Lateral Internal Sphincterotomy surgery after fissure your experiencecs?

[Ras 07]

Has anyone had a chronic fissure that was treated by surgery. Please tell me your experiences (good or bad) after surgery. After the surgery how long did you have unbearable pain.
I need to undergo this surgery as well and your responses will give help me a lot.

[Wahapainan]

I had the surgery done last September and the pain of the fissure was much worse than pain from the surgery. In fact the two days later I had a movement and it was a relief that the pain was gone. I was given pain medication and only took them for probably 12-16 hours after the surgery and probably would have been fine without anything.

[DeliahC]

Not the same situation with everyone, everyone heals different times.... some sooner than others.... glad for you

[allsmiley]

any updates on your LIS surgery?  results of your condition/surgery?

[naturalcure]

I had a lateral internal sphinterotomy about 4 weeks back. The first few days were very painful and it seemed like the fissure pain was nothing. However, by the second week the pain of the operation wound did subside. However, even now after almost one month it does pain if I pass gas very strongly from the rectum. Also, my problem of the rectum not opening properly and going into spasms has not gone. The doctors told me that my sphincer muscle was very tight and therefore this procedure of lateral internal sphincterotomy would be required to losen the sphincter and allow the stools to pass and thereby slowly heal the fissure which due to my extremely tight sphincter muscle was constantly creating a massive problem for me in my elemination of stools as well as aggravating the fissure.

I found that my major problems have not gone away and that is having a proper bowel movement. I was addicted to suppositories and abuse of them is what probably led to my extremely weak condition. The doctor tried to make me stop taking suppositories but I just wouldn't go (as I had become addicted to them) even after 3 days. So, I first tried cremaffin and took double the required dosage. (30 ml instead of 15 ml) Cremaffin is a mixture of parrafin and milk of magnesia. That still didn't help me and eventually I still had to use a suppository. Then a doctor gave me Cremalax which is sodium picosulphate and also made me take cremaffin in addition and that is the only thing that made me have bowel movements. Of course at times I would have diarrohea as it was difficult to get the right dosage of the combination for me. In any event during this hell I was undergoing everyone thought my major problem was the inability of the rectum to relax and thereby pass the stool. They felt the fissure over there was causing my rectum to go into spasms and therefore recommended this procedure of lateral internal sphincterotomy. I got it done 4 weeks ago and my pain did lessen of the fissure after about 2 weeks. However, the wound pain of the operation was intense for the first few days. In the last week I have been told not to take any laxatives of any kind. Not even stool softeners to try and go naturally. However, this just hasn't worked. I strained and aggravated my would a couple of days ago. Today, I was desperate and resorted to using a glycerin suppository and unfortunately my rectum tightened in trying to pull it up and it scraped my entire wound while going up. I am now undergoing the same pain I had BEFORE THE operation. I am afraid I have damaged my wound of the operation which was now healing till now. Also, I am afraid I might have created another fissure by my stupid antics of straining and using suppositories once again. I however am desperate and do not know what to do. I cannot go through this whole hell again. I had lost weight from 140 pounds (which already was a slim weight for my height of 5'10") and now I am below 110 pounds currently around 105 pounds.

Till, today I was keeping my chip up but after this suppository experience and now me experiencing pain in my rectum in the wound area as well as other areas I am truly down and do not know what to do. Please someone advise and help me.

[NAVCHAPDOC]

I am going to tell you how to start getting better but you MUST do this to a "T".. You must give up eating everything but apples for at least 2 weeks. NOT applesauce or apple pie, plain ol' apples. With nothing but apples onboard you should not need any kind of laxitive. You must also drink NOTHING but water. No coffee, soda, milk ect...If you can have your doc order you some NITRO-BID ointment as well it is a big help. I have a "cronic" fissure for about 5 months now and I tried everything from creams, fiber, botox injections ect... Nothing worked. I am a big sissy with the idea of surgery and so I just came up with this plan. I am about 2 weeks into it and feel about 80-90% better. I am not all the way there but it is a major improvement. The nitro-bid helps alot with the post BM spasm. Hope this helps.

