Hi,
I first got my fissure in Mar 2011. Since then it bothered me only about once in a while for 2-3 days at time and was pretty manageable. However, things took a turn for the worse this April and since then I have been constantly dealing with the fissure. I saw a GI doc in early June who put me on Rectiv and I was on it for three months. When that didn't help I consulted 3 different CRS's since then I have been on Nifedipine for about 1.5 months, again without any improvement.
Each CRS examined me and told me to continue the regimen water/miralax/rectiv/nifedipine and see them in a month, I have gone back to the first two and am going back to the 3rd in a couple of weeks. The first two more or less said that surgery was the only option at this stage and they didn't think I could heal based on conservative measures alone. The first CRS does what is known as Standardized Anal Dilation(SAD), while the second does LIS. The third said that she does both both Botox and LIS. I have more or less ruled out the SAD and Botox (low healing rates and high recurrence rates compared to LIS) and decided that if I have surgery it will be LIS.
I have come here to get some advice on whether to have the surgery. The thing is that my fissure isn't very painful - the bowel movements are painless (thanks to miralax), the pain happens post bm, only when I am sitting down - it is a 3-4 level pain, unlike some of the horror stories that I have read here. The problem however is that dealing with this kind of pain day after day, wears me down mentally and physically. I have been on a strict diet, maintained soft stools with a combination of water/fiber and miralax, done regular sitz baths, tried all kinds of remedies seen here - manuka honey, coconut oil, vitamin B6/B12/C/E etc. but haven't been able to shake off the fissure. I have curtailed my social activities, exercise/running. While thankfully, I can manage OK at work, I am at a stage where I wanted to push hard on the career front, but the fissure prevents me from doing so. More importantly, I have struggled with (thankfully minor) depression in the past and I am worried that the longer the fissure and its collateral damages linger, the higher my chances of relapsing.
At the same time I am fearful of surgery, I am worried about the recovery period and the risks of incontinence. I am less worried about developing incontinence in the short term (I am a 30 year old male), but more about developing incontinence when I get older as LIS will ensure that the sphincter has permanently lost some of its strength.
I am sorry if this sounds like a rant, but any advice will be appreciated.
arbguy