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Hi Anal Fissure sufferers...this is my story:
I started suffering from an anal fissure last August 2012...almost a year ago.
Some facts to help you put my case in context, since every case is different and most posters don't give you key facts you can compare with.

Age: 49
Sex: Male
Height: 6'-0"
Weight: 160 lbs
I exercise regularly...3x to 5x per week until this past August, because of the fissure.

Diagnosis: posterior anal fissure and a hypertonic anal sphincter...in other words a very tight butt. My fissure was chronic and it was deep! I also had anal itching and proctitis (anal inflammation). Per the two doctors my "out of this world, drive me crazy" anal itching and proctitis were a result of the anal fissure.
I also had 3 hemorrhoids banded back in 2010 and three more banded this past April...during my colonoscopy...more on that below.

My symptoms: No need to get deep into this...I have had every symptom mentioned on this board...incredible pain 11/10 from the spasms, pieces of glass coming out during a bm, blood, after a BM, I was miserable for 8-10 hours. This pain could not be controlled by any drugs and it was affecting everything in my life. I could not think or concentrate and I was obsessed with research anal fissures. I did have a lot of anal itching and sometimes I would have quite a bit of inflammation. I have read/researched for countless of hours. BTW...I know pain. Many years ago I passed a kidney stone.

What caused my anal fissure: I don't have any idea and neither do my doctors. I can speculate, but I have no supporting facts. I travel a lot for business...it could have been minor constipation, could have been stress, dehydration, etc.
It started back in August of 2012, went to emergency care in Northern CA, they could not figure out what my problem was, I was in incredible pain, gave me morphine and sent me home with some creams I could apply to my anal area. I started doing a lot of research (doctors and symptoms) and figured out on my own that I probably had an anal fissure. This board and the community was so helpful in my due diligence. This research yielded a CRS (colon rectal surgeon).
Decided I would go to a CRS at UCSD. This was in the October timeframe. Spoke to the CRS and my anal fissure diagnosis was not confirmed at the time. She did an exam and thought I had proctitis. By then my fissure seemed to have "healed". She recommended I go for a colonoscopy, since I was close to 50 yrs old to make sure all was ok and rule out other possible diseases/problems.
Went for the colonoscopy in early April 2013. This was my "downfall" and by this I don't mean to say people should not get colonoscopies. WE ALL SHOULD! When she went in to do the colonoscopy she re-tore my anal fissure. Pain was soooo severe after all the anesthetics from the colonoscopy (and banding of 3 hemorrhoids) wore off. There was a lot of back and forth on the phone the next day with the nurse and CRS. I went back to the hospital/Dr office the next day without an appointment to get some help. The CRS looked at me and confirmed that I had an anal fissure. She felt really sorry for me. She put me on valium and oxy and told me to do lots of sizt baths. I took these drugs for two weeks and felt I was on my way back to recovery. I also went on diltiazem for 8 weeks and ate a ton of fiber. The diltiazem cream was burning, so the compound pharmacist created another formula using cocoa butter. This new formula did not burn. Nothing worked...I still had spasms (not as bad as before 5/10), but I could tell the fissure was not healing. I had suffered enough (April through June)!!! That is when I decided on LIS surgery. I did not want to be like many of the posters in this board that wished they would have had LIS surgery earlier. I had made my decision early June and started interviewing CRS's. Did not go back to my CRS in UCSD, because, even though she had not created my fissure, I was still not confident that she did everything she could to avoid re-tearing my fissure again. Bluntly, I was scared going back to someone that I felt had "hurt" me before.
Anyway, interviewed two more CRSs and they gave me the exact diagnosis...deep anal fissure and LIS is the only way to fix this. BTW..One said, we can try botox, but it is just a matter of time before you land on someone's operating table. The other gave me a 50/50 chance that botox would work.
One of the CRSs said one thing that stuck with me: There is no "best CRS doctor to do this surgery! In Southern CA we are all good at LIS. A doctor can't get out of residency without doing many of these". Net-Net: I was looking for that "BEST doctor" to do my LIS and he basically said, stop wasting time...talk to 2 or 3 CRS get a few opinions and make your decision. I finally settled with a doctor in Scripps that had done hundreds of LIS over the last 15 yrs.
One more thing...something that helped me deal with the pain between April and June were the sitz baths and a moist heating pad (electric) that I would sit on for hours. These two "tools" would keep my pain level at 3 for most of the day...tolerable.

Diet: My diet has been very high quality, organic for much of my life. My main meal in the evenings consists of a big salad, with lemon and olive oil dressing and a lots of vegetables with some kind of protein. I eat lots of fish, chicken, meat and pasta. I do cheat sometimes and will eat things that are not so healthy...fried chicken, pizza, etc. But generally (95%) I eat very well.

BM's: I am very regular and bm's are never (99%) hard or difficult to pass.


