My gastroenterologist did a colonoscopy a few months back and found an anal fissure along with a few skin tags. Today I saw him again and he booked a date next week for hemorrhoid ligation. I was confused, it sounds like he's just going to leave the fissure as it is and try getting rid of any hemorrhoids?

This doesn't sound right at all. I was expecting to be referred to a surgeon to perform LIS or botox at the least. I've never heard of hemorrhoid ligation.

What should I do? I don't feel like going through this painful process if it isn't going to solve the root problem. Clearly the fissure sounds more serious than treating a hemorrhoid.

Hi,
I think you are completely right in treading with caution!
I would seek a second opinion from a Colon & Rectal Specialist to ensure this is the right move or go back for a fuller explanation as to why they have decided on this route for you.
I personally wouldn't undergo any form of medical intervention in such a delicate area until I am satisfied I have all my questions answered and the correct procedure is justified.
GL to you in sorting it all out.....

I could be wrong, but in my extensive and obsessive reading I'm sure I've read they generally treat a fissure BEFORE they treat hemms. I too would seek a second opinion. I hope you get it sorted.

The hemorrhoid surgery is what caused all my problems in the first place. I got anal stenosis gradually from that surgery, then a fissure at 12 o'clock position that healed, then a fissure at 6'oclock position that didn't heal, after a year with the fissure I had LIS, it failed, I struggle for 5 more years in utter agony. My stenosis got so bad I couldn't pass a pea or a piece of corn without it getting stuck. I finally had double flap surgery in 2013. It really helped. My CRS told me too many hemorrhoid surgeries are being performed and too aggressively. The skin tags your doctor saw are more likely from the fissure. I would proceed with caution. If you're not comfortable with this surgery don't have it. Take care. Suzy

Yes. I totally agree with Suzy. Trust your instincts. How I wish I had not had hemorrhoid surgery! These days with Proctofoam and banding they can be dealt with short of surgery and the risk of scar tissue is much less. I have 2 non healing fissures due to hemorrhoid surgery (or ligation which is the same thing) now and am facing flap surgery. I urge you to get a second or third opinion and see a colo-rectal surgeon and not a gastroenterologist.

I agree that you should consult a CRS. Does anyone know what ligation is? I thought it was banding?

Volans: Would not have any hemorrhoid surgery of any sort unless it was absolutely essential, such as a thrombosed hemmie. Hemorrhoids are normal. We all (or nearly all) get them. The anal fissure is a different kettle of fish altogether. See a CRS.

Msimon: here is a link to ligation, and it is another name for banding: http://emedicine.medscape.com/article/1892099-overview

Thanks Savaici. I thought they were the same. I personally think that banding is a good idea if it will avoid a more invasive procedure later on. I have a genetic predisposition to hemmies and never want to go though a hemmie surgery again if I can help it. Having said that, it is pertinent that the damn Doctor not tear you with the anoscope in the process
Of course, I have also heard that a fissure needs to be addressed before hemmies, in most situations. Or at least address them at the same time in the case of getting LIS.

Thanks for the advice. I saw my surgeon today and she said I have to have an anoscope done next week to see if LIS is necessary.

AARRGGHHH!! I went in for my anoscope appointment today and they said I would be sedated and asked "You haven't eaten anything recently, right?" Uhhh, yes I have. "Well we can't do the procedure then, come back in two weeks."

These idiots never told me I would be sedated, they never told me not to eat or drink anything for 12 hours, and they didn't even apologize that they screwed up. If I was to get a referral to another specialist it would take even longer so I just have to stick with what I've got. It's times like this I wish my health care at least had the option for privatized care. I'll pay anything to make this painful wait go away.