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Recovery from Sphincterotomy and Fissurectomy
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Recovery from Sphincterotomy and Fissurectomy

Hello. I am 23 years old and I suffered from an anal fissure for 10 months. I tried many forms of treatment and finally decided on surgery to relieve the intense pain (the pain was a 10 on a scale from 1-10). I had my surgery 5 days ago (Sphincterotomy and Fissurectomy). I have had 4 bowel movements since the surgery and I am still in a lot of pain. My Doctor told me that the pain caused by the fissure would be relieved immediately, but it doesn't feel like that is the case. I also have had pain from the incision constantly throughout the day since the surgery; it is hard to walk, sit, sleep, etc. I took Vikodin for the first two days but decided to stop do to very hard stools, I have been taking Advil to try to control the pain but it doesn’t really help that much.
The first three bowel movements after surgery were very painful because they were quite hard and I had to strain to get it out (even though I have been taking fiber supplements, drinking a lot of water and taking stool softeners since the surgery). The fourth bowel movement was softer but there was still a lot of pain. There is hardly any blood. I am not sure if the pain is from the fissure or from the incision. My Doctor made me believe that the pain would be gone almost immediately from the fissure so I expected recovery to be a breeze, but so far that has not been the case. I opted for the surgery to get rid of the intense pain during bowel movements, but the pain is still persisting. Is it normal to be in this much pain still? How long will it take for the pain from the incision to go away? Once that pain is gone, will I still have pain from the fissure? Or will I be pain free? I’m in a lot of pain and I need help.
Tags: Recovery
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14 Comments Post a Comment
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Avatar_f_tn
I had this surgery December 14. I also thought relief would come immediately. It has been almost two weeks and I still have severe pain after a bowel movement. I do have some lidocaine inserts that help some. I go back to my doctor in a few weeks and hope to have some answers.
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Avatar_n_tn
I had the fissurectomy and Sphincterectomy last week (Feb 3rd). Prior to that I've been in sharp and unbearable pain for the last 9-10weeks. After the surgery, I didn't move my bowels for the next 2days and when I finally did, it was hard and I thot I had another fissure in the process. It scared me to pieces just the thot of moving my bowels.I dread going to move my bowel. It's exactly 1 week today, I've stopped the hydrocodone(prescription) 2 days after surgery due to fear of constipation. I now drink gallons of water, eat a lot of high fiber meals only, fruits and veges. I take Advil as a substitute for the hydrocodone. My stool is considerably soft, blood stained and still hurts like mad. It's hard to stand/sit for long but just a little comfortable lying down though. The pain is agonizing, unbearable and
fierce, to say the least. The Lidocaine ointment was a life-saver for me before the surgery, now when I apply it, feels like an expired good. My anus feels raw, bloody and as if someone's constantly poking it with a sharp instrument. This is a nightmare and would appreciate any relief anyone can advise.
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Avatar_n_tn
I HAD THE SURGERY ON JAN 22, 2010.  IT IS NOW 7 WKS LATER STILL IN A LOT OF PAIN.  NOT AS MUCH AS IN THE BEGINNING.  TONIGHT I AM NOT ABLE TO SIT, LAY DOWN, OR STAND WITH PAIN AFTER A NOT SO PAINFUL BOWEL MOVEMENT.  I CANNOT WAIT UNTIL I FEEL NO PAIN.  A LOT OF PEOPLE FEEL BETTER IN A COUPLE OF WEEKS.  NOT I.  WARM BATHS ARE THE ONLY THING THAT BRINGS A LITTLE RELIEF.  
IT TOOK ME 3 WEEKS TO GO BACK TO WORK.  AND 2 MORE WEEKS TO WORK FULLTIME.  I AM A MEDICAL BILLER SO AFTER SITTING ALL DAY IT HURTS.  HOPE YOU ARE BETTER.
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Avatar_f_tn
Anyone have any updates?
I'm four weeks post and still in pain.  I had awful pain for two weeks and had to have incision site opened to check for infection.  None found but pain persists though not as bad.  Returned to work third week.  Can't sit or stand for long and laying down is also not that comfortable. Bowel movements feel like incision site is so tight I can feel it stretching. Just a little burning after but have small amounts of leakage later that burn and hurt a lot. Wearing gauze to help with that but it causes pain also.  Feels like rectum wants to fall out at times....lot of pressure and heat feeling.  I'm hoping that this will all pass soon.
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Avatar_f_tn
Fissurectomy & botox was best thing I could have done!! I am almost 4 weeks out of surgery and feel great - I am a 30 yr old active female for reference.

