Suffering from what doctors diagnosed as small chronic anal fissure posterior about 1 cm high in the anal canal with inflamed skin tag, I constantly have more or less a kind of inflammation of the area (besides ever lasting presence of razor blade like pain directly on the site of the fissure and occasional spasm like pain)
For instance I tried nitro twice for a couple of days, but I get so sore and inflamed so I stopped and situation improved to the tolerable level with aloe and VCO. Reading about good results with nitro, and having more hours of spasm, I decided yesterday to give nitro another chance, and according to my doctors advice, applied it only on the outside. Huge mistake again! After a morning BM I ended up with so much more soreness and inflammation I am freaking out. . Especially the upper part of the anal canal around the dentate line and internal hemms feel scratched.
Hope it will settle down soon. I am much more worried and confused when inflammation aggravates so much and I break emotionally feeling so helpless. I could bear spasms so far, although the pain from spasm can be severe, they do not make me so worried. I am considering LIS and fissurectomy offered to me, but I am not convinced how cutting the muscle could help inflammation and how will I deal with two more cuts in my anus when this small one brings such misery. And yet, the only time I get relief is when I manage to sleep and muscles are relaxed, so ...

How are your experiences with such inflammation if you get some. Is possible that it comes from the fissure?

HI rio

I see your post is falling fast with no responses so I thought I'd
bump you back up for more responses. We know your going through
a tough time now, please stay the course you will get through this.

Inflammation is your bodies response to try and heal things down
there. Remember in LIS the cut also is to reduce the resting pressure
thereby increasing bloodflow thereby helping healing thereby
reducing inflammation. So yes the cut itself can cause inflammation,
along with other irritants.

Yes hopefully others with your similar condition will come in with some more
help. Have you tried any other prescription cream like nifedipine or diltiazem?

How are your bm's as of late?

Whatever you decide, getting your bm's under control (soft/no straining) is your best way to
fight this.

Good luck to you rio, things indeed will get better.

Buttastic (great name).

I think Diltilazem or NIfedipine cream is not available in my country and as I am so sensitive to all ointments I am not sure, I am afraid they will cause same problems. It is slightly better now when I am using only coconut oil and some chammomila.
My BMs are o.k., they are soft and never hurt.
I must stay positive and paitient (right now fighting with a cold-flu). You dear forum members help me tremendously with your advice and attention.

Maybe someone who had LIS and/or fissurectomy will remember how much inflammation and burning in anal canal have had before LIS and was it improved with OP.

Hi Rio, you ask how more cuts in your anus can help when one small cut brings so much misery.
As Buttastic says, the LIS will reduce anal pressure to allow more blood flow to the fissure. Also, once the sphincter is cut, it is a C shape, not an O and apparently this prevents spasms. That's how my CRS described it to me. And the spasms aggravate the fissure, so it's good to stop them.
Also, the LIS cut is in a different part of the anus from the fissure. Fissures are typically at the midline (usually the back) because that area has low blood flow and as weak, more prone to tearing. LIS cuts are to one side, and heal much faster.

As for inflammation, it sounds as though you have an allergic response to nitro. If you get the chance to try diltiazem or nifedipine, you may find you don't have an allergic reaction to those. Or maybe you could try to get the nitro compounded with a different ointment.

In the meantime, try heat. A hot water bottle (very warm, not hot) will relax the anus. My only fear is that heat itself may aggravate the inflammation. Could you try alternate heat and cold?

Are you doing sitz baths? I have heard of people adding aloe to a sitz bath.

Good luck!

Thanks Scientist. I am obviously sensitive to so many things. I use hot bottle all the time and it helps a lot, but do not dare to take any more sitz bath because I got urinary tract infection after one of them. (I was strict with hygiene, but I get UTI with swimming too, I am prone to it). I assume that many of you do not have same level of burning prior using nitro or dilt., nif., I am thinking this inflammation could be some autoimune condition. I read too how some sufferers complain about burning feeling, red skin and a lot of inflammation and was wondering if some of you had it and then had LIS done and then inflammation went away.

Well, diltiazem did give me an itchy rash after 3 weeks, and even the nitro seemed to be making my anal area itchy and red, but that was after I was healed, after using it for 3 months.

Sorry, I can't answer your question about LIS because I didn't have it. I hope somebody else has an answer for you!

Hi Rio,
Lis helps relax the muscle and reduce the spasming. I also had an anal fissure with nasty skin tags. They would swell and hurt something awful. I had LIS in 2008 and it didn't help me much. I got relief for about 4 months and then things started to get bad again. I'm one of the unlucky one because the LIS caused me more scar tissue. I narrowed considerably in that area and having any kind of bm was not good. I waited 5 years until I couldn't do it anymore and went back to my CRS. My diagnosis was anal stenosis with chronic inflammation and he considered the fissure secondary to that. In april I had bilateral advancement flap surgery. He removed the scar tissue and replaced it with fresh tissue from my bum. The donor area was left open to heal. It was a rough surgery but I'm glad I did it. In removing the scar tissue the skin tags were also gone. I'm coming up on 7 months now. I eat a normal diet and take a little less than a normal dose of miralax at bedtime. I'm doing good now. I'll always be mindful of my bum because I don't ever want to go through that again. Surgery is a personal choice. You have to weigh your options and decide what's best for you. If I could say anything though I waited way too long to do my surgery because I was so afraid. The pain you get with a chronic fissure and the spasms are to me worse than the surgery itself. And each day after surgery gets a little better. Some heal faster than others but in the end healing is the goal. Good luck in whatever you decide to do. Suzy

Here you go rio

Just in case your still wanting info on swelling post LIS and you
haven't searched here yet, here are two excellent threads on it.

search.php?keywords=lis+swelling
search.php?st&sk=t&sd=d&sr=posts&keywords=lis+swelling&start=30

HThelps GL...

Thanks Buttastic It is a lot to read and from expieriences of other members I am begining to understand more.

suzyljank wrote: I had LIS in 2008 and it didn't help me much. I got relief for about 4 months and then things started to get bad again. I'm one of the unlucky one because the LIS caused me more scar tissue. I narrowed considerably in that area and having any kind of bm was not good. I waited 5 years until I couldn't do it anymore and went back to my CRS. My diagnosis was anal stenosis with chronic inflammation and he considered the fissure secondary to that. In april I had bilateral advancement flap surgery. He removed the scar tissue and replaced it with fresh tissue from my bum. The donor area was left open to heal. It was a rough surgery but I'm glad I did it. In removing the scar tissue the skin tags were also gone.

Suzy, I admire your patience regarding to what you have been thru. I read some of your posts. I am glad things improved for you and hope your troubles will be gone forever.

Hi Rio,
So sorry you are here with Fissure problems. I haven't had LIS but have had Botox, which helped for a while.... Unfortunately I am still suffering. Have you been offered LIS? I notice you are in Slovenia, so the treatment options may be different to the UK. Here they only offer LIS as a last resort, Botox is usually offered first. Keep fighting, Good luck.