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Hi, 

I was diagnosed with an anal fissure this summer; tried nifedipine + lido and did little to help, so the surgeon did a fissurectomy and botox injection. He said he removed the skin tag but it's either still three or I rapidly developed a new one of the same size. We're about three months out and I've tried a month of cipro (no help), 10 days Flagyl (started to help, but the side effects are terrible and once I got off of it the symptoms came back). I do sitz baths as often as I can and and taking fiber three times a day. Right now all I'm able to do is try to control the pain, but it seems to be worse than where it was prior to surgery. 

My GI doctor wants to try a month of Alinia 2x per day, but we're waiting on the pharmacy approval. She thinks this is related to chronic inflammation in the area, but is not ready to call it Crohns or anything else. I had been tested for Crohns in 2017 and was not diagnosed with it. 

Has anyone had issues like this? I've had my pouch since 2015 with a few bouts of pouchitis, but generally it has worked fine. Are there any suggestions besides what I have done for relief, and has anyone had luck with healing a fissure? The surgeon said a last resort would be to do a loop ileostomy to allow the area to heal, but after all the issues I've been having, I'll probably travel to see my original surgeon who did my pouch for another opinion. 

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