[sewyouthink]

Had the LIS today; went great, not much pain at all and have only used a little bit of Percocet. I will let you know how it goes over the next week. I am glad I did it at this point anyway; it is over and maybe my chronic spasms will stop. I am very hopeful and my doctor thinks everything will be fine and I really trust her.

[jrb62651]

I had the surgery almost 6 weeks ago. After a couple of weeks most of the pain was gone, but I have this throbbing pain in my tailbone area right at the top of my crack. I was under the impression that I should not be having any pain anymore. Has anyone experienced this and should I contact my doctor about this problem?

[Aliaa1993]

Hi, I have done the surgery 4.5 months ago and still feel a strong tailbone pain. How is yours now?!

[Joey1262]

Had the LIS yesterday; went great, not much pain at all  my Dr also use a local inistega and have used a Percocet. today I had bowel movment and a litel pain and it seems to me is going a away. hope within a week or so all will be good. good luck all.

[dj9876]

Had closed lateral sphincteromy and stapled hemorrhoid surgeries 2 days ago.I was also impacted and surgeon had to clean me out...only pain medicine i have taken was 2 tylenol...i was worried about the first bowel movement..had bowel movement this morning..no pain with movement...i feel sooo much better than i did last weekend...I thank God for this surgery

[mina1982]

i had lateral sphincterotomy 1 week and 1/2 ago. i had 2 fissures, and the doctor burned out few polyps that had been formed. the first days after the operation i was in pain, but it took tramadol, pain reliever 2 times a day. i took a lot of medicines after surgery, including soft laxatives. i was very affraid of the 1 BM, which happened 2 days after surgery, but it was easy and pain free. i was recomended to take tramadol before i had the BM so i would feel a little pain. Today i can walk better, even sit for a while, but i have mild abdominal pain before and after BM. and that's scary, because the doctor told me i had very thin mucose of my internal muscle. so i have to fight constipation, but even if i drink a lot of fluids every day, take fiber suplement, eat soup, salads, apples, i still don't have soft BM. I hope i'll be better soon. And good luck to you all.

[davtpt]

Just had my second Sphincterotomy Surgery done four days ago, the first one was done 3 years ago, I have IBS ( or so the doctors say ), So over usage of the rectal area caused fissures which were very painful, I feel like I was hit with a baseball bat several times plus I also have the feeling of an ice-pik inside of my anus, Don't know if this is a condition which will continue seing that my stomach alwas wants to push my food down and my bottom's in pain and sometimes can not be in synch.... I'm a 43y/o male, this is NOT normal and no one in my circle ( world ) understands.....

[sanders671]

I had a surgery about 2 months ago. My fissure formed after giving birth to my son. 2 weeks after he was born I began to have INTENSE pain with bowel movements.It got worse and worse. After being told it was hemmorhoids for 6 weeks I decided to get a 2nd opinion. I was in so much pain that I felt like I was pooping knives!! Went to the colon and rectal surgeron and he said I definitely had anal fissures and by that time I had done all the conservative treatments so he offered surgery and I figured after giving birth, being in the worst pain of my life for 6 weeks...surgery couldn't make it worse. So 2 days later I had the operation. The dr said my fissure was 3 times the size of a normal fissure. All I have to say about the surgery is "GET IT"!!!!! The surgery was a miracle surgery!!!!!!!!!!!!!!!!!!!!!!! The moment I got home the pain was gone. I was told that I could remove the packing the dr put in after the surgery that night. I was so scared it would hurt but not a bit of pain...and I wasn't numb because I felt it come out. Next day had a bowel movement and it was uncomfortable but nothing like before. Within a week I was enjoying my bowel movements again, had quite a bit of itching from healing for about 6 weeks. But after that pain, I would take itching for the rest of my life if it meant I never had to go through that again. I would tell people I would birth a child every day if I didn't have to live through that pain!
The surgery allowed me to be a mom finally! If your dr recommends it, GET IT!!

