Fissure Recurrence

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Fissure Recurrence

Postby Davo » 01 Feb 2012, 09:19

Hi guys,
What are your understandings of fissure recurrence following healing?
I have read many things and the chances of recurrence are high following GTN/Botox but extremely low following LIS.
I am on GTN and doing well so far however my CRS has told me the chances of recurrence following healing are 1 in 3. Reading various reports and studies on line suggest this is between 25-40% whereas other surveys have suggested no recurrences at all (at six month follow up).
I have also read that people with longer term chronic fissures are more prone to recurrences than short term (but still chronic) fissures.
Finally I have also read that people since sentinel piles (skin tags) are also more prone to recurrences.
So I am just wondering what everybody else’s experience tells them and what they have been told by their doctors/CRS’s?? Also if anybody else on here is going through a recurrent fissure could I ask how long you had your first one for and how long you were healed before you had the recurrence?
Davo
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Re: Fissure Recurrence

Postby workingonit » 01 Feb 2012, 11:42

I thing all you said is how I understand it to be.
My CRS doesn't seem to think I will heal and will have to live like this forever. (gonna get a second opinion next month), but anyways.
I first noticed it last June. No spasms but super sore. Couldn't sit for long. I may have had it before that though as I had a skin tag. But I thought it was a hemorrhoid. So I healed up in a couple weeks.
Then we moved and it was months before I could see a doctor about the hemorrhoid, which was actually the fissure. Perhaps it never fully healed? Perhaps it would come and go just a bit. I wish I knew. It got worse in late September and I started trying to get referred to a specialist. My referrals kept getting lost and finally I found another GP (who mistook it for a hemmie too) and got the referral I needed. I told her who I wanted to see, as I had been researching it by then. It all seems so stupid in retrospect, but a lot was going on at the time.
I think the chance of recurrence is higher without surgery because it takes the skin over a year to regain most of its strength and in that time your sphincter is probably still on the tight side. So any variance in diet in that year is gonna be a problem.
My mom is a case of success with just a cream. It took her months to fully heal, and she was actually all set to go for the botox, when the doc said that it looked like it might finish healing on it's own. It has been 1.5 years since she healed and she is still fine. She sticks to a diet with 30g of fibre a day (no supplements or softeners) and drinks lots of fluids. She maybe has a glass of wine now and then and a cup of coffee in the morning. Every now and then, she eats like she shouldn't, like cheese and crackers for dinner. But it didn't recur. So I guess her skin is stronger now.
Since I take after her, I hope I heal as well as her too. Touch wood and whistle!
Sure hope it works out that way for you too. Sounds like you are doing great! You just need to be patient.
-woi
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Re: Fissure Recurrence

Postby Guest » 01 Feb 2012, 12:01

Fissures and their healing and recurrences happen differently for everyone. Once you have had a fissure you are probably always at risk for another one. I started getting fissures as a teen... Nothing as bad as what I get now, and they would heal with no intervention. Then things changed. Got my first really bad case during a terrible time in the 90s when i had salmonella followed by a C. Diff. infection caused by antibiotics. Took months and months to heal, which it finally did. Next major bout happened in 2000... Again... This time took almost a year, but finally healed... Until... Somewhere around 2004... Back again... Took about six months or so that time... Until 2011... This time though ... These are fissures like I've never had... Multiple ones (3 or 4 currently)... It started back in September but for some strange reason I didn't think it was a fissure. You'd think with my fissure resume I'd pretty much know it when it happened. But it just really felt more like irritation, not the razor blades pain I'd had before. The CRS confirmed multiple fissures, one deep enough to see the muscle fibers underneath.
I think fissures are really complicated and people get them for different reasons. Fortunately, most people who have some sort of procedure do have successful outcomes, at least for the current fissure situation. But still, over the long term they are still probably going to be vulnerable to new fissures. Very long term followup data are just not really available on that. My dad had fissure surgery many many years ago (and several hemorrhoid surgeries)... He still gets fissures (probably many years chronic at this point...and he still has hemorrhoids... )
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Re: Fissure Recurrence

Postby sputnik » 01 Feb 2012, 15:48

these little cuts are just horrible. Myself, got in sept/11 and couldn't see it anymore in nov but still burning on and off so i don't know if its back or what as i don't see it. I do get occasional hard stool. I am thankful so far the pain from my fissure has not been severe but ongoing. Oh boy i hate to write this as i will jinx myself. I once wrote on my ibd support group i never had a hemmi and what popped out ina week was a hemmi.
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Re: Fissure Recurrence

Postby workingonit » 01 Feb 2012, 15:51

touch wood and whistle ; )
-woi
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Re: Fissure Recurrence

Postby Davo » 02 Feb 2012, 06:33

My father had a very nasty fissure about 12 years ago, before the days of LIS. They actually fitted him with a temporary (2 month) coloctomy bag which effectively put his butt out of use for 2 months.
After the two months the colostomy bag was reversed and he has never had any problems since. He never actually changed his diet or his alcohol consumption so in my opinion he fully healed without surgery. (appreciate he had surgery for the colostomy but AF just healed naturally)
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