Has anybody had a Sphincterotomy?

I'm on my 3rd day sphincterotomy post op for treating a fissure and stenosis I'd been managing for 3 years previously. I skipped botox and went straight for surgery given I felt I'd struggle to keep fissures away permanently with just botox. My doctor didn't warn me the pain would be as severe as it is. I was prescribed hydrocodone but haven't used due to fears of constipation. Instead I took max dosage Tylenol for the first day and then switched to motrin, which seems to be doing a slightly better job with less pills and no liver limits. After leaving the hospital, pain set on about an hour afterwards. The incision pain is focused to the left of the anus and is the main area that causes pain. It's worst in the night and best in mid morning. It hovered around a 7/10 for day 1 and improved by single digit percents each day so far as long as I take pain relievers. I lay in bed most of the last 3 days but walking slowly sometimes feels better especially because it keeps spasms at bay. The first day I had severe bloating from gas that I couldn't expel due to the passageway feeling simply too swolen and painful. Eventually the gas became intense enough to where it passed almost by itself with the smallest amount of voluntary pressure I could muster. Most of the rest eventually found its way out though it was decidedly unpleasant. My biggest hurdles have been sphincter spasms I get when lying still or getting out of bed and pain during bm, both of which are excruciating. I get involuntary sphincter contractions every couple minutes that squeeze the incision. The pain prevents me from sleeping at night. Talked to a doctor and was told this can happen and they prescribed me valium which I haven't received yet to try. Meanwhile this being the 3rd day post op, I started having my first bowel movements, all of which feel like passing glass through a way too tiny passage and is miserable. Have to do them immersed to minimize pain, yuck. My anal canal feels half the size of what it should be, not sure why, and the stool only comes out in the tiniest amounts. Each little bit passes against the still present and inflamed fissure as it's forced out , which is combined with pain from the incision. I've had to make 3 separate trips to the bathroom today to try to pass what stool there is and each time is equally brutal with little to show for it. It's also hard to tell gas from stool which means constantly pulling out the sitz bath every other hour and dreading what might happen. The bathroom is a war zone. No blood after day 1. Only been eating foods with some fiber content and drinking water all the time and peeing nearly clear urine every hour or so. have also been applying hot and cold packs and doing sitz baths. I could not have done this surgery without family members around to prepare food and run to the pharmacy. Praying this gets easier...

Dr L. Feingold has a procedure with 4 steps. step#1 allows patients to have sedation.step#2 he gently dilates the anus with special retractors.step#3 cleans out the fissure with with curettage to stimulate healing.step#4 he then cauterizes the wound with electrocautery to seal the wound.step#5inject traimcinolone which is a generic kenalog, a steroid into the fissure.he claims superb outcomes for virtually all 115 of his patients.i am not a doctor. I had an anal fissure back in 2012. I used strong doses of nitroglycerin,and my fissure healed.this Dr Feingold

says no worry about possible incontinence,cause he does not cut the muscle.his contact info is:phone# 2123421155. web site columbiasurgery.org/colorectal I'm not a doctor and have no personal experience with his method.

please read my post concerning a Dr Feingold.

I'm a 42 year old male. I had a prior hemorrhoid surgery. Active lifestyle includes hiking, cycling, long drives. I have a BMI of about 31. I am on a low dose of blood pressure and cholesterol medication. I am providing this information for context and comparison to those with fissures and are considering getting a Lateral Internal Sphincterotomy (LIS).

I had my L.I.S at the end of March 2021. Being nervous about the procedure, I began researching complications and reviews from people who had the procedure. My search brought me here. There were so many helpful comments, I felt compelled to leave a response since having my surgery. As I type, I am 2 weeks post surgery. Punch line first, THE SURGERY WAS THE BEST DECISION! I am so much happier and nearly pain free since the surgery. Please read on if you are interested in more detail.

For anyone dealing with fissures, you know the pain is intense, unbearable at times, take forever to heal, can come back often. My episodes would last several weeks at a time and would occur every other month or so for more than a year. The impact of having fissure(s) had a massive impact on my mental and physical well being Each episode seemed to be worse than the prior event. I have no regrets getting the surgery.

