lateral internal sphincterotomy…. boom!

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I, just like anyone on this forum am a sufferer of chronic anal fissures.  Im a 30 year old otherwise super healthy and fit male.  Ive been suffering from fissures for 12 years. Let me clarify that over the 12 years it wasnt a constant ordeal.  Some years id only be affected for a week, two weeks, or maybe three. In the beginning it was a little blood here and there and a sore  rear for a couple of days. As the years went on the occurances became more frequent and heal times were growing in length.  Battled it with the common suggestions: lean light diet, high fiber intake, supplemental fiber, and gallons of water.  All are great things but when the problem becomes chronic the requirements to obtain health (in my case) were more than that.  This year has been the worst... i own my own small business and am fourtinate that things had been going exceptionally well (and im penny mc pincher and save every dollar i can) because 3 weeks ago i reached a point to where i could not work any longer.  A year ago in my mind surgery was out of the question.  Im a control freak (hence me working for myself) and the thought of being put under while someone with a scalpel operates on an area that is of up most sensitivity was out of the question. Plus the fear of the unknown just scared me to death.  3 weeks ago i came to the realization that there were no other options... unless i could make a living doing construction while laying on my couch... Went to my general physician because i needed a refferal to get to a specialist.  No problem there, he hooks me up with a surgeon and i make a consultation appointment.  That appointment took place this past Monday at 7 am.  I meet him, instantly like him.  Hes a busy man so he was to the point.  That was fine with me.  Didnt need a hug from a doctor, i needed a doctor to look me in my eyes and tell me he could help me.  He did just that, in fact he told me it would only take him 15 minutes (the procedure ended up taking 20 becasue i had a polyp he removed as well) to help me and that i was going to be very upset with myself for letting this rob me of my quality of life over the last 12 years.  Since the procedure is so short he scheduled me for the next morning at 7AM.  He typically didnt get to work until 8 but wanted to help me so he began his day an hour early to take care of me.  What a blessing!  I was there early, got hooked up with a good nurse and at 7:15 they knocked me out.  I woke up in what felt like 5 seconds but was actually 2 hours and it was over.  I didnt get to see the surgeon again because he was so busy but he told my mom that i was in much worse shape than hed originally thought.  Told her he didnt see how i was living my life!  By 1130 AM i was back at home on my couch!!!  Nauseous from the drugs but local numbing shots had the rear end feeling no pain at all!  They gave me a perscription of 25 325 MG hydrocodones (not super strong) pain pills.  I know that pain pills can and will constipate you so i went into this whole thing with the goal of ONLY taking them if i absolutely NEEDED them. if you have a fissure youve dealt with pain.  so the day of the operation i ate nothing, didnt want too.  Numbness wore off that night at 930 and it was rough but nothing i hadnt dealt with before. Actually i defined it as a 7/10 as to where the day before i was an 8 or 9/10 after a bowel movement.  I took one pill that night (they wanted me taking 1-2 every four hours) to go to sleep.  Day two still didnt eat.  Some of that was fear of making myself go to the bathroom part of it my stomach just wasnt feeling it.  Day two i did not go to the bathroom either.  Had me super nervous because im SUPER regular.  I go every morning within 20 of being awake.  I chocked it up to the fact i hadnt eaten either day and that i hadnt eaten much the two days before the procedure.  I was also soaking in the tub 3 times every day... tub is amazing!  I took one pain pill night two to help me sleep.  Day 3 i woke up and could tell i was headed in the right direction.  Ate oatmeal for breakfast and bounced from the couch to the tub.  That night i did use the bathroom some.  Of course i was scared to death, new stitches, a sore in an area thats been miserably painful!  Just like he said,  the feces never once hurt my fissure.  Sure, it felt weird going having stitches there and yes there was some blood at the incision site but after the BM i got in the tub and it helped relax it all.  I also ate a huge salad that night.  If i am taking stool softners i always take them before the meal then a serving of mineral oil after the meal.  Never took a pain pill on day 3.  Day 4 i woke up and the bowels wanted their regularity back.  Scared to death but cant hold it in for ever (hahaha) i went, and i went a lot.  Again, absolutely NO fissure pain.  Just that odd pressure from having the stitches.  That specific BM took me 50 minutes but it wasnt anything more than a 3/10 on the pain scale!  Then, 30 minutes after that BM pain hit me.  But, id just really stretched that area out for the first time so it was to be expected.  I instantly took two pain pills and got in the tub.  Sat in the tub for 45 min.  By the time i got out of the tub the pills were working and it wasnt a big deal.  probably a 4/10.  The rest of the day was all good.  Tub to couch, couch to tub.  I didnt even have to take a pill to sleep and slept pretty good.  Today is the 5th day after the procedure and the bowels were regular again this morning... went a lot again.  So instead of waiting on things to hurt again i took 2 pills and a bath.  Boom! same result.  Now its 6:15 in the evening, my pain hasnt been over a 3 today (last week every freakin day was a freakin 8!!!!!! a 10 being my a$$ is going to the hospital).  Yesterday i ate a squash fried in heavy olive oil and today ive eaten a big salad again.  Its crazy where i was mentally (where you all are now) a week ago.  Just the fear and the lack of trust is what kept me from doing this years ago.  If your problem is chronic i find it very doubtful that diet, fiber, and water are going to fix it.  My problem... plain and simple... my hole was too small.  Nothing was going to fix that except for a surgeon and a scapel.  Im a big believer in God and prayed heavily on this for a long time.  The way it went for me was sent from him.  Everything from start to finish.  I tell you what else helped me a lot, i met someone two years ago on a job and he saw me drinking my fiber and asked why i did.  long story short he had the same problems and had the surgery 6 years ago... hes never had a problem since and he swore to me that the surgery (if performed correctly) was absolutely nothing compared to dealing with it daily.  He was 100% right and i was very thankful to have him on my side.  Ive bombarded him with questions and hes been amazing about it.  Very thankful for him.  

