This is for those who have and AF and even remotely considering surgery. In my months/years before surgery I scourged the internet for a possible cure, and read hundreds of posts about it, and came to realize that when most people have an issue, they are willing to post about their problem but when they get it fixed, there is little incentive for them to go back online to tell the others what worked...just how it works.....well, I'm making it a point to go back online and tell you what works. Heres the bottom line right off the bat: if you've had anal fissure(s) for more than a year and have tried home remedies w/no success....get over the fear, find a reputable proctologist and just get the surgery.
My story (condensed):
I had a bad fissure for about 3 years (I'm 29 now). At first (never heard of an AF before) I thought it was hemorroids. I was embarassed about it and put off going to the doctor for probably a year (first mistake). I kept using PrepH ointment and it didn't work very well. The severity sort of came and went and depended largely on my diet. Drinking booze made it worse. Drinking + eating a big mexican meal with jalapenos really made it worse. I tried all the recommended diet changes...no alcohol, chocolate, milk, caffeine, etc etc.....and while it did help....it wouldn't fix the problem. It got to be very, very frustrating, depressing, infuriating......After a few visits to the procto I learned that I am a tightass, and not in terms of money. I couldn't really feel the 'spasms' they talk about that prevent the tear from healing - and honestly not sure that was the reason for not healing, but regardless, the tight ******** wasn't helping my to take a poop....sorry to be graphic (if you're at the stage of looking at AF surgery, youre past caring about graphic - and more than likely are very familiar w/what I'm talking about)
but the big poops getting pushed through the tight butt just aggrivated the fissure and absolutely prevented it from healing.
After a short amount of reading online I knew of the possibility of surgery early on but shut out that idea completely....just wasn't going to happen. I had visions of being spread out on the operating table with giant tools and sharp things up my butt.... So I tried everything...and I mean everything....all the home remedies, sitz baths, epsom salt baths, every cream and lotion known to man, using petroleum jelly before and after i took a dump (that was fun), prescription nitroglycerin ointment, weird exotic indian digestion herbal pills, every stool softener and laxative they sell within a 50 mile radius.......eating nothing but oatmeal, beans and salad for many months.....some things helped...but did not fix the problem. (Another side note: taking Miralax everyday for months SEEMED to have made me develop an allergy to polyethylene glycol. This stuff is bad. Some people get away with it....but I have a rare reation to it - chest pains. If I ingest even a little bit of it I'll get tightness/pain in the chest. And PEG is in EVERYTHING - shampoo, pain pills, toothpaste, deodorant, different types of foods, aerosol sprays/air fresheners...etc etc etc....!)
I got used to the idea of having the surgery, and after speaking w/my proctologist on my 3rd visit for a few minutes, it was a done deal....he got me in the next week for surgery. At this point I didn't care...I was past the fear and just wanted to be done with it all. I knew it was going to suck for a while afterwards but when you read about and hear your doctor say the words "better than 95% success rate" - its music to your ears. I asked about the other 5%....and he said that none of them had to wear diapers or anything else like that....most of the time they had slight problems holding in gas or at the very worst, small amounts of 'leakage'. (Still scary, I know....but trust me...its not a concern to the vast majority of patients)
The surgery (a Lateral Internal Sphincterotomy
in my case):
Keep in mind that they knock you out completely for this surgery. At least in a civilized country they ought to. You do not feel a thing. You lie down on the table, they shoot you up, and in less than 10 seconds you are out. You wake up in a post-anesthesia haze in post op and then they feed you more happy pills. You feel abolutely no pain for several hours. After all the shots wear off it does suck, I will not lie to you. For about 5 days your *** will hurt. Hopefully you can take the vicodin w/o getting constipated (I'm lucky in that area) But heres the good part - your first BM will probably be less painful than all the BM's you've had over several months w/the anal fissure. Within two weeks you'll be having pain free poops. Within a month you'll almost be back to your normal self. Doc said my fissure was COMPLETELY HEALED at my 2 month check-up.
Its now been 8 months for me and I am 99% back to my pre-fissure self. Why not 100%? I guess if I had to list the negatives....the short list would be: very seldom passing gas when you don't intend to (and I'm talking stretching out after a workout, not while riding an escalator or anything)...and I have to wipe a bit more after BM's. Side note: here is my tip for wiping (even if you currently have an AF): USE THE DISPOSABLE MOIST WIPES! Don't let that dry paper get anywhere near your butt if you have a AF. Now I can sort of "start" w/the paper then use the moist wipes if I'm being thorough (which I always am) - and the big tip - use some Aquaphor ointment....just put a dab on the toilet paper or moist wipe and it will help clean as well as sort of lube it up for comfort. I asked my procto about this and he said its fine. I basically do it every time I have a BM. This may sound like a lot of work if you're used to your pre-AF wiping sessions, but trust me, its no biggie after going through what I went through!
So to sum up - surgery on you butt is scary. But if you are tired of fighting the anal fissure - you need to see a doc about the LIS (http://en.wikipedia.org/wiki/Lateral_internal_sphincterotomy) if you want to get back to your normal life.
Feel free to ask any questions!