Hi from the US, fissure sufferers. I got my fissure from a colonoscopy, which I will never do again. I'm 9 months post fissure, so it's chronic. Amazing how this little cut can take over your life. a bad movement will put me in pain the entire day so I make sure to go before too late so I can sleep. It really lasts 10 hours sometimes. I see many are here looking for alternatives to surgery. I am also scared of what doctors call the, gold standard, procedure, the sphincterotomy. Also, there is sometimes recurrence of the fissure even after surgery.
I have to ask the obvious question. Maybe others have found out. Why can't the fissure simply be sewn up, like any other skin injury?
The first doctor I asked this responded..."It can't be sewn up because the area is unsanitary". Ok so, What's the difference then, if it closes on its own? Also, I thought it was understood the wound would be sterilized before closing.
The second doctor I asked responded...."It's just not the procedure we do". I cannot except this answer either. Both replies are missing any scientific satisfaction.
Doesn't it seem strange to put the scalpel inside the fissure, cut the muscle, and leave the injury open? Dissolving sutures can be used if necessary. Anyone get a real answer?

Welcome! I am not sure of the surgeries, having never done that myself when it comes to a fissure. But, there are a lot of posts on the about what surgeries people have had, what others have tried, etc. I did dilation; took a long time to heal, and now I have one again after about five years. Read the success rate of the surgeries, etc

Sorry you are in pain. I can truly emphasise.

Thanks for the invite, I'm very sorry there is so much suffering here. All this pain resulting from such a simple wound makes it more tragic. I see some people are near the end of what they can tolerate, and I've been there too. I thought I had the fissure beat a few times and I was eager to bring my non-surgical solution to the forum, but I've had setbacks and I need to be certain I am leaving helpful information.

I don't know what others think, but in my view your non-surgical solution would be welcome here.

A couple of other issues concern me about current treatments. Skin can be weakened or thinned by overuse of topical medicines. This damage can be permanent. This is known to occur in unrelated skin problems where topicals are used very often. This would obviously be very serious for long term possible fissure recurrence.
Getting back to the LIS surgery, aside from the incontinence risk (estimates vary). I haven't seen the long long term risk addressed. Likelihood of incontinence increases with advanced age. This almost certainly will be worsened with a history of sphincterotomy surgery.
I keep wondering why can't doctors just sew up the fissure like any other wound. I know access to the fissure for stitches, while more difficult, can be achieved.