Hello,
I've been reading this forum for about a week now, I've learned a lot from you guys, but I have still some concerns.
My story: I've had fissures for almost 5 years, what I used to do to treat them is fix my constipation problems by taking a stool softener powder called Movicol and the pharmacist also gave me horse chestnut pills and new healar cream, the fissures usually heal after a week or two.
I moved to Canada, I used laxitives 2-3 times a week to avoid constipation as drug stores don't have the relief of constipation powder.
Ten days ago I had a really bad constipation and I went to the bathroom and tried but it was too hard and I stopped and took a laxitive thinking it will soften the stool, guess what, it didn't! Now I believe I have multiple fissures, the first 5 days I was bleeding during every BM and the pain was bad as the stool softeners that I bought didn't work. I ordered the product (constipation powder) online and it helped me the past 3 days I've been having much better BMs no bleeding, but still I have pain afterwards for hours. I'm considering doing the LIS surgery to get rid of these fissures.
My concerns are, 1) the complications 2) recovery time. a) Would it affect me if I go to the university? I don't want have pain during a class nor pass gas during a lecture :( b) I play a self-defense sport and I want to know how long after the surgery would it take to go back to gym. And a problem that I'm having is that I can't find a good colon/rectal surgeon here in Canada, St. Catharines or Toronto area so I can check my situation with the surgeon.
Can you help me this guys?
Sorry about my English and thank you for your time,
Matt.

Hi Matt - I'm so sorry that you are suffering. Just so you know, in Canada, Movicol is called Restoralax. It's the same stuff and you should be able to buy it at any drug store. As for the surgery, you are looking at 6-8 weeks recovery time, but you will likely be able to resume mostly normal activities after two weeks. Attending lectures might be ok after two weeks, but I'd say your workouts are a no-go for a month or so, depending on how quickly you heal.
I'm sorry to say that getting a surgeon will likely be a bitof a challenge. We have ridiculously long wait times in Canada so you should get your GP to refer you asap. I was waiting so long that out of desperation I went to the Rudd Clinic in downtown Toronto to have an LIS. I had a horrible experience there, although the surgery fixed my fissure. Others, like redcharger and Adam had good experiences. I think you should talk to you doc asap and get a referral. You might get lucky and not have to wait too long. In the meantime, maybe your GP can give you a script for diltiazem or nitro, ointments that can possible heal new fissures. A surgeon would likely have you try those ointments first anyway.
BTW, you English is great! Welcome to Canada! I hope you feel better soon so that you can enjoy your new home.

Oh yeah - complications! That's pretty important! The number one fear everyone has is incontinence. The risk of that is very small, for incontinence to stool. Some people pass gas a bit more after the surgery, but that often subsides after a few months. Other experince leakage, not a lot, but enough to irritate the butt. Again, this often improves afterna few months. Another possible complication is developing an infection. This happened to me - I developed an abscess at the incision site that eventually formed a small fistula. I had surgery for that about 11 weeks ago and I'm feeling pretty good now. The risk of infection is pretty low, but it does happen. The surgery to fix a fistula is pretty straight-forward and the recovery wasn't any worse than the LIS.
If you are looking at surgery, try not to worry too much. It sounds worse than it is and it gave many of us our lives back :)

Thank you so much for your replies.
I have more questions if you don't mind, I live in St. Catharines, can you point me in the direction of a good clinic or doctor/surgeon so I can go for a check up?
I have never been to a doctor about this before and never done a colonoscopy which is my concern right now, since my fissures are getting better a bit and the pain is not as bad as the first days, I fear two things if the doctor/surgeon tells me to do a colonoscopy to check my situation:
1) The pain while doing the colonoscopy
2) Going to square one with fissures after doing it
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Edit: When the bleeding stops and the pain is getting better (slowly) and the BMs are getting easier, does that mean the fissures are healing?
Thank you for your time,
Matt.