[male2205]

My name is Mario and I suffered from an anal fissure for almost 7 weeks and though is been openly discussed in all the forums I've read over the past month and a half, I can not stress enough how painful, uncomfortable, and challenging this can be, I couldn't say that it is the worst pain anyone could have but I can certainly say that nothing I've been through before compares to it. My mother had one and she openly says that giving birth is a walk in the park compared to this. Two of my friends went to surgery because of fissures and they certainly don't regret having made that choice.
After a month and a half of trying everything and anything possible and after two visits to a board certified colon and rectal surgeon and his colleagues, my Dr. recommended surgery and it didn't take me more than two minutes to say yes.
Now, two days ago I had a fissurectomy and lateral sphincterotomy and even though the whole experience takes a big toll on you, I feel I made the right decision. I believe and have faith that things are going to finally get better. I felt pain once the anesthesia wore off but I got pain killers and the pain subsided a lot, in fact, on the second day after surgery (yesterday) I barely felt any discomfort. Of course, I didn't have any BM which by the way was my biggest concern. Needless to say, just the thought of having a bowel movement scared the crap out of me and today, less than 48 hours after surgery, I had my first BM.
I can't lie to you, it was painful but not nearly as painful as I thought it would be and it was a lot!  Sorry for being so descriptive but some of you will surely appreciate me telling you this,
I've been in pain afterwards but is less intense that whatever I had before the surgery, at least better than in my worse days with the fissure.
I'm bleeding only a little and going to start with the warm sitz baths after done here.
I'll keep you all posted and pray that your pain will go away very soon.
Blessings to all

[male2205]

I suffered from an anal fissure for 6 weeks and though is been openly discussed in all the forums I've been to over the past month and a half, I can not stress enough how painful, uncomfortable, and challenging that can be, I couldn't say that it is the worst pain anyone could have but I can certainly say that nothing I've been through before compares to that. My mother had one and she openly says that giving birth is a walk in the park compared to this. Two of my friends went to surgery because of fissures and they certainly don't regret it.
After a month and a half of trying everything and anything possible and after two visits to a board certified colon and rectal surgeon and his colleagues, my Dr. recommended surgery and it didn't take me more than two minutes to say yes.
Now, two days ago I had a fissurectomy and lateral sphincterotomy and even though the whole experience takes a big toll on you, I feel I tookj the right decision. I believe in faith that things are going to finally get better. I felt pain once the anesthesia wore off but I got pain killers and the pain subsided a lot, in fact, on the second day after surgery (yesterday) I barely felt any discomfort. Of course, I didn't have any BM which by the way was my biggest concern. Needless to say, just the thought of having a bowel movement scared the crap out of me and today, less than 48 hours after surgery, I had my first BM.
I can't lie to you, it was painful but not nearly as painful as I thought it would be and it was a lot!  Sorry for being so descriptive but some of you will surely appreciate me telling you this,
I've been in pain afterwards but is less intense that whatever I had before the surgery, at least better than in my worse days with the fissure.
I'm bleeding only a little and going to start with the warm sitz baths after done here.
I'll keep you all posted and pray that your pain will go away very soon.
Blessings to all

[Patient1111]

I had my surgery today and I was wondering what kind of "look" your surgery area is suppose to have... I feel like the doctor left tge area "inside out" as he had to have it in order to perform the procedure... I wonder if this is normal like will it go in naturally as the swelling subsides or will I need to manually push in? Right now I can't sit normally or lie down in my back because of this.. I think once it's pushed in how a normal anus is usually then it won't feel so uncomfortable like this... Did anyone experience this? Plz help what is normal after the surgery??

[patient915]

Please post your question as its own post because this one is so old.

[hotdish]

I had the surgery almost a month ago, and wanted to add my experience.  I came across this forum prior to the procedure, and found the stories of others helped prepare me.  

I'm a 34-yr-old male, and had been suffering with the fissure for about a year.  I had no idea what it was or why it was happening, but the worst of it was the itching.  I did have bleeding with almost every bowel movement, but the itching and burning was so painful that I couldn't work out, ride bike, run, anything other than sit on the couch.  I assumed hemorrhoids just from what I could gather on the internet.  So after months of referrals I was finally seen by this specialist.  After diagnosis, I was given a month supply of the nitro-glycerin gel.  Along with the gel, I completely changed my diet.  I already drank plenty of water, but upped it even more.  I had already given up caffeine, and quit nicotine years ago.  I fought through the pain and resumed exercising 5-6 times a week.  Still, absolutely no change.  It was at this point that the doctor recommended a lateral internal sphincterotomy.  I just wanted my life back at any cost, so I agreed.  

