I'm new here... sadly. Actually been reading a lot of these forums for about 4 months since i last started to have fissures...
My story began that i have developed a fissure after a serious bout of constipation following my miscarriage and D&C. Seriously i do not know if it was my strict ginger confinement diet after the miscarriage that caused the constipation, the D&C operation that has disturbed the bowels or simply bcos i was too depressed and lost too much tears (water) frm crying after the D&C...
The first fissure gave me the worst pain in my life. I thot i'm gonna faint in the toilet passing shards of glass repeatedly , that i told hubby to check me up if i have absolutely no sound in the toilet! This fissure has healed after a week... however, the worse is yet to come. I thought i could stop my lactulose since i'm healed BUT suddenly have another bout of semi-hard stools that gave me ANOTHER fissure next to the old healed fissure. GOD, that i was then i saw a CR, took the GTN, fybogel and licocaine jelly...
The GTN and my high fiber diet healed my NEW fissure for about a week and then... i think i suddenly got another bout of hard/semi-hard stools (or maybe cos of my tension when bm) that hurt / torn other areas, now at the back and the right side.
Sigh.... it's a very long story, so i cut short. Eventually fybogel gave me prob of too large stools, and i have to switch to lactulose again...and then when things were healing, i have switched to prune juice and vit c for a month... BUT After another 2 months, when I thought i have finally healed 3/4 of the fissures. I RECENTLY AND SUDDENLY, have another bout of semi-hard and dry stools that torn open ALL 3 FISSURES.
Sigh... what shall i do? After 4 months of ups and downs, i'm back to square one. I'm in pain, disappointed and sad. My CR kept asking me to do the LIS, since i have exhausted all the conventional methods (GTN, lactulose, prune juice, aloe vera, fybogel, high fiber diet, sitz bath)...now i'm even started on magnesium, lactulose (again), vit e oil and aloe vera (again)...
I have countless of setbacks for my healing, and i'm beginning to think i'll be like this for the rest of my life... I have dropped 5kg in 4 months and getting skinner by the days, especially recently after the retear, i absolutely don't dare to eat...
if i do LIS, how do i take care so i won't have infection? And what are the chances i'll become incontinent? And possible to prevent scar tissues? what if i do have scar tissues when recovering? And what's the chances of recurring?? As i have so many retearings before, i really don't know if surgery can still throw me back to square 1.
And bcos i still hope to have a child or 2... if i have LIS, does that means that it's better for me to go c-section in future?
really hope someone can give me another natural remedy which can help not to retear again or advice....
thanks lots...

Hi there,
sorry to hear your story, and all the pain and grief you're going through.
Well, as you've tried all the non-surgery approaches, then you only really have a choice of botox or LIS. I think overall, the LIS is better, as the botox isn't permanent and usually needs more than one round, and most people progress to LIS anyway.
In the hands of a competent CRS who has done many of those surgeries, the risk of incontinence is almost zero. There are lots of us on here undergone the surgery - none of us are incontinent. The horror stories that you read on the internet are because they have had the op performed by a surgeon who doesn't know his ass from his elbow!
As you probably know, the LIS doesn't actually heal the fissure, just provides the best enviroment for it to heal. The chances of it reoccurring? Well, I'm the wrong person to ask!! I've had 2 fistulas reoccur, now perhaps a 3rd!!Yes, they can reocurr, but they will heal quicker, and most people do heal without them keep coming back.

Thanks val for advice... was thinking the same... but one thing i'm very curious, why do i suddenly have a bout of semi-hard stools (usually last for 2 days or so) when i am eating about the same every other day? Seems like the constipation can just happen whenever i m stressed or for some other reasons i'm not even sure any more...And if it's semi-hard stools that can easily re-tear the fissures, won't it retear the fissures again after LIS? So.... that is y i kept thinking it is due to the sudden constipation that caused all these fissure unable to heal.... IS THIS THE SAME WITH THE REST OF FISSURES SUFFERS?

Another thing i would like to ask,.... most of the people here only suffer 1 fissure? For me, i have multiple (1 can be seen, the 2 deeper in my canal as my CR said), so can the chance to heal by LIS be lowered?
And i did read that some people can recover fully without surgery (most keep on high fiber diet, magnesium, softeners, wheatgrasscream, etc), I really do not know y can't i???
Also, do i still need to take stool softeners for the rest of my life even after LIS?
Someone who has similar problem as me, kindly advice... thanks...

Hi there,
I had LIS last year and have healed. LIS will stop the spasms and the tightness which is causing the re-tears. It may be that the bm's you are having aren't the reason your fissure keeps tearing. Once we get a fissure and the muscle goes into spasms, re-tears will happen no matter how soft the bm's are.
Here's a link that you may find encouraging. She had three fissures before LIS and healed.
http://anal-fissure.org/t2527-a-little-over-one-year-post-lis-counting-my-blessings#52185

hi dawn, thanks for the link, very encouraging indeed! at first, when i had a fissure and got healed after a week, i really have no idea why stopping the lactulose (stool softener) will cause me to create another fissure despite firmer, semi-soft stools! So i guess you are right about the spasms. BUT the thing i do not know is WHY did the spasms and tightness still exist despite the fissure is 95% healed?

and Dawn, can you tell me more about ur LIS experience? How many fissures have you and how long u take for the pain to go away and completely?
thanks thanks... i nd all the info i have before i go for it...

Sometimes I think we get too caught up in wanting to know how and what caused another tear! In my honest opinion, they sometimes just keep tearing for no reason, or no reason we know about. We like to blame ourselves - think what we've done/not done/eaten etc, and avoid what we thought caused it, then it happens again and we search for another answer! Fissures are annoying little buggers that feel healed one minute then creep up on us and hurt all over again!
I think that if the muscle is too tight and spasms (whether you actually feel it or not) then the fissure will never heal until the muscle is made to relax.

dwarfs8 wrote:and Dawn, can you tell me more about ur LIS experience? How many fissures have you and how long u take for the pain to go away and completely?
thanks thanks... i nd all the info i have before i go for it...

Hey there,
I had one fissure. I haven't felt any fissure pain since the day before my surgery. It took 6 weeks for my fissure to heal. I had a skin tag removed with my LIS that was caused by the chronic fissure. I was sore, like a bruised feeling but not like fissure pain. It took about 2 and 1/2 weeks to feel pretty good and carry on with normal life. In my case, the surgery was much better than dealing with the fissure, even being sore and swollen didn't compare.
AS for the tight feeling and a fissure being 95% healed- if the sphincter is too tight, the fissure will re-tear. I healed for 4 weeks before having my surgery and still re-tore for no good reason. I never changed my diet, stool softener or anything and it still happened.

dwarfs8 wrote:hi dawn, thanks for the link, very encouraging indeed! at first, when i had a fissure and got healed after a week, i really have no idea why stopping the lactulose (stool softener) will cause me to create another fissure despite firmer, semi-soft stools! So i guess you are right about the spasms. BUT the thing i do not know is WHY did the spasms and tightness still exist despite the fissure is 95%
healed?

Once you get a chronic fissure the internal sphincter just flips out and closes up. I guess it's trying not to tear again when it clenches. Who knows really but that's how we're made. Crazy!!