Advancement flap help

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Hi,

i have had a fissure since hemmorhoid surgery in feb 2012. I have tried everything except a sphincterotomy as I have normal anal resting pressure.

i had an advancement flap with fissurectomy 6 weeks ago and am still in significant pain.

has anyone else had this procedure done and can recommend if it is still normal!

i haven't got a follow up for another 3 weeks

help!!

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8 Replies

  • Posted

    Hi there, 

    I had advancement flap operation 4 weeks ago this coming Tuesday. Was all set to have the sphincterotomy following two failed ops for botox. My consultant doesnt want me to have it due to potential risks associated. I understand where he coming from but im at the end of the road with pain. Had enough to the point I told him to stitch me up and give me a bag. The AF op appears to be working (I didnt heal from fissures and suffered for 15 years or so) its hard work but im watching everything I eat and drink to aid the recovery and to give the AF best chances of healing.  Im eating plain bland food and small portions. Little fatty foods, little animal fats, nothing cooked in oil, no herbs at all which is harder than you think when you look into the ingredients in products, no spices not even pepper, small amounts of foods with acidity. Lost nearly 2 1/2 stone since January but seems to be helping to control the pain. Medications didnt have much of an effect, morphine did but im not taking that turn in the road. Leave the ibuprofen alone,  can cause bowel irritation.  I ended up back at a&e after first op a week later with uncontrollable bleeding. It was then I found out about the ibuprofen.  Are you eating alot? Have you changed your diet? What kind of foods are you eating and is there anything what triggers the pain?  What helps for me may not help others but hope the above is if use. 

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    • Posted

      Thankyou for replying to me!

      i take the ibuprofen as I don't get on with anything else. Even paracetamol makes me dizzy. I only take it in the morning, before my bm.

      i eat a very limited diet, no bread, pasta, white rice, red meat, eggs. I do still eat dairy though, and add a glug of olive oil to my food, to add some much needed calories, and help lubricate the stool. I also take 2x movicol a day and drink lots of water to keep everything soft. 

      The flap I was given is a mucosal flap... It's all internal, not your run of the mill flap. I'm struggling with a very raw sore patch that has developed externally just outside my anal opening.

      you sound like you are doing well 4 weeks in.... I wish I could say the same!

      i don't have a follow up until 17 oct, and my consultant is too busy to fit me in before that.... So I'm left feeling deflated, thinking this op has been a complete failure.

      do you mind me asking where your surgery was done??

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    • Posted

      Hello,

      I take two paracetomol every 3 hours or so, even if i dont have the pain level to warrent it. i've tried to leave it out and take only when required but the pain is too much. It is noticeable the healing process has started as there is not much blood after a bm.

      Plain chicken, white rice, white bread, boiled potatoes, oven chips now and then, some red meat but maybe once twice a eek at a push. Vegatables but not sweetcorn. Chocolate now and then but selective, nothing with nuts. Coffee (not decaff) Orange, Cherries & Berries cordial.

      I was taking the movicol twice a day but really had enough of it, same with lactulose. I'm finding the whole situation really depressing, very low indeed.

      Whilst mine was also internal it was quite near the opening. I too suffer with a sore but it's not all the time. I've likened it to nappy rash, however wouldnt reccommend the use of Sudacream, thats a no no for me. Pain and irritation had to wash it off and was nearly in tears. I use Johnsons baby lotion (the pink one) seems to be less aggressive, make ya bum smooth too. ha ha :-)

      Were not all the same, I'm male and 42 years old. Like i said earlier, sufferer for around the 15 year mark now. I wouldnt wait for my follow up, i would be on the phone or even there in person to ask to be seen, even if it was just for reassurance. The following week after my op, my consultant was on annual leave but said if i needed anything to ring his secretary and he was contactable. Very very nice man. I dont have a follow up, all he said post op was see you in around 3 months unless I needed him sooner. Do yourself a favour and ring up in the morning, what have you got to loose? Nothing but time, if you leave it how much worse you going to get, ring up and tell him/her how you feel and that you have resulted to this forum for help. Thats not how it should be in the UK.

      Nottingham Queens Medical Centre. What about you?

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  • Posted

    Hi! I really dont know about a flap but might as well share my horrible experience with an anal fissure. 2 mos ago i started on a diet so i go to the loo 3 times a day for 2 days and there it started. At first the burning pain was healed after 3 days, i thought its over...after 2 days of passing a not really hard stool it started again, i think it was a re tear but this time the pain is excruciating i almost fainted when i go. The pain is intolerable and ive tried almost all the creams in the pharmacy. Ive got a laser treatment from a very good doctor, but before the treatment which took 2 weeks long before I went with the procedure because thats the only slot available...ive treated myself with virgin coconut oil and mayinglong musk cream...this works like magic! My AF is really big according to the doctor that it will not heal on its own because it needs a laser treatment. And he asked me what creams have i used

     I told him about this cream and he said just continue with it if it makes you feel better. He told me he needed to cut the muscle because ive had spasms and the area is so tight already. He made a fresh wound and treated the big fissure with a laser. There is a little pain from the local anesthesia but the whole laser treatment which lasted for only 20 minutes felt good. The next morning when i went to poop, there is still blood with a little discomfort but not like the pain before. 2nd until the 7 day its really getting better but still with a little blood. Im on my 20th day now and thank God, no pain no blood, back to normal again. Im still taking fybogel once a day and lactulose before going to bed and next morning the stool is really soft. My diet, oats in the morning and 3 pieces prunes, lentils for lunch or any kind of vegetables but mostly sprouts. Chicken...nah...it will make your poop hard. I avoided meats for 2 mos now except for fish. Fish is very good in the tummy. A carrot juice a day and fruits mid afternoon. brown bread with a little salmon in the evening and 2 more prunes. No rice at all. No sugar, junkfoods, sweets, anything artificial. Just a healthy diet. Sitz bath with epsom salt 3 times a day and my coconut oil and cream 3 times a day plus fkax seed oil 2 times a day and vitamin e and c. All of these will make your recovery faster and dont forget to really pray, pray, and pray. He can work wonders. 

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    • Posted

      Thank you so much for taking the time to share your story.

      ive not heard of having the fissure lasered ..... Was it the fissure or the muscle, like a sphincterotomy??

      i was told not to sitz bath after my surgery, but 6 weeks on, I'm sure I can give it a go now, and I have some Epsom salts. How much do you add??

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    • Posted

      Hi! The head nurse told me, the muscle was cut and they need to laser the big wound so there is a fresh cut and thats the one who will heal faster. I really dont have an idea what they did down there but its really worth it. The doctor told me its good you didnt go to the hospital for surgery because it would take months before you can go back to a normal life. And what he said is true... No surgery, no worries. This medical clinic specializes on treatments for bottoms only. All sort of problems for bottoms... ;-) theyve been here in Dubai for 20 years. The name is Jehad International Medical Center. By the way the epsom salt is 1 tablespoon only... The doctor is really good he assured me after 10 days there will little to no pain at all... And his true to his words... 
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    • Posted

      That sounds great.... But I've not heard of anything like that here in the uk..... Maybe I'm wrong?

      i will try the Epsom salts.... I'll try anything!!

      thankyou for posting..... And good luck with your healing!!

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    • Posted

      Hi! Yep. They only have their center here in Dubai ang KSA. And theyre the only ones doing it. Even for hemmorhoids its also laser, every treatment they use this laser technology... And the patients are 100% satisfied. Good luck with your healing also. Ill pray for you. 
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