Hi everyone.
I am a 40 year old male, slender build, otherwise healthy. I developed an anal fissure after having diarrhea that felt like it was trying to prolapse my rectum. It was so very traumatic and I felt the sharp pain right away. I have a history of constipation and developed hemorrhoids from straining and sitting on the toilet for prolonged periods. I have had a thrombosed hemorrhoid before so I thought this pain was another one. I tried to tough it out for 6 weeks, trying everything I could like eating healthy, being regular with fiber but no success. The pain was excruciating - the longer I stand, the worse the pain. It also occurred when I sat down and leaning any which way would not help.
I decided to see a CRS and he immediately diagnosed me with an anal fissure.
He gave me nifedipine cream to use for 6 weeks. I used it and I definitely felt the effects - passing gas was easier. Pain with sitting improved. Pain with standing was still the exact same. I would sit on a heating pad as it was not convenient for me to sitz bath as often as recommended. I went back and we decided to go for surgery. I went with the botox because I was afraid of leakage, the irreversibility of the procedure, etc. I had botox injection and a fissurectomy. I had a pretty rough post op course. I was deathly afraid of having my first BM and it was very painful. Day 3 after the surgery, I had the worst spasms ever, lasting hours. I had to take an oxy, motrin and tylenol and try to sleep it off. I was sweating, in tears and about to rip my hair out!
After 2 weeks, I actually had some mild relief but the pain still comes with standing, usually after 5 minutes and I would have to sit or kneel for a few minutes. At week 4, I had enough. The pain was actually getting worse and more often. It was affecting my life, my marriage, my mental well being. I lost 20lbs. I only defecated at night for fear of the even worse postBM pain that lasts 8-10 hours. I was miserable. My CRS would not consider an LIS until 3 months after the botox.
I went for a second opinion at that point. The next CRS examined me, saw the fissure and how sensitive my sphincter was because it started spasming during the examination. I got the LIS a week after the visit (got lucky with the timing!). After the surgery, I felt weird but the LIS incision pain was barely 0.5/10. I didn't have a BM until post op day 2 but I did not have ANY of my prior fissure pain. I did feel a small twinge, almost spasm like a few times but it barely affected me. I did not have any postBM pain. I had no leakage. I only passed gas easier and it sounds much louder too! I did not want to jinx it. I wanted to post on here so bad, give the good news. I waited until it was about 10 days post op. I am 100% recovered. I have not had any rectal pain at all. My constipation, even, is improved though I still regularly take supplemental fiber. THE LIS WORKED! My life is now mine again. I hope this gives others hope. I hope your pain is ephemeral.