First of all, I made two mistakes the night prior to the procedure.  I ate pizza, which I'm assuming was the culprit for constipation, and I Google'd "Lateral internal sphincterotomy".  No matter how curious you are, do not watch the medical video that comes up when you search for this, especially not the night before.  My doctor told me it was a very simple procedure, which it probably is, but I didn't need to see how it all goes down.  

My Doctor is a highly-experienced gastro surgeon, who claims he's done this procedure thousands of times.  He told me the prep takes longer than the surgery, and that he's only in the OR for about 5 minutes.  Mine was just for an anal fissure, no hemorrhoids or anything else.  

So the surgery itself was a very simple out-patient procedure.  I got to the hospital at 6:15am, and was out of there by 11am.   When I awoke in recovery, I had absolutely zero pain.  I had to pee, which I was able to due despite being quite numb in that general area.  The general aneasthesia had worn off by the time we left, so my wife and I went shopping, all less than a couple hours later.  I was prescribe hydrocodone for pain, which if you've ever had it you'll know does an excellent job.  

So after a normal day, I still had zero pain.  I didn't attempt a bowel movement that evening out of fear, and not feeling the urge to go.  The next night I still had not gone, nor felt the need, so I called the nurse.  They recommended milk of magnesia, which I'd never before taken in my life.  After a few hours I went to the bathroom, and unfortunately went from constipation to diarrhea.  It felt slightly painful, but no worse than going with the fissure.  I made sure to soak in the tub after every trip to the bathroom (which is inconvenient with diarrhea, but I wanted to keep clean).  By the following day, things were solidifying.  I continued taking Miralax and Benefiber daily, which kept me regular.  

A week to ten days after the procedure, I was still finding blood after wiping. This freaked me out a little so I again called the nurse and was told it was completely normal, and that slight bleeding can continue for up to a month.  A couple days later this ended.  I still had absolutely no pain, and above all, the itching was for the most part gone.  Still occasionally itchy with healing, but nothing like before.  

The hardest thing to get used to is controlling something you've trusted your whole life, which now reacts differently.  For the first week or two, you're not entirely sure what is gas and what isn't.  It feels uncomfortable or weak when clenching.  This completely went away for me.  Things are back to normal and I'm excited to have my life back!

I just had my post-surgery appt this morning and the doctor said things have healed up nicely.  I've had a few surgeries over the years now, a tonsillectomy, a vasectomy, 3 knee surgeries, and now this.  I would actually rank this one the mildest out of all those as far as pain and inconvenience.  If you've found an experienced doctor, there is no reason to continue living in pain.  This really isn't that big of deal!  

[Dubarnik]

I'm a 51 year-old male.  I had anal fissures two years ago that healed, and have had them again for the last 6 months.  Tried Nitro-Bid and Pramosone this time, but no healing. Had my LIS two days ago.  An army doctor at BAMC in San Antonio did the surgery.

Post-Op:  My lower back, I guess where the spinal anesthesia was administered, has been stiff and painful.  Also, I've had some anal bleeding.  My bm's are normal and not causing any pain.  I soak in a hot bath after each bm.  I was really worried about the small chance of incontinence from the surgery, but with no signs of it yet, I'm optimistic.

Recommendations:  If you're suffering from anal fissures, get the surgery.  There is no need for you to try a wide range of alternatives.  Try one, maybe two things and then if it doesn't heal within a month or two, it probably won't and surgery is the answer.  About anesthesia, I really wanted general anesthesia but let the anesthesiologist talk me into the spinal.  I regret it.  My wake-up time would have been quicker and the post-surgery pain lessened.  Finally, ask your doctor lots of questions.  My surgeon was wonderful, but I think she could have been more specific about the first few days after surgery.  My lower back muscles hurt and are really stiff.  Did she know that this might happen?

[Big1980]

So I thought I had internal hemmeroids, but after being looked at by a surgeon, we found out that it was 3 anal fissures. I also had 3 skin tags that made things very difficult. Mind you I had be straining and struggling to go to have a BM for 3-4 years now. Due to no health insurance I had to wait.

Anyways, I had the Lateral Internal Sphincterotomy in early January. And really hoping this would help since surgery is one of the last really effective methods. I tried witch hazel, fibercon, etc. But nothing made them go away. So the surgery procedure was fairly easy, day in and day out.

