Hello good friends,
2 months ago I was celebrating that my fissure problems were gone... And I did have 6 dreamy weeks with no pain whatsoever and a cured fissure through the regular Nifedipine etc medications, really back to normal life... However, a sequence of hard BMs set me back some, and here I am again to ask your thoughts.
So I've been having some bleeding and moderate pain after BMs in teh past 3 weeks. The pain isn't really that bad, it's a dull ache 1-2hr a BM and which lasts for 2-3 hours. However, given the blood, I went back to the CRS.
I was so "tight" and anxious given the setback that she said she couldn't really exam me too well. In the past, she could see the fissure very easily, but this time she couldn't see it. This was a good thing and made sense considering that I don't have the fissure pain like I had before. But anyway, she recommend an exam under anesthesia to check whether my fissure is back or if this is "just" hemorrhoids.
She also asked me what would I want to do during the exam as she could treat some of the stuff since I will be knocked out anyway. She said she could do a LIS, Botox and a rubber band ligation if she finds hemorrhoids.
I'm still thinking about it. She said herself that my fissure was't deep or long and was pretty external, and I had another doctor before recommending against a LIS for it. My current thoughts are around authorizing a Rubber Band ligation for hemorrhoids (pretty safe and effective procedure as it seems) and Botox in case she sees a fissure. Although I know that LIS is very effective, given my low pain (it goes away COMPLETELY 2-3 hours after a bowel movement, and all that happens when I'm in pain is that it's uncomfortable to sit), I think I'll be conservative.
She also said that this second episode could actually be "just" internal hemorrhoids with some levator ani problems given that my pain is dull, goes away, improves when I walk and is more prevalent on the left side. I used to feel this when my fissure was very acute, but I was mostly focused on the fissure and not this pain before. She gave me a muscle relaxant in the hopes this would address the levator ani and let the hemorrhoids heal themselves.
Any thoughts from people here? :)
Thank you!