After dealing with fissures - yes, plural (anterior & posterior) - for 11 months (first 2 months untreated, 9 months on niphedipine/stool softners), I almost completely feel like my old self again 4 weeks post op! Surgery was not bad- went to chief of colorectal at the BI in Boston. Came out 45 mins later, felt a little something,uncomfortable (not pain).

Here's what I did & it has worked so far:

Week before surgery- three softners a day (breakfast, lunch, dinner), 1/2 cap miralax at bedtime with water (I was worried about starting this but is completely safe, is per dr's orders & I have found is crucial to keeping things soft- as in my experience sometimes the softners alone would work one day & not the next- miralax works all the time for making things soft esp in conjunction w 3 softners/day & was recommended by dr), benefiber, salads & fish for protein. Enema night before & morning of surgery (per dr & very important to make sure you have some time after surgery before urge to deficate). After surgery, hospital gave me two oxys for car ride home- get the oxys not percoset b/c with oxy you can also take advil at the same time to combat any swelling.

My regimine= day of surgery: every 4 hrs, one oxy, every 6 hrs take three advil - so yes you will be combining the two which helps pain and also any swelling, ice for 15 mins every two hours. Had a couple of spasms but was not in pain, just uncomfortable. The day after surgery, i no longer needed the oxy. took three advil at approx 5-6 hr intervals- important to not wait until you feel any pain. Drank a TON of water, ate tiny amounts of food (oatmeal, fruit, prunes, cauliflower ONLY), sitz baths 3-4 times/day. Laid (not sat) around on either side, slept, read- first BM was not bad, I was very tentative & slow going- absolutely NO pushing & used wet nap wipes, not TP. if you feel like you have to push, stop immediately (take my advice here), take a softner & drink 24 oz water. next time urge comes it will be better. You may feel like you cannot fully relieve your bowels and may have instances where feces "poke" or seep out a TINY bit. This is normal I believe from botox and is temporary. At this point you may feel you are fine, can move around, etc. Do NOT. stay in bed & laying down. More active you are, more swelling down the line (more on that later). 3rd day was same - no real "pain" but uncomfortable for sure- kept on 3 advil 5-6 hr intervals. 4th day was BAD upon BM (thought i ripped a stitch, which i did not). since i had NOT been feeling a lot of pain, i pushed a little- reinjured myself & pain was bad during & after. sitz baths directly after BMs, spasms, icing, laying, fruit, roasted plain veggies, salads, broth only, no chicken/meat,etc. Pain was not anything worse than first two months of untreated, searing ripping I felt at first onset, so if you've been dealing with fissure, you can handle it & won't be anything new. this BM & after BM pain lasted for another 3 or so days - during this time frame very important to take sitz directly after BMs. Needed to sleep/rest after intense pain after BMs. After that 3 day setback, I was sure to NOT PUSH even a tiny bit upon BM, def no skipping Miralax and softners, no deviation from fruit, ton of water, veggie only diet. Laid in bed for 7 days altogether, finally up & about after that, but just to put dishes away, move from room to room, make a veggie snack myself instead of getting pampered. It was at this point, I thought I had developed hemmeroids from tissue portruding out of my anus (not a lot, but there was definitely bulbus stuff there). Called dr- said most likely is swelling not hemmeroid, and continue again w/ ice/advil. At this point, felt ok, was back to work after 12 days (sitting on a very cushy pillow).  At 14 days, follow up visit w/ dr confirmed swollen tissue from surgery (not hemmeroids) potruding out of anus. dr said very important to continue rest, sitz baths and no exercize for one week. At 21 days, swelling down (not gone), no pain, tiny bright streak on feces only. I did my usual flat land 10 mile hike- had to stop 5 miles in as pain in rectum which lasted approx 10 mins. Continued after pain stopped & finished other 5 miles and took sitz baths immediately upon returning home & 1/day for a few days after. Been fine since. MInimal gym work, walking, started having alcohol again in moderation. However, do not overdo it. I am home right now as I had two drinks at dinner tonight & started feeling a little uncomfortable after BM where there was once again a bloody streak (no pain at