Should I have fissure surgery or keep trying lotions?

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Regular Member

Date Joined Jul 2009
Total Posts : 25
   Posted 2/16/2010 5:56 PM (GMT -7)   
I haven't posted for a while.  Background:  Anal Abcess (large) Surgery - March 2009
                                                                     Surgery to place 2 seton? drains - June 2009
                                                                     Surgery to remove drains and check on abcess - October 2009
Currently it seems that the abcess has not reoccurred.  However, I have a small fissure towards the back which will not heal.  Surgeon does not think I have IBS or Crohn's but she has not done biopsies (that seems dumb to me - she had 3 opportunities - why not do biopsies while I'm under anesthesia just to check on other possible issues?)
So now she says let's do more surgery and "have a look".  Easy for her to say - it takes me quite a while to recover from anesthesia, I am overweight, and have sleep apnea, and I'm am getting really tired of signing forms acknowledging that I can die from these "simple & quick" (her words) precedures.
My concerns:  She says she cannot find any fistula but that "doesn't mean I don't have one".
                       She says that she can cut a muscle inside to help heal the fissure.  Sounds ok until you read that the risk of incontinence is 15-36%!
                       It just seems like a cycle of surgery every 3-4 months until "something" works.  Really? - How can I do that for years - I'm 58.
                       She said the 2nd surgery would probably take care of things, then the 3rd, and now she says the 4th will probably do it - Really? Seriously this time?
                       A part of me wants to get a second opinion, but I know the next surgeon would just say "don't know - have to put you under to have a look"
Bottom line - please help with advice - I don't know if it's better to live with the moderate pain and irritation of a small skin tear (and it is miserable, I'll admit that) or continue to risk my life (and incontinence) with repeated "minor" surgeries that may or may not make things better.  What's worse is that I don't know for sure that I don't have a small cancer or IBS or Crohn's cause the stupid surgeon didn't check.........
Thank you for your help.

Veteran Member

Date Joined Dec 2006
Total Posts : 559
   Posted 2/18/2010 10:13 PM (GMT -7)   
This does not sound normal to me, and I think you should be seeking a new surgeon.

An honest surgeon tries to avoid surgery unless it's considered very beneficial or necessary. Doing surgeries "to see if it works" is not normal, but profitable indeed for the surgeon (especially if you have insurance).

Crohn's since 1988
3 resections

Regular Member

Date Joined Jan 2010
Total Posts : 265
   Posted 2/19/2010 5:55 AM (GMT -7)   
Usually surgeons only mess with fissures if you are very, VERY, very upset about it. Specialy if you have a IBD. It's a risky and bothersome area.

I have a 'won't heal' fissure, and docs keep telling me to keep going. That "endure" is probably better then cutting.

Why don't you visit a clinic (not surgeon doc), instead of a surgeon?
Diagnosed in nov/94 - Started with Prednisone, followed by Pentasa, entocort, flagyl, Imuran, Cipro, etc.
Blockage - First Surgery 2001 (no ressection)
Severe bleedind - 2003 - Stopped by 60mg of Prednisone
Stricture leading to a ressection in Dec/2008 - Second Surgery
Now on Remicade + 100 mg Imuran + Iron (sort of remission, not sure at all)

Veteran Member

Date Joined Sep 2005
Total Posts : 675
   Posted 2/19/2010 10:03 AM (GMT -7)   
If it's an option, try Remicade first. It healed my large horrendous fissure. I have another one that I've had for several years but it's tolerable.
I don't think the incontenence risk is quite as high as the surgeon has quoted. Big gamble though, huh?  If Remicade hadn't cured my dibilitating fissure I would have done the surgery for sure.
For me, no creams or bath soaks ever did a thing for me.
Bad fissure Feb 2005. Started Remicade 2006. Fissure #1 healed, now deal with smaller fissure that comes and goes. Clean scope 2009 except for fissure. Also on Pentasa.

Regular Member

Date Joined Jan 2010
Total Posts : 193
   Posted 2/19/2010 11:31 AM (GMT -7)   
A second opinion seems needed.
Age 58, Crohn's since age 21
3 bowel resections, 1980,88,95
1 fistula repair, 2005
digestive enzymes
L-glutamine powder 3 times a day
sublingual B-12 and B complex
2 T. cod liver oil
2 tsp. tart cherry juice concentrate
Multiple vitamin, 2,500mg vit. C, 1,000mg calcium mag.

Regular Member

Date Joined May 2009
Total Posts : 173
   Posted 2/19/2010 6:03 PM (GMT -7)   
I had a fissure as well that was associated with my initial onset of Crohn's. One of the most painful things I have ever experienced. If yours is seriously painful I might consider the lateral sphincterotomy. Mine has since healed after starting treatment. I currently have a painless fissure that is slowly healing with Remicade. In general I would be careful of surgery "down there".
"What can't be changed must be endured" - unknown

DX with distal Crohn's colitis Oct 2007, predominantly in rectum
Colozal (750mg): 3 pills 3xdaily
Cortifoam - 1 nightly
6MP - currently at 100mg and waiting for response......

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