Had my LIS surgery last Friday, July 5th.
How did I prepare before surgery:
I ate extra healthy...I am already in the habit of eating healthy, but I took it to the next level in order to prep for surgery and post surgery.
I ate lots of fiber and most importantly I drank lots of fluids (3 litters of water per day...peeing every 30 minutes). I knew that the anesthesia and possible pain meds (oxy with Tylenol) that I would have to take post op would cause constipation. Of course I could not eat or drink anything past midnight before the surgery. I did not do an enema before surgery as doctor suggested. I did not want to create more pain.

Day of surgery: Had a bm at 8 am. Had to be in the hospital at 945 am for check-in. Surgery would start at 1145 am. Pain level at 3 but increased to 6 by the time I was on the operating table.
Surgery was performed under general anesthesia. Had a team of 6 people including the doctor in the operating room.

Immediately after surgery:
In the recovery room I was given 2 oxy/Tylenol tablets for pain. I had a bit of a burning sensation right after I woke up and my throat was sore from the LMA they stuck into my mouth/throat for anesthesia gases.
My wife drove me home. I was pretty groggy the whole evening. She fed me a good dinner in bed while I rested on my side...baked chicken with a huge salad and brussel sprouts. I also drank 2 liters of Gatorade (felt I needed the extra sugar and electrolytes) after surgery and drank another liter of water before bed.
I was in no pain at all! The only thing that I could think of was that first bm.
Took one Colace and ate a prune before I went to sleep.

Day one - Saturday July 6th.
No pain whatsoever! Did not take any prescription pain meds.
I took 2 Tylenol because I had a head ache, I assume from the anesthesia.
No BM the entire day. Kept eating lots of fiber and drinking lots of liquids.
Removed the dressing pad doctors had put on my butt to cover the wound.
It had a bit of blood on it.
Took a shower, rinsed by anal area with warm water, blowed dried my anal area with blow drier set on warm and put a feminine napkin in my underwear to absorb blood.
Before I went to sleep I checked for blood, very little.
BTW...I was a bit concerned that I had no BM yet. Mostly concerned that the longer I went without a bm the more pain I would feel when the first one would come. But it is critical to stay optimistic and have patience. I still had 2 more days ahead of me before "bringing in the cavalry/reinforcements"...milk of magnesia or another laxative. I am highly regular, so I don't take laxatives.
Oh...one more thing...I did eat 2 prunes and took 1 Colace on this day.

Day two - Sunday July 7th:
Feeling really good. No head ache. Slight pain on my butt...more like it is sore...pain level 1/10.
Wondering when the first BM would happen.
Got up and drank a cup of decaf coffee and ate two more prunes. This started the BM machine in motion...I could feel it coming.
Now this is what I did to have my first BM after surgery:
Early on during sitz baths treatments back in April, I had realized that the warm water from the sitz bath in my tub was stimulating my body to have a bm. Don't ask me how. Probably because the hot/warm water relaxes the anal sphincter.
So, now that I knew a bm was coming, I tried (did not push or put pressure on my anus) to sit on the toilet for 2 minutes to see if I could go. I was not able to. 30 minutes went by and I tried again to no avail...but I could feel the BM "crowning" in my butt...I am sure you know what I mean. Sorry for the graphic description.
So, I filled up the bath tub with hot water, sat in it and finally felt like it was going to happen. I hopped out of the bathtub, ran for the toilet, sat and nothing...Arghhh!! So I started to think, would it be so bad if I had my BM in the tub? (after all, I had seen a Clorox commercial where a kid is all happy that he pooped for the first time and the mother says where?, thinking he did it in the toilet and ended up pooping in the tub). Well I did it in the bathtub...it was like those births I have seen in movies/TV where the woman births a child in the tub. I tell you, the size of my BM was like a child...holly cow!! I have never seen anything like this come out of me before...it was really hard, like a cylindrical brick! I got out, I will spear you the details, cleaned up the tub with Clorox, took a shower and I was a new man!!
I had a second monster BM on the toilet 30 minutes later and I felt great. It was all about "priming the pump" if you know what I mean. And the hot water and doing it in the tub was the game changer.
Very little pain...took two Tylenols and went for a walk on the beach with my wife later that day.
One of the things I think is important is to get some kind of exercise after this type of surgery. Blood flow is vital and exercise creates lots of blood flow to every part of your body! Walking is all you need in the early days after the surgery.

Day 3 - Monday July 8th:
All is great. Have not taken any prescription pain meds since the two the nurse gave me in the recovery room and have packed them away in case I ever need them in the future.
Had a great BM this morning with very minor discomfort (.5/10).
Have been on calls and working all morning. Sitting has been a little, and I mean a little, uncomfortable.
I am so happy I did the LIS surgery!!!! I would highly recommended to anyone.
Hope you have found my story helpful.
I will come back and check in once in a while.
Hooray!! I have my life back!!!
I am looking forward to starting my runs and work outs again and resuming my normal life, but I will be patient. I have a flight to India July 17th. I should be in great shape by then.
The best thing...I HAVE NO PAIN! AMAZING!!
And no incontinence (gas or stool)!!!
And anal itching is all gone!

I wish all of you the best of luck and lots of blessings!
Remember, don't be afraid of the surgery. I recognize that LIS is not for everyone, but it is for many people. LIS was a game changer for me.





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