See a specialist

Make sure you like your specialist (as soon as i met mine i liked him)

If they can confidently look at you and tell you they can help you let them help you

Pray ( you should do that every morning and night anyway wink)

Ive used Calmoseptime ointment a lot, before going as a lubricant, after going as a soother.  Ive even been using it after the procedure because it is a skin protectant from infection (get it on your finger one time and youll see what i mean haha).

Be strict about what you eat, that has never been a problem of mine but im sure it is for some people.  If you put it in the top its gonna come out the bottom and you can control what goes in, in turn, means you can control what comes out.  You eat salads daily your gonna be better off than eating steaks daily... duh.  Good luck everyone!  Tomorrow morning i start my 6th day of recovery and I havent had a smile like this on my face in months.  GET  THE  SURGERY  

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  • Posted

    So happy to hear this testimony! Thank you so much for sharing!!

    I have been dealing with one for 7 months but am terrified of the surgery as I have chemical sensitivities. The anethesia could make me sick for weeks and create a whole health set back. That said if I do not heal on my own(and I have healed a lot ) I would never try to live this way and would do the surgery. I have two toddles we adopted under two years old and want my quality of life back. This on top of the typical symptoms I suffer with daily is too much to live with. I love God and trust him daily and pray for him to lead me. This testimony gives me hope. Can we private message so I can learn more . Please keep me posted and I am so glad for your success and healing. Praise God !!

    Best-Jennifer

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  • Posted

    Hello Eric,

    This Erick , with the k . That's harsh to hear that you were suffering from that for so many years ! I too have recently been diagnose with a fissure . At least that's what my colorectal surgeon said . I've been dealing with this issue for almost going to 2 years approximately.good days , bad days ! Thank god no bleeding . I too will be afraid of surgery ! I'm hoping that it won't lead to that . Let me ask you what is considered a chronic issue ? With having a fissure ? What were your symptoms then ?

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    • Posted

      Oh, I too was given the strict fiber diet , but considering what you said that didn't work except surgery. My doc is ademant that is all what I need in order to heal , plus prescribed diltiazem to relax the muscle in anus .

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    • Posted

      I labeled mine as chronic because it was never really gone.  Over the course of 12 years Maybe the longest break i had from an episode was 9 months, and that was early in the 12 year prison sentence.  I know i never made it a full year with 0 problems. This whole last month I did not bleed much.  The pain was as bad or worse than times that i would bleed.  With that said, id been on point with diet.  I never miss fiber either.  Im talking salads every day, oatmeal every day, some soft pan seared vegetables every day ect.  I was also taking stool softeners and mineral oil just about daily for that last 3 weeks leading up to the procedure.  When i was doing that and my stool was coming out soft and lubricated and it was still killing me I knew then that i needed help. Honestly, 100% from the moment i decided to have the procedure i got better mentally.  I decided to trust God and trust someone else to try and help me.  For me, I genuinely believe that even if my first tear hadnt happened at 18, even if it was some fluke.  Like constipation or just a series of poor poor quality meals, I was getting a fissure.  Like i said before, my problem was the size of the hole.  Then after damaging, it stayed in such bad shape that the resting pressure of the muscle was not going to let it heal.  The tear in the skin would allow sphincter to become damaged therefore sending it into spasms and too much tension in which wouldnt let the tear heal.  Vicious cycle.  Another reason after deciding for me that surgery was my option, my dad came by and we talked and i told him my decision.  He thought it was best and told me that his dad and his grandpa fought this their whole lives.  Why he didnt tell me this before..... idk.