all). Decided to call it a night & lay down to rest. No more alcohol for a week at least & will be sure to do a sitz tmrw a.m. I lost 8 lbs the week after my surgery due to diet, laxatives, water consumption. I have watched my diet since then (no meat- veggie burgers & flax seed buns, carrots, oatmeal, etc). I will work toward getting back to normal but will not do that until I see no more blood streak for a month as this is the last time i want to deal with this. this is a personal choice & was not advised by any dr, but i am not taking any chances after dealing with that pain. It obviously takes a lot of concentrated effort for a couple weeks, but you will be so thankful you did it. It is also very important to know the pain is not anything worse than you've already experienced- no one told me that and I was giving myself nervous breakdowns for 3 weeks prior to surgery imagining how the pain could possibly be worse than what i had already experienced. Get the surgery- you will not regret it, believe me!! Good luck!!!!!!!!
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Avatar_m_tn
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.  Will post again in a few days.
Blessings to all
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Avatar_m_tn
today is Christmas eve and 8 days after my surgery, it sure feels like baby Jesus gave me the biggest present yet. I feel like 80 to 90% better than 6 days ago and there's barely no pain left. It's still uncomfortable to go the bathroom but I'd say is mainly because of the psychological consequences of going through surgery, cause in all honesty, most of the discomfort is gone. As i said in my previous post, I had both a L.I.Sphincterotomy and a Fissurectomy and I feel like I've gained my life back.
I know it's a hard choice to make guys but if you're really in pain, the kind of pain that takes over your life, the one that is so excruciating that makes you wish you were unconscious 24 hours a day....not being able to sit, walk, sleep, drive, etc. That's the type of pain I was in. If that's your case, then go for it...
I still have the stitches and they should dissolve within the next week or so but even with stitches, things look and feel much better.
I still do the sitz bath, still taking stool softeners (colace, metamucil, bark powder "cascara sagrada"), and lots of water, but hey it's for your own good.

Hope this helps and pray that you all get better very soon!
Merry Christmas
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Avatar_f_tn
I'm a 25 year old female. Had been dealing with a fissure for about four months. After trying to home remedy, which I thought were hemorrhoids, and having now affect, I got over the awful embarrassment and decided to go to the doctor. Upon inspection of my so called hemorrhoids, he found that I indeed was suffering from a fissure. Prescribed nifedipine .2% ointment to be applied 4 times a day for 2 weeks. Seemed to help a little a first but then had a hard BM and all hell broke lose again. Went back in after 2 weeks of treatment with ointment and fissure was still not healed. Opted for the internal lateral sphinctorotomy to be done with the pain. Worked myself up pretty good before surgery on Tuesday, which was pretty much a waste. I am now 3 days post op and in relatively little pain. Had first BM day after surgery and it was pretty painful. 2nd was today, also a lot of pain but took a sitz bath immediately afterward and that helped loads with the pain. Was prescribed vicodin for at home pain releif and found I really don't need it much. Plus it'll constipated you if you take more then necessary. Have been doing 3 stool softeners a day since surgery and drinking lots of water. Was advised to do only the softeners and water rather than a fiber supplement. Found that BM move a little better after the initial start of it. all in all I feel like I made the right choice in going with the surgery and hopefully in a couple weeks I'll be able to take a crap like a normal person again.
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Avatar_m_tn
Hello community! I'm a 36 year old woman, and I had a fissurectomy & sphincterotomy 6 days ago. I took oxycodone for a couple days and was feeling decent enough, except when I had to have a bowel movement. It was extremely difficult and painful for a few days, and I felt it wouldn't happen if I didn't push hard. I know you're not supposed to push hard, so I called my doctor who told me to try Milk of Magnesium. He also said if that didn't help after a day or so to try Miralax.

