Two years ago I had a hard piece of stool that caused an anal fissure and bleeding. Since that day I've had constant problems.
First, extreme pain when passing stool, sphincter going into spasm, then an external hemorrhoid appeared which soon after dissapeared leaving skin tag.
Now, pain when passing stool is much better compared to what it was soon after it happened however sphincter will still go into spasm most of the time.
Other symptoms I have: when stool is soft it will be flat, if it's a bit harder it's ok and round but since I've been eating more fibre to keep my stool soft mostly it will be flat. I believe this is because of the spasm but cannot be sure and need reassurance?
I am unable to fully control winds and I gas a lot.
Fissure keeps coming back and it clearly visible on the outside when it does however it will heal too (at least the part on the outside) but other symptoms don't go away or don't get a chance to go away because fissure comes back very soon - first time I have a bit harder stool.
A couple of doctors checked me. First one said I had internal hemorrhoids. Second one few months after the first one said I had an anal fissure, checked inside with fingers, said other than fissure sphincter looked healthy but a little tight. Told me to eat fibre and use GTN cream (Rectogesic).
I was referred to general surgeon today but have an appointment in two months time which is terrible as I worry and think about this constantly and feel depressed. I don't even talk when I'm at home due to depression and worrying.
I'm 24 and this is an ongoing problem of two years. I don't have any blood in stool nor on toilet paper. There is no history of such problems in my family.
I also work in an office and sit on my ass up to 12 hours a day.
Please give your thoughts, experiences and support.
Thanks
P.S. I posted this same message on another forum but I think it's more adequate to post it here.

After two years and this much mental anguish, I would say you need to consider the LIS to end your spasms and get your life back. I suffered 7 months and then decided I had had enough.
Sitting on your bum so much everyday is surely part of the ongoing problem with the spasms, as I really only had spasms ( and some bleeding) but no pain at the fissure site much. But sitting was a nightmare, it would bring on the spasms especially early in the day.
Driving the car was a huge pain.
The flat stools need to be addressed, because that indicates a blockage somewhere and no one on this board could "reassure you" that it's just your sphincter causing that.
How have you altered your diet to help manage the fissure?
Unless there is some underlying condition to indicate otherwise, I think you should seriously consider having the LIS, although Botox is an option in some areas.

sitting for long periods of time will require then for you to get up at least every hour and take a 10 minute walk. if you can do that, that will help. yeah, it seems like you will leave your desk so much but in respect, you need to help your butt be happy.
my situation started out just like yours. but i let it go on for close to four years. i had a super hot poker anal spasm attack while driving one day that i was crying and just wanted to drive off the key bridge and finish it all. it was that painful and crazy.
with regards to depression and worrying, how about putting that energy and turn it into some more mind-relaxing time for you - such as a yoga session (buy a DVD), take a warm (not super hot) bath/shower (if bath, don't add any soapy stuff to the water), cook yourself something wonderful and healthy (not sure what your favorite veggies are but how about steaming about three or four of them and add a nice side of pasta or whole grains) and a salad (avoid dairy and spices).....you can see what i am trying to say here.
the worrying will only make you tighter down there so it will help a lot if you can relax a bit.
have you ever tried squatting over the toilet bowl when you have your bm?
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the good thing about your situation is that you say you haven't seen blood in the toilet or on the paper when you go so that sounds encouraging. but as we all know on the board, the fissure doesn't need to bleed to let you know it's there.
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are you worried about your doctor visit or is there something else? maybe if you let us know, we can help you with some of it.
i know it's hard to relax with everything that is going on but that will be very helpful if you can learn to do that too while you wait for your next appt.

I felt like I was reading my own story! I've been dealing with my fissure for 4 years. I had LIS in 2003 and was good for a year and I tore again. Have had recurrences ever since, not as severe as the first time (until now). I has no bleeding with my fissure either (until now). It sucks! I, too, am very depressed.

I am sorry that you are going through this. You will find similar stories here. What have you done diet wise to help? Have you tried any stool softeners? Baths?

You will find some great advice here-though it takes some time to go through all the old posts.

You probably do have an overtight sphincter or one that is reactive or spasmy. I think after living with this so long that botox or LIS might be a good way for you to go. I hate to think of you living with this longer than you have to.

Hi guys, thanks for replying.
All I have been eating recently is fruit (oranges) and vegies.
My stool is soft but because of the spasm I often don't empty my bowels completely and the piece that stays in will dry up and be hard for the next time I go.
I thought this was one of the problems and my doctor confirmed it as well when he examined me.
I'm more worried about passing wind all the time and not being able to fully control it. As well as flat stools. Is it possible that the tear was so severe it had an effect on my ability to control wind?
The fissure is something I got used to, am able to control to a certain degree, but I worry constantly it might be something else.
I will now see a colorectal surgeon, have him examine me, and if it's just an anal fissure, probably opt for surgery in the not so distant future. But that's in two months and until then I feel like I'll go crazy.
P.S. Also I've another problem (on top of all this) I forgot to mention - I am unable to wipe myself off completely. That's why I take a sitz bath after every BM. Anyone had this problem?

are you physically incapable or does stuff just not wipe up all the way? either way, sitz baths are good for that. you may also consider giving yourself a mini-enema just to wash out the region and expell that last bit. hard tipped poos are a common problem we face.
My poos were flat-ish until LIS the other day. They became increasingly so as the fissure took longer and longer to heal and a hemmie developed. Now they are normal again is size and shape. Still, hemmie/spincter is only one possible cause of flat stools. At this point, I'd worry more about keeping them soft enough to be smushed flat. that is a good consistency for this problem we share. No need to reinjure yourself for aesthtics that are going to be flushed anyway.
Don't know what to say about the wind. Prob. the only time I had that was after botox shots. It could be you have both h and f and that they are allowing a little passage way for air. that could explain the difficultly cleaning up too. Perhaps you could ask your CRS about this.

The pain in wiping is a very common problem and what you're doing is very good. Do you think moist towelettes might help?
Your gas "incontinence" is something you really should discuss with your surgeon before any LIS, as the LIS may make that worse, but that would depend on the cause.
I would occasionally have flat stools too, and that went away after my surgery, so i wouldn't be too concerned about it but again, it's something to talk to the surgeon about.
And you *do* need to give your arse a break at work, somehow!

Maybe you should try Milk Of Magnesia to avoid the hard stool. Many people use it as a stool softener on a nightly basis, long term it is safe, many of our Dr.s have approved it for long term use. I would start slowly, 1 tablespoon before bed and work your way up from there.

I am so sorry that you have all those problems : (((. It could be that your fissure , since it is so old, made a lot of scar tissue and that could cause gas incontinence as well as some stool leaks after BM. I was warned about that possibility by my CRS, and that is why I decided to have LIS after "only" 5 months of suffering.
All the best !