      Well if you have an external hemerrhoid you should know.  Round, tight, can range in size and imagine it being a hernia on the rim.  Personally, ive never had an external hemerrhoid bleed.  Id had enternal ones bleed a little but what id noticed about my internal hemerrhoids is that they were up in me a few inches.  The pain wasnt at the rim or the first 1" like my fissures or external hemmerhoids.  Felt to me like 2-3" in me.  Only had them 2 times.  With those they wouldnt send your spinchter into spasms.  With a fissure, after id have a bm,  i could feel that muscle having spasms.  Uncontrolable pulses.  As time would pass after a bm the spasm would become less intense.  I use the bathroom every morning so by 730 im done.  Typically by 5-6 PM IF id layed around all day relaxing my sphincter would relax as well.  Think about this, i know the fissure itself hasnt healed that much in 10 hours but the relaxation of pressure instantly made it feel better.  The surgery, IF DONE CORRECTLY, provides you with a permenant pressure relief.  Its 11:50 AM on tuesday right now, exactly one week ago (actually last tuesday at 11:40AM) i was just getting home from the hospital and ive yet to go to the bathroom (and ive went probably 10 different times) and feel pain on my fissure.

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    • Posted

      Wow! That's all very interesting and very insightful. We all have different symptoms yet share a lot of similarities with this demon fissure . One thing so are you saying that your fissure still hurts , even after surgery ?

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  • Posted

    Eric, so glad you had the operation. It's amazing how fear can take over and all we needed was to have that wound removed so the skin can heal.

    I am on day 15 and going well smile my surgeon told me not to apply any creams down there except internally the diltiazem. I am struggling with the crazy itch that you may experience, this is not internal or around the anus but everywhere else. I experience it twice a day it's horrible but when I compare what I used to experience to an itch I have no complaints

    My GP advised I take antihistamines and ibrufen to help with the itch but again not to apply any creams. I was told that applying anything down there is too soon and to put up with the itch. I have also been told to come off the stool softeners after day 7 to allow the body to not get used to them. The alternative is to eat prunes, spinach, courgettes and weetabix smile it's been working like magic so far!

    Leaving these tips for you.

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    • Posted

      Yes he said for 3 months. I have temporarily stopped it due to the rash I have been having under his instructions but will go back on it once I calm down. I have been told it's a heat rash or as the wound heals the irritation inside causes external itch and rash.

      Have you had the surgery and stopped using the cream? He told me I must continue with it until the wound is fully healed.

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    • Posted

      I have not had the surgery but will if I can't get all the way better. I used the cream after I found out what I had and within two weeks I was so much better but it made me constipated. I also got the rash but more so the constipation ripped it back open and I wasn't ever constipated to begin with I got hemmroids and strained through them and got the fissure. I have never been constipated like that ever but I have chemical sensitivity so I react to things very strongly and adversely. So I would not be able to use that cream ?? That is what is holding me back from the surgery the anethesia as I get so horribly sick from any media herbs etc...let alone chemicals that said if this continues I will still get the surgery as one can't love like this !

      I am happy for your healing and success. Please keep me posted on your continued healing. Did you have the LIS or a fissure ectomy

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    • Posted

      Hello green,

      Wait , your applying diltiazem internally ? The gel right? that's what was given to me but for external use .

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    • Posted

      A little dot internally of diltiazem, it's designed to ease the muscle and bring the blood flow to the area so that healing can speed. The surgeon and GP told me internally despite the tube reading external use. Also it's a white cream not gel.

      I am not using it right now due to the irritation in the area but today I went to my GP and she advised I get back on it once I can but most importantly to keep my diet controlled with veg and fruit and to keep the stool soft.

      For now I am not using anything, no stool softeners no diltiazem just antihistamines

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    • Posted

      Poor you, it sounds like you have more than one thing going on.

      I got a fissure on dec 2015 after a minor operation. The painkillers they injected in me led to severe constipation after 48 hours. I was given the GNT ointment which worked and after two weeks I made the mistake of stopping it. 3 months later it returned but returned so badly that an operation was needed. I had it surgically removed an excursion assuming a LIS.

