I have had an anal fissure for 5 years, basically have been using nifedipine since 2006. As long as I stay on the nifedipine my fissure stay about 90% healed (No bleeding, spasms etc) I do get some pain sometimes if I have a hard poop or some diarrhea! Although the hard poop is much worse then the diarrhea! Yikes!
Anyway the specialist I am seeing says I can use the nifedipine ointment for as long as I want without any side effects. He thinks surgery for me is not the right option because of the risk of leakage (he says that there is a 45% percent chance of this that is not made known to most patients who have had LIS surgery)
He says the trick to keeping this under control is intake 35 grams of fiber each day (to keep bowel pressure to a minimum and stools soft etc) and use the ointment properly! Most people he says do not use the ointments correctly... he says you need to get the ointment as far as you can stick your finger in your butt! If you get it on the fissure, even better because it will absorb right into the opening of the fissure and into the bloodstream etc
My other secrets are too never, EVER use toilet paper and always use baby wipes and a butt cleansing spray to keep you butt clean after BM's. I sometimes will take a shower after if I can and then add some butt moisturizer as well :)
I can live a normal life so far, yes I do have some pain but it is bearable for now.
I just don't trust Botox as of yet and think the ointment can do the same job.
As for LIS, I just want to avoid surgery unless I really have too... why risk leakage and possible infections. They are cutting you open so there is risks involved! If I could not live a normal life, then that would be a different story... If LIS meant relief then I am all for it, but only as a last resort.
Hope this helps and I hope they come up with something new in the future that will bring relief to all who suffer from this little beast!

Hey there,
I can't believe you have had a fissure so long...thats awful.
I have to disagree with your doctor on the 45% chance of incontinence. I have not read of one person on the internet or know of anyone who has had permanent incontinence. I would never use a doctor who said there is a 45% chance though. Maybe he isn't confident in himself to do the procedure. I know of a few people who have had this procedure and if you read all the post on this board and research on the internet on other boards you will see that is really unheard of unless you are obese or elderly.
I respect your decision not to have lis. No one could talk me into it until I was ready myself and I'm very scared of the surgery but I have seen some really good results.
I'm not sure if you are aware but having a fissure without surgery can also lead to infection. There have been other people on this board who have developed infection and fistulas with their fissure and had to have surgery to drain them.
I agree I hope they come up with something better in the future. It's a scarry operation to have to choose to get well.
Good luck w/ your healing :)

I echo what Dawn said. You may want to seek a second opinion. The group of CRS's that practice in my area are very conservative in the cut. He told me that they had a Resident go through all the LIS procedures the group has performed and they only had 2 cases where people had incontinence with gas. As mentioned, people that have issues already have weakened muscle structure should not have an LIS. Also, I was told that males have more muscle structure so that also reduces the risk.
I had a fissure for 4 years and then got another. That is when I finally broke down and got a LIS done. If I had to do over I would have had the LIS done after a year. I was basically was at the point your at now. I got the fissure healed to the point where it wasn't super painful but more bothersome. Also, the longer the fissure exists the more scar tissue that can build up causing stenosis of the anal canal.
But surgery is a big step and you need to feel it is the right thing for you. I was scared to death of it which prolonged my suffering for years.
I also wish you good luck. And hopefully you can get it completely healed with the ointment. I took nifedpine orally and that is what got my first fissure somewhat healed.

I agree with the 45% thing as well. I NEVER would have considered this surgery (well, maybe I would have) if there was darn near a 50% chance that I'd be filling my pants without authorization.
I have done a ton of research on this topic and the final conclusion I came to is it's RARE to have permanent incontinence as a result of LIS surgery.
Anyway, I was a lot like you. I did anything and everything including canceling my surgery TWICE to avoid this operation. I finally had enough, broke down and got it done.

I had the LIS.... 1 year ago... it did not help at all.
If i have loose stool... its fine...
BUT if i have harder stools... it cuts and bleeds like before... its like i never even had the surgery...
except for the large bill i am still paying on.