Anal Fissure and Acid Bile Diarrhea

Been a while since I have been here.  4 years out and maintained 190 lb weight loss.  But have a anal fissure that is not healing properly due to bile acid diarrhea.  I have done the lidocaine and Botox treatment with no success.  On colestipol.  Cant do the surgery because it will make me incontinent.  Taking hot baths and ibuprofen helps.  Any others with similar problem and suggestion?

Why will the surgery make you incontinent?  It is my understanding that there is only a VERY small chance of that happening.

I know from my anal fistula surgery that the incontinence issue really depends on where the fissure is located. SItz baths helped with my fistula and they were more convenient than an actual bath. Hopefully some of the fissure people will chime in.

Have they done anything to lessen the bile acid problem?  I know I've seen some posts about different food choices lowering the acidity. Not sure if that really applies in your case but it might be something to google or you might use the search to check the archives. Actually checking the archives for the fissure too might be helpful.

I hope they find a way to resolve this. Not an easy thing to live with.

I am SO sorry you are having to deal with the fissure!  There is NO worse pain in the world than fissures.  I have been on a very long and draining process with the fissures which has included; 5 botox injections, the Lateral Internal Sphincterotomy which lead to an abscess which then lead to a fistula and 6 additional surgeries to try to fix the abscess.  I am going in for my final surgery in June.  

BUT!  (haha pun intended) Once I had the lateral internal sphincterotomy I have NEVER had fissure pain since!  It truly saved my life which used to consist of screaming in a bathtub for hours after going to the bathroom, pain killers and laying on my back with my legs in the air.  (I'm only 26 so this has ruined my life for the last two years.)   I have had NO issues with incontenence.  

I would suggest getting a second opinion on the surgery.  Honestly, the Lateral Internal Sphincterotomy was a life saver!  Now we just need to get cracking on this fistula!  

Best of luck!  PLEASE reach out to me if you have ANY questions at all!  I have seen every single Colo-rectal surgeon in the Chicago-Land area and have been through this for a few years so I'm happy to give any guidance and support I can.

Best of luck to you! 

Thanks to all for the comments.  I just had my second set of Botox shots and I'm incontinent.  Yes I have to wear adult diapers.  Surgeon is afraid to do sphincterotomy - which could cause permanent incontinence.  At least the Botox should wear off and this will resolve.  There is an alternative that is reserved for failed sphincterotomies, I think its call the anal advancement flap.  They take skin and cover the fissure so it will heal.

I don't have any advice but you may want to look for other wls boards to post your question to as many people as possible.  I'll pray for you.  This sounds awful!

Well I have had a very similar situation. Be sure to talk to you CRS about the incontinence u are worrying about. Anal fissures that are severe like in my case only heal after the muscle is cut. I had a LIS at the end of October last year and have no problem with incontinence, it is always a possibility but not super common. I'm thankful I had mine done nothing hurts worse than those fissures , good luck!!!!