I know all about anal fissure unfortunately. I had a chronic one that had been there 5 years at least. It would periodically open up, bleed, but then close again, so I never did anything about it. Then last year it opened and wouldn't close. My rectum then started to spasm, and this opened another smaller fissure on the other side. Now I was really hurting, and had to have surgery.

The surgery is nothing. It is done on an outpatient basis, and takes about 15 minutes. I was in and out within a few hours, without a lot of pain.

But my recovery has been tough. I still have a lot of dull aching in the backside, occasional spasms, and irritation, although the bleeding has stopped, and a lot of the stabbing, ripping pain. Looks like I'm on the right track.

My rule of thumb as far as fissures go, is that if you have developed a sentinal skin tag (or pile), that can be felt, and is evident in the stool (you will see a trench in the stool where the tag is rubbing against it), your scar tissue is so bad that the thing isn't going to heal on its own. Also, if you have been bleeding for months, and have modified your diet to no avail, I would consider the surgery.

If you don't have lots of scar tissue and a skin tag, it can very well clear up on its own. You may need to get a medication like Diltiazem to help relax the muscle and assist with bowel movements. Go see a gastro-interologist or a colo-rectal surgeon, and they will help you out.

One word of warning. When I went to the surgeon, he did a VERY painful exam on me in order to look at the fissure. It was pretty quick, and necessary, but it hurt like the devil, and I have a pretty high pain threshold.

But your fissure may not be anything like mine, and the exam might not be as big of a deal.

Stress is a huge factor with this stuff. If I get stressed out and anxious, the muscles down low clench up and make things worse. Do your best to relax, or even take a vaction for a few weeks to straighten this out.

Fissures are not serious at all, just super painful, and they can be difficult to treat without surgery.

fissureman,

I think doctors play down the pain a lot. Every person who has had a lateral internal sphincterotomy on this board complained of post-surgical discomfort, oftentimes lasting for a while.

It's been 2 months since my surgery, and some symptoms are gone, but others remain. I don't have any tearing, burning, ripping, stabbing pain or bleeding anymore, and my BMs are pretty easy. But I still have some spasms, and a deep aching feeling in my backside, like charley horse. The more BMs I have during the day, the worse this feeling gets. I try and limit myself to one in the morning. Hot baths help this, and working out seems to help a little bit as well.

If you never got to the spasming point, your recovery should be pretty quick. I didn't start to spasm until more than a month after my fissure started bleeding. The spasms have been with me ever since. I think it might be fissure-induced Levator Ani Syndrome, something that is pretty much impossible to treat -I just have to wait.

It is a long, difficult, recovery, but not as bad as hemmroid surgery, which I guess is awful.

Beware of nuts, popcorn, spicey food, and red meat. These will set you back.

Also be careful with the stool softeners. I took too many, along with Mylanta to control gas, and I gave myself diarhea, and that REALLY irritates the incision point, and any residual fissure. Even too much fiber causes me problems. I now eat a regular diet, work out, sometimes take a fiber supplement, and use diltiazem to calm the spasms.

I had to have the surgery. I had 2 chronic fissures, one old one, and a new one. They were not going anywhere.

if you are having rectal spasms, believe me, you would know it. Have you ever gotten a twitch in one of your leg muscles that went on for hours? Imagine that in your rectum -painful! The spasms can move around as well, I feel in in the testicles sometimes, like someone is giving me an electrical shock.

I've had some improvement in this area -it's not as bad as it was a month ago. There is an intense spasm called "proctlagia fugix" which is one of the most painful things I've ever experienced. I almost had my wife take me to the emergency room one night, when I woke up with this. 2 ibuprofins, hot bath, and lots of concentration got me through it. I've had 3 episodes of this since developing the chronic fissure. It's like getting a baseball bat between the legs.

If you don't have any spasms, I'd say your prognosis is really good. You should be in good shape a couple weeks from now. The other members of the message board all had spasms, and a couple people have had really big problems -even more pain than me, and that's downright debilitating.

Ask your surgeon for some Diltiazem to help with BMs. And use some vaseline if necessary. I think you are feeling the incision site right now, and that can bleed and burn. I still feel mine from time to time.