Hey,
For the past few months, I have been having very painful bowel movements. Sometimes there is blood on the toilet paper. It gets cured after few weeks and then the cycle starts again. So I went for a colonoscopy today and my GP told me I have few small hemorrhoids and anal fissure. Im guessing since this has been happening for past few months, its chronic fissure. He also told me my anus muscles were really right. It was very painful even when put in the scope(Yes, I didn't get anesthesia...very bad idea). He recommended High Fiber diet and Colace along with Miralax. I tried this diet but doesn't help much. So I wanted to know what should be my next step. I asked about surgery but he said it'll be painful since they have to cut open a muscle in my anus. Im afraid, my fissure will heal for now but will return later on just like it has been. It gets very painful to the point where I don't feel like going to the bathroom sometimes. I have bowel movements everyday so its not like Im getting constipated. So I wanted to know your opinion on what I should do next. Any advice would greatly appreciate it.

Ah! Isn't it dreadful!! I have 2 fissure and multiple internal piles ....oh the joys! G.P's in my exp are not sympathetic and hand out laxatives and send u on ur way!!?? After 4 of the most painful months of my life I think I am winning? I use Anoheal cream 2 x a day, Lidocaine for anaethetic relief b4 a BM and I take a sachet of fibre gel..yuk after my tea! Its still painful but more bearable. Surgeon wants to give me botox injections soon-oo now I feel like an orange county housewife ha ha! If botox isnt successful then its LIS which after much reading I will have done. Oh other big tip is you must drink at least 2L of water and stay off caffeine. I have my usaul morning coffee and then water all day long. I notice the difference the next morning if I don't do this!!
Hope this helps you?
Hang in there x

Hey jsn,
Welcome to the forum!
If you've had your fissure for 2 months, yes it is chronic. If you aren't seeing a (colorectal surgeon) CRS then that would be the first place I would start! You need someone who deals with fissures and butt problems everyday!!
I had LIS 9 months ago and it wasn't as painful as living with the fissure.
I was sore but nothing like the fissure pain. Best thing I ever did! It kind of sits wrong with me that the dr. just told you that it's painful and they cut the muscle but failed to say it will heal the fissure?!
It's a good idea to eat a fair amount of fiber but not to much. The main thing is avoiding foods that are sharp and don't digest well(pop corn, taco shells,nuts) or anything that can cause firm/hard bm's. The miralax has been a life-saver for most of us on this board. Most CRS will prescribe one of the fissure ointments such as diltiazem, nitro, etc. You may want to ask about one of those.
I think it's really important to have a good CRS who gives you options.
The LIS does involve cutting the internal sphincter (muscle) which relaxes the sphincter and allows the fissure to heal. It may be necessary to heal your fissure once it becomes chronic. Most folks will try everything before resorting to the surgery. I did that myself for 8 months, but in the end needed the surgery(LIS). I could kick myself for not doing it sooner but I totally understand wanting to try everything else first.

Appreciate both your responses. I have a quick question, since I have a internal hemorrhoids and fissure, how would the CRS test for it? Will I need to prep for the exam or how does he check for those?

hopetoheal, I just don't want to go through the prep I went for colonoscopy again. The prep was more brutal then the procedure it self for me. I just wanted to know what they use to detect internal hemorrhoids or fissure. It seems like anoscope it is. Since I have really tight muscles down there, I don't want the fissure to rip open the fissure. Even the small camera they use for the colonoscopy was painful enough. My GP didn't mention anything else about the surgery other then its going to be painful. He did say they'll have to refer me to another doctor since he doesn't specialize in surgeries.

There's no prep Jsn. My CRS never used a anoscope. She just opened me up a little w/ her hands and saw my fissure. I know they need to use the anoscope to see the internal hems.
I was told once that they could sedate me to do the exam with a anoscope but I never did it.
I'm sure if they can visualize your fissure you may get away with not having the scope used and they can get a good look at the hems the day or your surgery(if you have the surgery)- while your knocked out. The only down side to that is you may not know if any extra work is going to be done there before your procedure is done.

Oh yeah! Colonoscopy prep can be pretty awful! That stuff you have to drink is really gross. :D A doc doesn't need a colonoscopy to find hemmies and fissures, just an asoscope exam is enough. Sometimes a CRS will send a patient for a colonoscopy before performing an LIS if there is reason to think that there is an underlying condition causing the fissure; but I'd be surprised if you had to get another colonoscopy, since it I take it you've had a colonoscopy relatively recently. I'm really sorry your doctor seems to have made the LIS sound so bad. The surgery is not so painful, certainly not more painful than a fissure, in my experience. I think it's great that your doc is referring you to a specialist. A CRS is the best person to see, even if you try conservative methods first (like nitro ointments or calcium channel blockers). And if you need the surgery after all, then having a good CRS will be all the more important. :D

Its been a while since I posted here and thought I might update you guys on my situation.
So tomorrow Im scheduled for LIS Surgery. I saw my GP few weeks ago and he recommended I see a Colon Rectal Surgeon since the fissure kept opening up.
Im really nervous for tomorrow for any complication and the painful recovery. What are your thoughts on the recovery process? Would I be able to get back to my regular schedule within few days or does it require more attention?

Good Luck with your LIS tomorrow! I think you've made a wise choice getting the surgery.
You will be sore for a couple of weeks but it should gradually get better in that time. Take your pain meds and a good stool softener such as Miralax to prevent constipation from the meds.
It's not like fissure pain, but sore and swollen feeling. Things are usually really numb the first day. Just stay ahead of the pain and take your meds before they wear off. It's really not bad at all, just need to take it slow as things will feel sore and swollen. Most will agree it takes a couple of weeks before feeling able to get back to life. A few days may be possible but seems like a far strestch in my opinion. The popular vote has been the 2 week mark before feeling somewhat normal and able to get back to routine.