Right after the surgery I was fine, and felt literally no pain...which was amazing. The doctor removed 2 of the 3 skin tags, saying the smaller one should go back up. I did some soaking in the tub, took the stool softner, pain med and applied vaseline to the area because I had my skin tags burned off. I had no more real excessive bleeding and magically it didn't hurt to go to the bathroom.

It's almost 2 months later and I still feel a little discomfort when I have a BM (Though nothing as close to as before). The one skin tag is still present which says to me that fissure hasn't healed at all. Unfortunately for me, when I wipe again I am seeing more blood than after the surgery until now. So I really think they are still there. I do experience some itching during the day, but nothing too bad. I don't itch anymore because that will just irritate them more. I tried to wipe with a wet clotch after BMs, clean the area after with witch hazel and cotton balls. Though I don't see much of a difference, at least I know it's cleaned and may heal them.

I'm not very pleased, since this has been an issue for years. I suppose I would opt for a fissurectomy if you have them badly like I did. That way they are GONE and you aren't still recovering like I am. Though it's much easier to have  BM, I dread seeing blood and having to clean for minutes after and thinking it's just going to get worse. If you have one or two chronic fissures formed recently I'm sure the LIS is very helpful. It's really an easy procedure. My doctor did a great job, but I think I needed more down due to the results I am having now. Ask questions prior to he surgery!

Has anyone else experienced this? Any ideas of how to make them go away and stay away?

[petrikbb]

Hi there.

My name is Peter, I am 28 yo chap, and I´ve just underwent sphincterotomy and fissurectomy 12 days ago, and wanted to add my experience as well as an insight on the whole thing. Just to tell you beforehand - everything went fine, and I am doing great. I have suffered from anal fissure for years, but the last time it just didnt go away and became chronic. It took some time for me to make the decision to get it done, but I definitely appreciate that I have decided the way I did. I would like to stress, that I got it done in central european country, so there might be few differences in comparison to other countries regarding the whole procedure.

The surgery was done by the chief of transplant surgery department. I got into the
hospital on Thursday, they did enema the night before the surgery, have talked to the anaesthesiologist and decided to go for general anaesthesia. Got it done on Friday morning, woke up around noon with more of a discomfort than pain. The surgeon recommended Novalgin infusions every six hours for 3 days to manage the pain (according to him - once the pain kicks in, its hard to relieve it), and despite that I hardly felt any pain I went for it. I was concerned about possible constipation, but it wasnt the case. I got sick from the general anaesthesia, and did throw up like 5 times that night. It was quite inconvenient since I had to clench the sphincter quite strongly while at it, but it didnt cause any pain. I was pleasantly surprised not only by the absence of pain, but of incontinence as well. From the first day after the surgery all the way until now, I can control gas and everything else as before. I stayed at the hospital for 3 nights, and left on Monday morning.

The first BM happened the next day after the surgery, and it didnt cause any pain. It was a strange feeling, hard to convey in words, but it felt like a part of the anus/colon is missing, and the stool just falls off. I have had a BM every single day since then, and got better day by day. I could feel the cuts and incision site while having BM for 8 days after the surgery, but was much more in discomfort (tension,stinging, itching) than pain. As I have said before, its day 12 today, and having a BM feels normal. There is still a bit of blood and bit of a leakage, but it gets better every day. I went for a first check up today, and was quite tense about stitches removal, but there were none to take out. The doctor told me, that they normally dont sew it, since it could cause infection if parts of stool got stuck in between the stitches, and that the anal mucosa needs to heal on its own.    

What I did

There are couple of steps, that I would highly advise to contemplate couple of weeks before the surgery.

To me it seemed (doesnt have to be the case), that getting over the worst period with fissure was of crucial importance regarding the recovery (season of the year might have some impact as well). I have suffered tremendously for 3-4 months, before it got better in the end. At least to a point, when I could sit down and wasnt in blinding pain for 6-8 hours after each BM. In order to get better, I´ve adjusted my diet (ate only oatmeals, salad potatoes and vegetables), did sitz baths but foremostly took care of hygiene. I even started to think about cancelling my surgery a month ago, but understood its inevitability and went for it (hard part of the decision-making was, that I live in UK and was scheduled for a surgery back in my home country).

