I have suffered with IBS for over 20 years and now have to deal with this awful fissure as well. As if the IBS wasn't enough!
Anybody else on here have IBS?
Anybody with IBS had LIS surgery? How was the incontinence afterwards?
The fear of incontinence is the main reason I am so terrified of the surgery.
Thanks!

Hi, You're not alone. I've had IBS for over 40 years, before they even had a name for it. I got it after the birth of my daughter and it took them 4 years to diagnose me. At one point in my life I couldn't even leave the house because I had so much diarrhea. Then as I got older it was more constipation. I had to have a hysterectomy and hemmies surgery. Believe me it left the general area very fragile. I didn't even notice the constipation at first because I was greatful I could leave the house. If I would have put the pieces together sooner I would have realized that my opening was narrowing (a common side effect of hemmie surgery) but I never did until I got my first fissure. It healed on it's own but a year later I got another one and had LIS. While it relaxed the muscle some it did nothing to make the opening larger. My next step is a flap surgery but because I have IBS and still get the horrible cramping and diarrhea sometimes I'm a little afraid. I'm lucky though, my old gastro doctor gave me an IBS diet a long time ago and it really does help. I've kept it and when it starts acting up I go back to it. I know with the fissure diet they encourage lots of fresh fruits and veggies but if I sat down and ate a slice of watermelon I'd be in the bathroom all night long. I understand your frustration, there is so much doctors don't know. They should listen better to their patients. At least on this site we can help each other out. As far as incontinence goes the risk is really low. Most people who have some have it to gas and maybe a little liquid for a short time, remember as you heal things will tighten up some again. I can't tell you what to do just go with your gut. If you've weighed your options and are comfortable with your decision then stick with it but don't be afraid of the surgery. If you do decide to have it listen to your body. Don't over do it and give yourself time to heal. All the best Suzy

Thank you for answering, Suzy, and I'm sorry you've had to go through so much. I totally understand about the eating of lots of fruits and veggies or taking Miralax or lots of fiber. I have to be careful with all of that. Yes, it is all about knowing your body and trying to find a balance for yourself. But with IBS that doesn't always work either. I think my IBS is now alternating between diarrhea and constipation and that is what caused the fissure back in September to begin with.
Thank you again.

Yes, I have IBS, possibly Crohn's, and also severe post-cholecystectomy diarrhea (chronic diarrhea following gallbladder removal). If that wasn't enough I also have endometriosis that severely affects bowel function with even more diarrhea. LIS in my case is not recommended because I have such severe bowel dysfunction which includes urgency to the point where it is difficult for me to be more than seconds away from the restroom all day long. I barely make it there the way I am now, so doctors are concerned about what LIS would do to my ability to have any control at all.
That being said, it doesn't mean that everyone with IBS is excluded as a good candidate for LIS. Given that fissures are really common in people with IBS, (probably due to an underlying neuromuscular problem that affects the bowel, rectum, and anus), it is quite likely that a lot of people who have IBS have had LIS safely and effectively. One of the concerns of course is with incontinence, but another would be recurrence of a fissure down the line. If the underlying IBS isn't improved, I'm wondering if people with IBS who have had surgery might be at higher risk for fissure recurrence in the future.

I don't think you can every completely rid yourself of IBS problems once you have it. At least I can't. But doesn't LIS surgery significantly reduce your risk of future tears? Wouldn't that be the case even if you had IBS?
jr2: How do you cope with the fissure knowing you cannot have surgery? Have you found a way to heal on your own?

LIS helps heal the fissure you have now. Theoretically, it should help prevent recurrences, but I wonder about IBS. I wonder because at the end of the first year after LIS has been completed, sphincter tone returns to 80% of where it was prior to surgery. While the sphincter tone is diminished by 20% after the first year, which is still substantial, it isn't any more than is achieved using something like nitroglycerin or nifedipine. With the abnormal force and muscle contractions happening in the GI tract in IBS patients, I just have questions about potential recurrence.
Coping is difficult. I have multiple fissures all the time and have for a year and a half now. I don't have much choice but to cope and look at it in a similar way to all my other chronic painful health problems. Some days the pain is worse than others. Some days I just have to sacrifice to a lot of crying and keep constantly reminding myself to breathe, to hope, and then to mop myself up off the floor and help others in ways I can and genuinely celebrate their healing with them, and just get through the days the best I can.
On the more practical side, this is what i do every day...
http://anal-fissure.org/t5658-what-helps-me#79677

jr2: I am so sorry you have been through so much. Thank you for the link. That was helpful.
Suzy: can you share your IBS diet?

so tired...
You might want to check out a book called IBS Free at Last. It is a diet specifically to treat IBS based on really sound principles related to the types of foods that are triggers for most IBS sufferers, called FODMAPS, and how to orient your diet choices. Really helpful info. in it.
http://www.amazon.com/IBS-Change-FODMAP-Elimination-Edition/dp/0982063520/ref=sr_1_1?ie=UTF8&qid=1360290061&sr=8-1&keywords=ibs+free+at+last

Hi sure:
Breakfast: Shredded wheat or bran flakes but not whole bran , orange juice ( drink slowly and intermittently.) In addition, toast and coffee may be taken if desired. You may add a little fresh fruit to your cereal.
Lunch: Sandwich with lettuce and meat or cheese (avoid cheese if constipation is your problem) a non carbonated beverage such as iced tea, coffee, water or diluted fruit juice. Cooked fruits such as canned peaches or pears etc. NO RAW FRUIT except as permitted at breakfast.
Dinner: Meat, cooked vegetable, small salad (lettuce and tomato, dressing) and non carbonated beverage.

Foods to avoid, Raw vegetable except as permitted in salad, candy, chips, nuts of all kinds, pastries, beer, raw fruit except as permitted on cereal.
Acceptable snacks:
Canned fruit, pretzels, yogurt, frozen yogurt, jello non carbonated drinks. A glass of wine is permitted if it doesn't interfere with any medication you may take.
This diet was given to me a long time ago by a gastroenterologist but it still works. IBS sufferers have a difficult time digesting raw fruits and raw vegetables, that's why I've not been able to do the fissure diet but this diet still works.

I too have IBS although a mild one, not too many flareups. I have constipation though, never have a feelign I've quite emptied my bowels.
It is so frustrating to know there is nothing you can do about either, the IBS or the AF. AF does get worse with an IBS flareup.