Hi again Matt - I take it you don't have a GP (general practitioner/family doctor) in Canada yet? There are a number of websites that can help you find a doctor. I found one that looked fairly trustworthy:
http://www.stcatharines.ca/en/livein/FindAFamilyDoctor.asp
You can also look up various doctors on rateMD to see what patients have said about them:
http://www.ratemds.com/
I'm sorry I don't really know much about available surgeons in St Catherines or Toronto. Your GP should be able to help you out with that. You can also go to the website for the Ontario College of Physicians and Surgeons to look for the specialist you need.
http://www.cpso.on.ca/docsearch/
They have a doctor search and you can find records and contact information. Your GP will likely refer you to a surgeon s/he knows and who is in your 'catchment area'. If you are not happy with your GP's choice, you can also find you own surgeon outsided your catchment area, by using the Ontario College of Physicians and Surgeons website. You can then call the offices you find to ask about wait times, and then ask your GP to refer you to the surgeon you found for yourself. (I had to do that a few years ago for another medical issue - the surgeon my GP referred me to wouldn't be able to see me for almost two years so I found another surgeon who was able to see me in one month - it just took some research.) Just to give you a heads-up: getting to see a specialist for this kind of problem can take a LONG time, so definitely make sure your GP understands how the AF is affecting the rest of your health and your quality of life. Docs tend to underestimate how life-altering AFs are.
I had a colonoscopy done when I had my fissure and I was very surprised that it didn't hurt at all. The prep didn't cause problems with the fissure. That's mostly because it's mostly liquid that comes out, and it doesn't even sting much (maybe the drink alters the ph of the stool?). The procedure itself wasn't painful because I was put under sedation. It also didn't make the fissure worse. So don't worry about the colonoscopy - many folks here have had a colonoscopy with a fissure and it was not nearly as bad as they expected it to be. The worst part really is drinking down that awful solution that makes you poo. The trick there is to keep it on ice and make it as cold as possible, then it doesn't taste so bad.
Good luck with everything - I hope you get to a specialist very soon! :D

Thanks again for your help man. I really really appreciate it.
I will try to find a good GP and CRS, wish me luck!

Good luck, Matt! :D

Hello again,
During my search for a CRS my AF situation got better and it lasted for about a month with no pain, no blood and i controlled my constipation by taking restoralax two timesa day (two sachets) but for some unknown reason four days ago i got constipated and i got it back :( not much pain during BM since i use restoralax but the burning won't go away - hot showers, ibuprofen, nothing it lasts for almost the whole day and when the pain becomes less and less I get a BM and the whole process resets.
This is bad because i go to a university and i'm doing my mid-terms.
I have few question:
1) Is it okay if I take the stool softeners everyday? two times a day more than the recommended amount.
2) I'm looking for a good ointment, I used anusol but it doesn't help much, it takes away the pain for few minutes and then the pain comes back ( i had to use it like every hour instead of four hours which i think bad)
This is making me depressed, I want to go to a clinic but the inspection is what i fear - touching the AF and whatever that makes the extra burning is going to be painful and might make it worse.
I seek your knowledge,
Matt.

Hi again Matt - I'm so sorry you had a set-back. Your story is a very familiar one; unfortunately, that's pretty common with these dern things! I'll try to answer your questions and hopefully others will chime in too to share their wisdom.
1. Restoralax is quite safe to use everyday, from what I understand. It's not a stimulant laxative (it's an osmotic laxative, which means it draws water into the bowel to help make soft BMs, so there's less of a risk of dependency). I wouldn't take more than the recommended amount, though, without consulting a doctor.
2. Please be careful with anusol. The over-the-counter version is probably not harmful, but it won't help heal your fissure. Don't let any doc give you a prescription for Anusol HC. That has corticosteroids, which many of us here believe made our fissures worse (corticosteroids can thin the skin and make the tissue more vulnerable to tearing). Products like Anusol are actually more for hemorrhoids, not fissures. They can help dull the pain for a short time, but in the long term, they don't promote healing and can even cause more problems.
I really strongly encourage you to go to a doc right now and get a referral to a proper surgeon. Ask the doc to prescribe you some Diltiazem, nifedipine, or nitro ointments. Those are the proper topical treatments for fissures.
Many of us had to deal with major depression and anxiety when we had our fissures (I and many others were even on anti-anxiety and anti-depression meds). This takes a serious toll on our psychological health, so please don't wait around hoping things will get better on their own. I'm sorry to say this, but your fissure will not get better on its own at this point. You definintely, seriously need to see a doctor, and especially a colorectal surgeon. Please don't put this off! Fissures often get worse very quickly and you don't want to have to suffer while you wait for months to see a specialist.
I hope this helps.

Hey, thank you so much for your reply.
After my post, I called a friend and asked him if he knows a good clinic to take me there and he did, I went there and saw a doctor, I told him I had a BM and there was blood, and I've had this for almost 3-4 years it comes and goes but this time is way worse and I think I have multiple fissures, he said let's see - he looked at my butt for about 30-40 seconds (I almost screamed when he spread the cheeks(spell)) and he asked if I had put any creams I said yes, and then he said: "Nothing to worry about, you have a scratch and and small hemorrhoid, just keep doing what you were doing and take ibuprofen 600mg every 6-8 hours for the pain." I was like there is no way all that pain and blood from a scratch." after 5 minutes of talking I left.
I think I need to go to another clinic to check that out again, because no way it's just a scratch! Since I've had this pain/burning since this morning.
I took the pain killers and guess what - still burning pain (a bit less) but it's there.
I'm going tomorrow with a friend to Toronto, I asked him I wan to go to a clinic there (Rudd Clinic) my question is: Will they check my situation or do I have to get a referral?
Thanks again,
Matt.