I'm happy to say that the Milk of Magnesium made a huge difference, and I had a few BMs in one day. They were uncomfortable, but not painful. I should mention that I have also been taking fiber supplements (Metamucil) and stool softener (Colace) this whole week. I have switched to Advil, which is supposed to help relieve swelling. I have been going to work since my 3rd day after surgery (I mostly sit at a computer all day) and walking around moderately without any discomfort. I'm making an effort to eat high fiber foods, but I'm also eating regular foods in small amounts. I haven't really had much appetite.

I'm wondering- has anyone used any kind of ointment or lotion to alleviate irritation after a BM? Sitz baths have helped somewhat, but I still feel a sting for an hour or two once I'm out of the bath.

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Avatar_f_tn
I'm about to have the fissurectomy and lis done next week and I'm freaking out!!! Is the recovery that bad.....my biggest feat is having a BM....I've had a fistulotomy before and I remember the BM being absolutely horrible and was in severe pain from it.....will my first BM be anything like what I experienced after I had the fistulotomy?
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Avatar_f_tn
I'm about to have the fissurectomy and lis done next week and I'm freaking out!!! Is the recovery that bad.....my biggest feat is having a BM....I've had a fistulotomy before and I remember the BM being absolutely horrible and was in severe pain from it.....will my first BM be anything like what I experienced after I had the fistulotomy?
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Avatar_f_tn
I am a 26 year old female, I had a hemi cut off 4 days ago and my pain is just now going away. The colon and rectal surgeon told my I have to.have a fissurectomy and a colonoscopy. I have a fissure on the inside that he says is as big as his thumb if not bigger, it has been there hot a few years I guess, due to a tear a long time ago. I also have a skin tag on the outside. The fissure didn't start bothering me until I had the bad hemi. Now when I have a BM, it comes out but isn't really painful. I am very nervous about having a fissurectomy due to never having a surgery before and also due to how long just having a hemi cut off has bothered me. I just started my job 2 months ago and they don't offer short term disability, so that is another worry of mine because I can't afford to be off work without pay. I don't know what to do. Anybody have any suggestions? I go back for a followup on Aug 17th and that is when he wants to schedule everything. If it isn't bothering me, should I still do it?  
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Avatar_f_tn
I had this surgery done on 8 October 2013. Doctor asked me to get admitted early morning on empty stomach at  around 8.00 am then around 11.00 am I was getting set for the surgery .Nurse at the hospital shaved off all the excess hair to avoid any infection.  I was given general Anatasia which put me off to sleep for 4 hrs.  When I was awake my mouth wss dry They gave me tender coconut water which made we feel good.i was inserted a very very long cotton to absorb all the unwanted blood. around 12.00 pm my surgery was completed. it was just for 30 mins.with in couple of hours I was given normal food. Yes the cotton insted in my anal was very painful. around 5.00pm I was discharged and cotton was pulled out from my anal.OMG yes that was painful but I was prepared for it because I had been suffering from fissures for past  14 yrs. After I got home I avoided sitting insted was on bed for a week with complete rest. Note I was advised a week painkillers and a stool softeners.After surgery I had not gone to toilet for 2 days which scared me a lot but on Third day I went to the toilet yes I had pain I was very scared to push but it was not as painful I expected it to be. I was relaxed. I was out of pain with in a week .I am completely in veg diet for a while. I still continue my sitz bath since the wound was open I didnt want any infections. Now the wound has heald but itself. I am damn happy now. No more painful stools. But yes after surgery im passing lot of gas.i don't know why but that really doesn't bother me.
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Avatar_m_tn
Great advice!! Sounds like me, almost to the T.
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