by NeuropathicGuy » 21 Jun 2011, 22:53
Hey Mum,
It sounds like basically exploratory surgery, just without the surgery (unless they find something that requires immediate attention of course). My guess is it'll be pretty similar what I had done in the ER when I showed up there with bad fissure pain. They sedated me with IV painkillers and sedatives (conscious sedation only so I was pretty drugged up but not fully out) and then spread the ol' cheeks to have a looksie inside. They couldn't do this without sedating me because it was way too painful.
I don't think it's a bad thing to do, and in fact it's what I would push for if I were in your shoes. If the manometry test showed normal rectal pressures, then that means you likely wouldn't benefit from a second LIS, so they're looking for a source for the pain. If they find something like an abscess during the exam, my guess is they will most likely drain it on the spot (making someone wait to have that done would be a little ridiculous), but otherwise I wouldn't expect anything else to get affected. I wouldn't worry too much about the fissure re-tearing ... to be fair it's not something that can be ruled out completely (it's a possibility any time that area undergoes trauma of any kind), but IMO the risk isn't very high. I had my ass examined in this manner when my fissure was at its worst and it didn't get any worse afterward. And as everyone on this board knows, I'm kind of an epic complainer :)
Personally I still think that what you're experiencing is just one of the ups and downs of the LIS healing process. Obviously I don't know the intensity of pain it's causing, however, so if the pain is really, really bad, then internal hemorrhoids or an abscess can't be fully ruled out either. It's true that you don't have the classical symptoms for either, but that doesn't mean much as plenty of folks have diseases or disorders with atypical rather than classical presentations. Classical, specific symptoms only help to identify problems; their absence generally shouldn't be used to rule out possible suspects.
Long story short: IMO the benefit of being able to see the area and understand what is (or isn't) going on clearly outweighs any risks related to re-injuring the fissure. So I would personally be full speed ahead as far as this exam, and am glad to hear that they've made it an option for you. It's far better than someone blinding guessing what's going on. In the best case, they'll see nothing and you'll know it's nothing serious. In the worst case, they'll find something and initiate appropriate treatment. Both beat doing nothing :)