Hi!
I have a few questions that i'm hoping someone on this forum has the answers to. I've had two fissures for about 7 months now, one healed pretty much after 3 months, the other one is located under an internal hemmie, so thats probobly why the healng process is so slow. However, I've felt great the last few weeks, no pain, just discomfort and mild burning after a BM. Basically, pain that i can live with.. today i'm pretty sure i had a re-tear because of the extreme burning i felt for a couple of hours after my morning BM. Still no spasms, but i'm scared it's just a matter of time before the terrible spasms starts again.. On my last check, i was supposed to get botox, but my CRS told me that it wouldnt be necessary because my muscles are NOT too tight. Does that mean having LIS is out of the question for me?
I would rather do the surgery than having botox at this moment.. but if LIS doesn't help, then what? I dont know where to go from here, and my gp and CRS keeps telling me this WILL get better and one day I'll be healed. But i can't take this anymore, i'm at my breaking point.
God, I'm tearing up here ;(
Will LIS only work if the muscles are too tight? And about the LIS surgery.. Do they make the cut INSIDE the anus? or is it outside?
Hoping someone takes the time to give some answers, because like i said. I'm at my breaking point and I don't know how long my body and mind can cope with this..

Soey... I'm so sorry you are suffering so much after getting yourself to a " liveable" condition.

You are right, LIS is only given to people who have an elevated anal resting pressure. If the muscle was cut on a normal sphincter, it would cause incontinence and not necessarily help to heal the fissure.
The option for low to normal resting pressures is advancement flap surgery.

You could try giving Botox a shot... It's not permanent, and it's worth a try if your only other surgical option is a flap. There is also the option of all the creams... Diltiazem, nitro, nifedipine ... All worth a shot.

Hang on in there, go back to your CRS and discuss what else are your options.

OMB x

Thank you so much for responding! I'm hoping that it's just the burning that i have to live with now, and not the spasm.. advancement flap surgery doesnt sound too good scared that it will cause more damage Botox is not a good idea for me, because of my hemmies.. The botox will upset my hemmies, and i feel my fissurepain is enough to deal with on its own.. Can't believe that i had a retear, I'm still trying to convince myself that it's my internal hemmies, NOT the fissure.. Oh well..
This is 2014, I can't believe they dont know how to cure a PAPERCUT INSIDE THE ANUS!!!

I would say if the spasm does not come back using creams might help, but if the spasms come back your pretty much in the chronic stage. I would not want to live like that and think Botox would be the least invasive option. It is true that people, including me, have had trouble with hems after botox but things usually settle down. Unfortunately, as I found out Botox does not work instantly, it can take weeks, month to feel the full affects. Although people on the forum have had mixed results from botox, I believe it is due to the individual situations. Meaning, not having high pressure going in, no other complications like other surgeries, IBS, bad constipation and then making sure you get a large dose of botox. good luck.

Hi Soey,
I'm so sorry you're in pain today. It's very frustrating when you start hurting again after feeling great for a while. Hopefully this is just a little set-back. If you didn't spasm, I think that's a great sign. My bet is that you'll be better in a day or two. Take it easy, keep up whatever you do to keep your stools just right. Take pain killers. It's my belief that pain causes spasms or makes them worse, so don't try to tough it out - if ibuprofen (or whatever) helps the pain, take it!

If you find gentle heat helps, use a hot water bottle or heat pad to keep your bottom warm all day. Try to increase the blood flow to your anus. Use nitro, diltiazem or nifedipine, as OMB says, because they also increase blood flow to the anus.

If you don't have high resting pressure, I don't know how botox could help, honestly. It's supposed to partially paralyse the anal sphincter, and should have a similar effect to LIS. But I'm not a CRS, so I don't really know!

Just remember that set-backs are really normal. If you've had weeks of feeling good, and no spasms now, I think it's likely you will recover. I went through a similar process, and each time I felt really down and depressed. But I haven't had a severe episode for months now. Just some soreness now and again. Hang in there! But see your doc if you don't start to feel better really soon.

Thank you so much, i needed to hear that. havent had the spasms for weeks/months, and like i said, it was just alot of burning after my BM, and alot of soreness all day. And it felt like i was pooping pieces of glass again, and I know that's not a good sign.. And yes, one bad BM does alot of damage mentally. Might have to start using antidepressants soon.. I will talk to my doctor again in a few days if it gets any worse.
Thank you guys, Don't know what i would do without this forum :)