Another a Successful LIS Experience

Hello, everyone. I wanted to share with you my personal experience and journey with a fissure that I dealt with for 6+ months.

First of all, my heart goes out to all of you. I had plenty of breakdowns and cried like a baby on more than one occasion. I was miserable. I was not enjoying life anymore. I couldn’t be the husband or father I wanted or needed to be. Near the end, I was literally climbing the walls due to the severity of pain. Know that you are not alone. Know that it is perfectly fine and not embarrassing or humiliating to be suffering from this. We are humans with human body parts that can and do fail. There are doctors who go to school to fix these issues that look at and inside butt holes for a living. USE THEM. The issue is more common than we think, but people are so ashamed, embarrassed, and humiliated to even talk about it, much less have a doctor poke around down there. I found “comfort” in reading through these forums, but I also found/find them to be quite miserable. Not enough positive stories. There is also a lot of misinformation out there.

That being said, I will share my own experience with “the surgery.” To be clear, I had a LIS—lateral internal sphincterotomy surgery. I did not have hemorrhoids or a fistula.

I am a 48 year old straight male, happily married with three younger children. I have always been mostly fit, but had gotten up to 218+ lbs. In late August of 2019, I had a rough bowel movement where I really strained and forced it out. A bit of blood, but nothing major. I have had this happen before, but I always healed, and rather quickly. This time I didn’t. At first, it would hurt when I pooped, and then for a while afterward. Sometimes for a few hours—the pain would eventually go away, but would always return. I dealt with it. Some days (when I wouldn’t poop), it wouldn’t hurt. I was embarrassed and humiliated that this was happening to me. I was unreasonably ashamed to see a doctor. About a month later, I saw my family doctor, who said I had a fissure and was optimistic it would heal. He prescribed nitroglycerin, but the cheapest I could find it was $700(!!!) dollars. I went to a pharmacy that compounded the similar nifedipine for $70.00. I tried that for 3 weeks with no results. I changed my diet—only ate salads and drank about 2 liters of water a day, ate extra fiber. Drank a lot of Miralax. Did a ton of internet research. All basically says the same. The fissure ruled my life. I lost about 50 lbs partly because I was afraid to eat due to the eventual bowel movement I would have. My life revolved around my next bowel movement. Not only was it physically painful, it was also mental torture. I developed significant anxiety every time I would feel a bowel movement coming. I was unable to sleep because I worried my life would never be the same. I couldn’t enjoy life. I refused to consider surgery. Too many bad experiences on here. I was scared at the chance of incontinence, even with a 90-95% success rate. I tried Emuaid Max, Pranicura (burned like crazy), Amoils H-Fissure oil, petroleum jelly. Nothing worked. It got to a point for me where I had to use a warm water enema every time I pooped to ease the pain. The two things that offered the most comfort were a hot shower letting the water down my anus, and lying down with a heating pad set to “low” under my bottom.

Finally the pain got so bad that I eventually had no choice but to get over the embarrassment (this is big) and find a reputable colorectal surgeon to have the surgery done. I found one about 4 hours away in San Antonio, TX. I met with him, liked his confidence, and set up the surgery two weeks later. It got so painful that I was counting the seconds to the surgery.

My eventual diagnosis was a “significant” internal anal fissure that developed into an ulcer. Because of the ulcer, my colorectal surgeon would not perform the LIS without also doing a colonoscopy to rule out cancer. He found a polyp that was tested and found to be benign. The colonoscopy was done first, and the LIS was done immediately afterward. The colonoscopy turned out to be a blessing in disguise because I was forced to clear and flush my insides prior to having the LIS (this is not, but should be, required for all LIS surgeries). It allowed me to not have to have a bowel movement until two days after my surgery, which I firmly believe helped in my healing. I got to the hospital on Thursday, February 27th at 5:00 am, had the colonoscopy and then the LIS—both under anesthesia. I was out less than an hour later. It is actually a short, minor surgery if you “only” have a fissure. Takes about 15 minutes. Was on my way home a little after 8 am (my wife was driving). No pain meds, hardly any instructions post op. No stitches. Removed a gauze with a bit of blood. A bit of bruising on my left cheek. Couldn’t walk comfortably until Saturday. Absolutely no pain afterward, just minor discomfort. I had a bowel movement that Saturday with no pain and no blood. Throughout my healing, it took me a few weeks to get over the anxiety I felt each time I felt a bowel movement coming, but I did, by the grace of God. The anxiety part is huge. Doctor said stay away from the Miralax. Take some colace if I “want to.” Eat whatever I want.

However, I made a conscious decision to never let my guard down. I only eat oatmeal or high fiber cereal for breakfast, grilled vegetables and salmon for lunch and dinner most days, and drink a little over 3 (sometimes 4) liters of water a day—the water is an absolute MUST. It helps to drink from a one liter container. I have since started adding a splash of a flavored drink to cope with all the water. That really helps. Bought an instant pot to make cooking easier (and ALMOST enjoyable.

I do not and have not taken Miralax after my surgery. Every doctor that I talked to said prolonged usage of Miralax is not healthy. My surgeon said that we do not want to always have loose bowel movements because the sphincter will not get a natural dilation and can lose strength by being counterproductive. This makes sense to me as some believe and have had success using anal dilation treatments. I took 100mg of colace three times a day after meals for six weeks and stopped cold turkey. I do not take fiber supplements as I would rather get fiber from the food I eat. Proper diet is huge.

During my recovery, I would shower immediately after every bowel movement to promote cleanliness and prevent infection. I took two weeks off work, and that really helped. Had a one week post op follow up. I feel about 100% now. Though I never felt pain after the surgery, it would “remind me” every once in a while that I wasn’t completely healed. No pain, just the odd sensation here and there. Once in a long while I will feel my anus to be a little sensitive. I’ve had about two “challenging” bowel movements where I felt the stretch, but that’s all part of the recovery. I no longer strain. I make a conscious effort to just let the stool come out.

I have my life back. I looked forward to these days for over half a year of my life. I can’t tell you not to be scared about the surgery because I sure was. But it helped me immensely. I will not say I prolonged the surgery because I always had hope that I would eventually heal. I am a believer in Christ, so I prayed immensely and never lost hope. My faith was huge for me. The most important advice I would give is to find a GOOD colorectal surgeon with a lot of experience. Meet with the doctor and judge him/her. The surgery can be done by a general surgeon, but I would go with someone who has done hundreds of these surgeries. I actually met with a general surgeon prior to finding my surgeon but decided against him when he told me he only does a “handful” of these surgeries a year. Read the doctor’s online reviews. I realize these are tough times, and would imagine LIS is not considered an “essential” surgery by the unknowing public these days, but I would encourage you to consider the surgery, if fear is what’s holding you back. If it is money or lack of insurance, try to do what you can to save or ask about payment plans.

I won’t apologize for the length of this post, as I longed to read something like this during my time in pain. I am grateful to those who decided to write up their positive experiences because they meant ALOT to me. I didn’t want to offer a premature review of my experience until I had at least six weeks recovery as some say recovery can take 4-6 or even 8 weeks. We all heal differently. We also need mental healing. Part of my mental healing was staying away from these forums as they bring back painful memories. I recommend you take at least two weeks post surgery from your job with minimal sitting, if possible. Buy a donut seat cushion and don’t be embarrassed to use it. I’ve even taken mine to church (haha!). I wish you all the best in your journey. Don’t ever lose hope. Your life is precious. This experience taught me a lot about gratitude and how I approach life each and every day. I am a much different person because of this. Feel free to shoot me a private message or ask here if you have any questions.

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