I have had fissures for two years. For the last year (not counting the last four months) I've had severe pain and often blood after BMs. Six months ago, I changed my diet and went off fiber supplements and a high fiber diet and feel much better and can go the bathroom easier and mostly without pain. The severe pain went away, but I still have blood streaked stools now and then and once in a while sharp pinching pains that last for a few seconds then go away.
I went to see a CRS and he says my rectum is abnormally small, so much that he couldn't examine me (this is what may be the root of my problems with constipation, fissures, and two bouts of urinary retention with ER visits because of the pain), and recommended a fissurectomy, removing a skin tag, and a surgery that loosens the muscles in the rectum.
Should I get the surgery? Is it worth the possible complications if I'm not in much pain now?

Welcome!
I think surgery is the only remedy for this issue, at least for me, but I spend most of everyday in pain, if I wouldve been offered LIS on my first CRS visit I would have jumped on it, nothing else has worked for me to stop the pain and I have tried it all. If u r not in pain so much that it's affecting your quality of life, though, the creams and even Botox may help but a tight muscle is a tight muscle.
You haven't mentioned if u tried all of those things on the two years you've had a fissure but miralax/movicol/ restoralax worked to stop the bleeding for me I haven't had bleeding in three weeks but still have the all day burn.
From reading everything on here, I think that if the muscle is too tight you need the surgery. But that's just my opinion, read on and I'm sure you'll know what to do, this forum is an absolute lifesaver!
Good luck!

Hi rockpine!
Sorry you've been suffering for awhile. I agree with Elphie, and surgery has definitely been worth it for me, although I did not have the extra work done (fissurectomy and skin tag removal). I only had the LIS. I've had fissures for five years off and on, and still got by without a fissurectomy. I would say, only remove a skin tag if it swells and hurts and bothers you a lot, otherwise you'll endure a lot of pain for nothing.
My personal opinion, is that it's not worth wasting years of your life and $$$ on obscure 'remedies' that don't work, when the surgery is relatively easy.
You might try to get a second opinion from another surgeon--that would probably be a good idea. Maybe another surgeon wouldn't want to do so much cutting at once...and some surgeons feel that a fissurectomy just makes a bigger fissure. The more cutting they do, the more you have to heal.
Best wishes!

Thanks so much Elphie and Alpinestrawberry for your replies! This forum is awesome since it is hard to talk about with people who don't have fissures.
I was debating surgery since I haven't had much pain for the last four months but I don't want to relapse back into the pain of last year.
I haven't tried the Botox/creams nor the meds to stop the bleeding--I was recommended surgery on my first visit to the CRS. I wasn't sure if my condition was really that bad or if the doc was jumping the gun.
Right, it seems my problem is the way that I'm built--if a muscle is too tight, it's too tight and may continue to cause me problems down the road if it doesn't get fixed.

Rockpine, you wouldn't be the first to question having the surgery because you're not in a lot of pain.
For what it's worth, I can tell you I was pain-free (thanks to daily Miralax) and I still went ahead and did the surgery. Because I knew that if I stopped the Miralax, or ate the wrong thing, or didn't have enough water that day, the fissure would be back. And I was tired of walking on eggshells around my butt. And having butt problems was taking a terrible toll on me, mentally. I was tired of the anxiety that came with it. The day I had my surgical consultation, the doctor actually couldn't see a fissure (again, thanks to Miralax). But he could tell how tight the muscle was, so he offered me surgery right away.
Everyone has a personal limit to how much they can tolerate, and you'll know when you've reached yours.

Hi Rockpine-
I'll chime in with my two cents. I had this fissure first two years ago and it did go away with my own self treatment after 6 weeks only to return a year ago this week to stay and stay no matter what. I have used the Nifedipine ointment most of this year (even now as I recover from LIS and a skin tag removal 6 1/2 weeks ago). I had two rounds of botox injections and they helped some but I would have 4 good days, 3 bad days and my skin tag became very irritated and swollen and bothered me a lot. I finally had LIS Feb. 17th- it isn't an instant fix and I was really questioning whether I should do it or not as I had a lot of pretty good days and things weren't as bad as in the beginning. But like Alpine says I knew if I didn't live this perfect existence, it would rear it's ugly self and usually at the worst time. Very much like her this has really dominated my life far too long and has made my anxious self much more anxious. I am still struggling with the aftermath of that- I have always had a tendency to have small openings- my mouth, my vagina when I was younger, my butt- and I think if your CRS things you really need the surgery, I would do it. I am feeling much better- still a little irritation but no pain with BMs or bleeding for the last 3 weeks and it wasn't too bad really. It takes time to get over the surgery and when I was hesitating a good friend said I might as well go ahead and get the healing process started. I am glad I did that, although I am still afraid and can't trust that it is really gone or almost gone!
Good luck
!
Bambi

Bambi, it's funny you mention having small openings. Me too. My mouth is so small it's hard for the dentist to work on, and my gynecologist once commented that she needed to use her smallest speculum to examine me (and this was after I'd delivered a nine pound baby!). So why should my rear be any different? Maybe the fissure was always destined to happen, whether I knew it or not.

Thanks Bambi and Alpine.
You're right, I shouldn't judge AFs by their best days. It's better to take care of it while I can. I went ahead and scheduled the surgery for April 27. My body reacted by getting a bit anxious after scheduling it--I've never had surgery before.
All three of my body openings are small too. Ditto for what my doctor said about using the smallest speculum to examine me too. There must be something to it.

For me good days r so few and far between, that surgery is the light at the end of the tunnel. When my SIL lost her sight five years ago in an industrial accident, they tried so many things to try to fix her eyes for over a year, that by the time they tried to do a cornea transplant her eyes were too damaged and surgery didn't work. After her accident, another man had the same accident, they skipped right to the surgery and he can see! Just goes to show u that messing with something, like my AF, can make things worse, maybe if I had surgery right away, I might b pain free and all my other issues like skintags etc might never have happened! I am glad u r going straight to surgery, we deserve to b pain free after delivering 9 pound babies! Some of us without epidurals! Ouch! Just so u know, my SIL just had her second child, she's never seen either, but she is happy and a great mom despite being blind. Strongest girl I know I'm proud of her.

alpinestrawberry wrote:Bambi, it's funny you mention having small openings. Me too. My mouth is so small it's hard for the dentist to work on, and my gynecologist once commented that she needed to use her smallest speculum to examine me (and this was after I'd delivered a nine pound baby!). So why should my rear be any different? Maybe the fissure was always destined to happen, whether I knew it or not.

Me too, about both the dentist and the gynae. At my last smear test, the nurse said that if I didn't have my baby with me, she'd've never believed I'd given birth.