      It was meant to be a day surgery for me but I ended up being admitted because like you I reacted badly to the anastetic but nothing life threatening just dizzy spells, no appetite so dehydrated and low blood pressure. I preferred staying in overnight after such a procedure and I am glad I did as my first stool was the next morning under the hospitals supervision smile

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    • Posted

      Yes I was told to only use that externally too!! So you still had to use that even with the surgery? That worries me as I had a bad reaction to it
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    • Posted

      Sorry again , wait so you had surgery ? And diltiazem that I got is a clear gel that was compounded.
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    • Posted

      thank you.  i think for everone reading anyone elses stories.  Take it all in and put together a plan that works for you and that youre comfortable with.  mine itches at times but im not to day 15 yet.... i expect the itching to come.  i think when you get that itchy that means that youre almost all healed up... go you wink

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    • Posted

      Yeah I had the surgery and after was put on stool softeners for 7 days, naproxen 250mg for 3 days, paracetamol and diltiazem. With this itch and rash I stopped the diltiazem after 7 days when I saw the surgeon for my one week review.

      My cream is white, I didn't know it comes in another version. I've been signed off work for another two weeks as it hasn't fully healed. I don't know if the itch is a sign I am healing because this is all external sad

      I have been told this operation is so delicate and because it's in such a sensitive area to expect any symptom and allow time for my body to heal. Hey nothing is easy but I am certain nothing I am facing now is like anything I experienced before so I am just getting on with it smile... Loose clothes and a fan are my best friends right now.

      One question to you, have you ever applied the diltiazem internally? I have always been told to ignore the instructions and apply a dot inside. It stings like hell but as you heal it shouldn't

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    • Posted

      Yes I did. Sorry I replied to the wrong Eric smile see reasoned below. But I am using a cream version of diltiazem but on hold for now and instructed to apply internally.

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    • Posted

      Exactly! Ok , my doc became irritated with me because again the impression I got when I received the med is that apply the gel in affected area . Well it's inside ?! My doc said its only external . I was applying inside , I actually felt it was helping me .

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    • Posted

      Oh, so assuming that the one they gave me it's only for external use only .

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    • Posted

      Mine reads external use only diltiazem 2%, but the GP and surgeon both said one drop inside not to push it in fully but let it sit inside not externally. I doubted their instructions because it reads external use only so when I asked twice the surgeon snapped smile... I've stopped it for now just to allow the rash and irritation to calm down. My GP told me today the fissure will not return because I stopped using this cream but because my stool is not soft so to watch my diet. There's nothing we can do anymore after surgery but wave bye to red meat, fried food and all the things I personally would have binged on before.

      Another tip is avoid foods that build heat inside your body such as prawns and red meat ( red meat also costipates if not immediately it will that week). I've grown to enjoy courgettes that are oven roasted, mushrooms pan fried, spinach, watermelon and melon are natural cooling fruits and good for bowl movements. I now look anything up before I put it in my mouth.

      If anyone has discovered any foods that help please share especially breakfast ideas as I can't imagine me taking my bowl of weetabix into work ??. I've even cut out coffee for 6 months now. Any tips are appreciated

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    • Posted

      Man this is a good learning experience! As I said doc got mad at me for the many emails I sent her , she once again said don't put gel inside ! I stated that the pharmacist gave me an applicator to put in affected area . Doc stated ," who are you going to listen your colorectal surgeon or a pharmacist! " then you said your docs said its ok to put , not all the way at least where the spincter meets . And yes ! No meats . I noticed that when I eat things that aren't good to digest I ask for it .

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    • Posted

      It's def a learning experience and in all this I think surgeons are mad! I can't get any answers from mine but he sure knows how to operate smile.... do you mind sharing the full name of your diltiazem, I will look into the gel version. I am based in the UK I don't think we have this gel version but will ask my doctor if it's worth trying a gel and not a cream

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    • Posted

      Absolutely. I'm at work right now , I'll post it later the prescription that was given to me . Maybe things are different where you're at , I'm in Los Angeles.

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    • Posted

      I am so glad you are better and that the surgery was a success , it gives me great hope!!

      Thank you for sharing your story. Yes I have been through a lot and am now doing well until this nightmare the past 7 months!! Just horrible and it creates so much fear about eating and going to the bathroom and the pain is use horridic. I am much better now and hoping to continue to heal without surgery but in the end if I need to I will it just wouldn't be good for me but i am so hungry lol and exhausted from this misery

      Wishing you the best -thank you again for sharing !

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