure. I suspect your IBS is causing your fissure to remain active. Btw, i didn't know you had IBS. So, right now your focus should be on treating your IBS. Diet is the only solution. I do know you talked about soluble and insoluble diet. (Well, that bifurcation this past year didn't work on me and I surprisingly got better when I dumped my long food list in the trash. I realized that when there is something going on internally, as in my case peri-menopause, no strict diet helps). What kind of IBS do you have? If it is IBS-C&D, then there is medication for that. My friend has it and she has been prescribed something called "Belladona". How do you know you have IBS. Was it diagnosed after a colonoscopy? You also said that you have incomplete evacuation. That just answers your active fissure problem because whatever is left behind tends to harden and brush against the colon walls. Keep your Miralax (one cap in the night) regime on, until your fissure is gone. This should take care of your incomplete bowels. I took Miralax one cap after dinner and one Dulcolax stool softner after lunch for the first two weeks post-op. Then I skipped Dulcolax and continued with Miralax for another two weeks. Also, use some Epsom salt during the last 10 minutes of your sitz bath. I know it is uncomfortable in the beginning three weeks, but then it gets better. Sit on one cheek at a time. Epsom salt will take away the itching and burning. It seals the wound. Very few gastroenterologist s recommend this. I went to two gastroenterologist and one CRS, however, only one of them recommended it. As far as bloating is concerned, one best remedy is to have EV olive oil - cold compressed and organic (a 2 tbspn drizzle/do not heat or cook) with your food (lunch and dinner). It should help your IBS too. It helped my gas and made my stools softer. It is a natural remedy, so no negative thoughts. However, it should take three days to get the whole internal system lubricated. It will eventually help in sliding that last bit out too :-) . It will help your fissure heal too because it is loaded with vitamin E. By now, your internal wounds of LIS should have healed. Do you feel that? There is this feeling of soreness that starts disappearing after the third week. Have you started noticing that? Avoid sitting as much as possible. My case was extreme and therefore, had to avoid sitting (except sitz) for nearly four weeks. My area remained inflamed for four weeks at the six o'clock and 12 o'clock position, even though I applied Diltazem 2-4 times a day. I felt like my area was completely closed (imagine pooping through that !!). However, when I visited the doctor for a post-op 2 weeks check (too stressful), he said that I was healing right. I didn't feel happy though. (I was afraid to express my happiness coz I thought I would jinx it hahaha). Anyway, when I asked him about the swelling, he just asked me to continue with the cream and that the swelling should go away in a month. He also added that the surgery would leave behind uneven skin. Now after two months, I know what he was talking about. I used Diltazem for almost three weeks post-op even though my skin felt like gel and sore to touch. Then I read someone using A &D cream on this forum and was doing excellent after a fissurectomy. Many congratulated her and I do remember distinctly someone saying "you make fissurectomy sound like walking in the park". Yes, her surgery was that successful ! Well, I don't remember her name coz I use to read so many posts. Just the thought, that this cream is gentle and has the right ingredients made me switch without any doubts. A& D is an ointment that has Vitamin A and D and is mostly used for diaper rash. By far, it is the cheapest cream I have ever applied!. No,... ice pack just helps to ease the pain but does nothing to heal the wound. Also, please do not use the tail-bone trick after the surgery. I used that trick "before" the surgery. LIS and fissurectomy procedure, both target the area under the tail bone, thus making that area particularly, very sore. So touching or pressing that area while going is not right after a surgery. Good you mentioned that. Also, this is why I asked you to lie down on your side in my last reply. Lying down flat on your back (also sitting) puts pressure in that area, which further extends the recovery period. I am sure you are focusing on your diet. But there is something that you are not doing right with your diet. Why don't you go to a nutritionist (whole health associates) who will give you a list of food that you can eat for all your intestinal conditions. I did that six years ago for my thyroid nodule (an auto-immune disease with no cure except surgical removal) and it somehow took care of my fissure problem too. I was without fissure for whole five years until my hormones went wild. All I know is that "Beans" are a NO NO for IBS. There is very little info on IBS online. Some are lucky to have a gluten free and lactose free diet and successfully get rid of IBS (i saw that on Dr.Oz show). I know all this is not economical. Also, after this big ordeal that you have undergone, I don't think you are ready for another interrogation from any person, let alone a nutritionist ! Give it some time now. It is too early to draw conclusions. Like I said before, things start turning around after four weeks and in six weeks you will be absolutely normal.

Hi, my doctor also told me no restrictions on diet except to eat reasonably. I have IBS too so I kind of know what to stay away from. Fiber is good but too much fiber is not. I take a nightly dose of miralax and I cut back if I feel it's too much and I try to drink more fluids during the day. My doctor said if I eat a balanced diet there is no need for supplements. Iron and calcium can be very constipating. I agree on time. Some people heal quickly and some take longer. Just take it day by day. Good luck, Suzy

Thanks again for the quick replies mabs and suzy.
Yeah I have IBS and I did have a colonoscopy two years ago and also some stool tests, but recently I went to my doctor and asked for some additional tests because I keep thinking that its something more serious because I have cleaned up my diet a lot in the last year or so and taken supplement such as probiotics but the IBS wont subside :roll:
Its interesting that you were using diltiazem, I was on nitro before the surgery but my surgeon and my doctor both asked me not to use it anymore. Sometimes I really feel the need to!
Incidentally this morning I had my BM and it did all come out! Obviously there was more than usual and I think it did some damage...because I felt pain while defacating which I usually dont and then immediate burning and jitters, more than I do on other days...
And honestly I cant tell if the fissure is healing or not, I dont think it is. Because though I dont feel spasming, I do feel occasionally my anus shrivelling up, so its like a lower level spasm pretty much. It does feel like all the pain, zingers and burning is on the outside as compared to the inside. Another reason, I suspect that it hasnt healed and something makes me doubt whether my sphincter is lossened or not is that every time I have to pass gas, I have to push it out. The first week after the surgery, I was so loose down there that it would just slip out but not anymore. Additionally, passing gas seems to worsen the burning too, is that something that happens to others?
Some days are better than others but honestly I cant wait for this to get better.

Yes, in my case I would hurt whilst passing gas, sneezing and coughing ! I use to sneeze with my mouth WIDE open. So gross !