Next, took care of my diet, in order to build up the habit of having BM every single day - this proved to be of utmost importance after the surgery. Its essential, that you are regular after the operation, thus avoiding harder stools. Likewise, eat lightly and regularly after the surgery for at least 7-10 days and dont walk/sit around. Stay in bed. Your condition will let you know when to get back on your feet.  

Sitz bath after every BM and before going to sleep (using oak crust which works superbly for me) and rest. Thorough hygiene and dont forget to use gauze to keep the place dry. I have started with short walks upon day 10.

Just to tell you. I havent used any sort of stool softeners or any other medication for that matter. Found my way around it with my diet - lost some weight but it was definitely worth it.

Hope this helps.
Wishing everyone all the best.

[snapplesf]

Hello,

Thanks so much to everyone for sharing their experience. It really helps since docs never give you all details.

I've had fissures before, but had an awful one in January 2011 that just wouldn't heal. I get constipated easily even when my diet is good. The only thing that works for me is to sip on hot water throughout the day.

After trying nifedipine cream for a month, I went for Botox which seemed to improve things quite a bit, but then I had to travel. I hate airplanes as they constipate me and that resulted in another tear.

So after much deliberation, I went into surgery on 4/8 in San Francisco.

Its been exactly 2.5 days since surgery and it has been quite painful. Vycodin causes stools to harden so the first bowel movement after surgery was very painful as was the 2nd. I envy folks here who have had easier movements after surgery. I also don't feel like the stool just falls off. I've had to push it out even though it was not too hard.

I'm taking Vycodin every 8 hrs. I tried skipping it once and the pain was HORRIBLE. I really hope this fixes itself soon. Just wanted to share my experience. Will write another update after 5 more days

Thanks,
Snapple

[snapplesf]

Hello,

Thanks so much to everyone for sharing their experience. It really helps since docs never give you all details.

I've had fissures before, but had an awful one in January 2011 that just wouldn't heal. I get constipated easily even when my diet is good. The only thing that works for me is to sip on hot water throughout the day.

After trying nifedipine cream for a month, I went for Botox which seemed to improve things quite a bit, but then I had to travel. I hate airplanes as they constipate me and that resulted in another tear.

So after much deliberation, I went into surgery on 4/8 in San Francisco.

Its been exactly 2.5 days since surgery and it has been quite painful. Vycodin causes stools to harden so the first bowel movement after surgery was very painful as was the 2nd. I envy folks here who have had easier movements after surgery. I also don't feel like the stool just falls off. I've had to push it out even though it was not too hard.

I'm taking Vycodin every 8 hrs. I tried skipping it once and the pain was HORRIBLE. I really hope this fixes itself soon. Just wanted to share my experience. Will write another update after 5 more days

Thanks,
Snapple

[meg402]

I def do understand. I have IBS or what I believe is Chrones Disease. I don't think anyone really understands how bad IBS can be. I have abdominal pain almost every day. I have constant pain from my fissure as well. My Dr has tried everything from the NITRO-BID cream, to having botox injections twice now and nothing seems to work at all. My next step is the surgery to attempt to repair the fissure that causes me so much pain it is difficult to even go to work some days. This pain is terrible and not many people understand how hard these problems are to live with and what kind of impact they make on daily life.

[wiser1]

Hi, I have had a Fissure for 7 months now.My doctor did a colonoscopy to determine location and any other possible issues.I have already been diagnosed with IBS for five or six years.I have tried everything the doctor stated to heal fissure ( high fiber diet,daily intake of water, Nitroglycrin cream) but it has become of chronic fissure and would never heal on its own so in two days I will be having surgery.I am very scared but know that it can't be any worse than the flare ups of the fissure on my worst days.Thank you all who posted on your surgeries.It helps to read what to expect after surgery.

[patient915]

To everyone that has posted recently: You have responded to an old, outdated thread from 2008.  The people who originally posted these comments may very well have moved on.  Rather than reply to an old thread, we recommend that people start a new topic to discuss the subject anew.  To do that, please click on the green "Post a Question" button at the top of the page.  This will get your post the attention it deserves.  Thank you.