I was numb after the surgery, so no surprise there was no pain immediately following the procedure. My doctor didn't give me a prescription for pain meds. This made me nervous, but I knew that the strong pain meds could cause constipation. As the medication wore off, pain set it. It was intense, but not as bad as my worst fissure. Lucky for me I had oxy from a prior surgery to get me through the night.

On day two I removed the padding to see what was going on down there. They packed the anal canal with a small amount of material to absorb any blood. The nurse said this packing material would come out during my first BM. Before my first BM I was still in pain, less than the night before and much less than a fissure episode. Midday on the second day I had my first BM. I was so nervous. I was afraid of pain. I was afraid of opening the incision. I was afraid of leakage. It wasn't that bad. Everything came out with little to no effort. SUCCESS! After the packing material was out the pain was very very low. I opted to wear a "man pad" since then just in case there is any leakage or blood.

Through day three, pain ranged from 0-3. The notable moments were twinges of pain, not constant pain. I didn't need to take any pain meds, not even OTC meds for pain. Through day 3 I was still nervous during each BM, but was pleasantly surprised how little pain there was was. I shouldn't even call it pain, but more of a slight discomfort.

I stayed home for the first week. For the first few days I was told to ingest mineral oil to help keep things moving easily. The mineral didn't set well with me. It made me a little nauseous and was accompanied by a dull headache. I stopped the oil after day three. Note that I was taking fiber supplements and stool softeners prior to the surgery. I have continued to take them since the surgery to error on the side of caution. Also note that I was very regular, before and after the surgery. A BM in the morning is a given. Sometimes there is a second and third BM during the remainder of the day. I have a bidet seat which has been a blessing before and after the surgery. I use that in place of a sitz bath and opt to take a shower/bath after each BM to thoroughly rinse the area of the surgery. I then applied a thin layer of Aquaphor around the incision area to promote a moist healing environment.

On day 8 I left the house for the first time. I was nervous during my first trek. To this point I hadn't held back any urge to go the bathroom. Being away from an immediate bathroom was a little scary because I didn't know what would happen if I had to "go" and wasn't near a bathroom. All went well. No BMs while I was out. On day 10 I left the house again. I was more nervous this time, because I left before my 1st normal BM. I held off eating or drinking anything until I got close to my destination. All went well and I had a BM while at my destination. This was the first remote BM 😃 Another successful milestone!

On day13 I had a follow up appointment with the Dr. He was happy with the results and my feedback. He basically told me I don't need to come back unless there are any delayed side effects. That brings me to day 14th (today). I am so happy I had the surgery. No pain at all. Slight discomfort from time to time and so minimal I wrestled with even discussing it here. I still wear the "man pad" as a precaution since the Aquaphor can leave a little residue if too much is applied. I will probably discontinue using the pad this weekend since the the pads have been clean for the last several days.

Since the surgery I have been very mindful of how my body (and BMs) reacts to certain foods. I have made a conscious effort to increase my water intake. I have at least one fiberous fruit per day. Red meat was not good for my fissure situation. I will be cautious about how or if I reintroduce red meat (especially steak) back into my diet.

I haven't got back into my physical routine yet, only a couple walks with the dog. I'm going for a short hike with my sister tomorrow. I'll probably wait a little while to get on the bike.

I hope my shared experience helps you in the same way the shared experience of others has helped me. Take care and be well!

Tom

Hello, I have for a long time problem with anal fissures. At first the GP was telling me I had haemorrhoids until I went to a private doctor. I did a therapy with a cream for almost two months and after that I was good. After couple of months the fissure came back and I contacted the GP so the doctor offered me topical cream and antibiotics or surgery. Of course I chose the first option and it worked again . After couple of months I started feeling pain again and I really don't know what to do. at the moment is OK I noticed blood only once. I would really like a permanent solution but I don't know if this surgery is for people who have worst symptoms. would this surgery help me?

Hey...

I'm a 29 year old female and have been suffering from chronic anal fissures for almost 4 years. I have had botox twice, tried GTN which I couldn't continue with as the headaches were unbearable. I recently had a colonoscopy to check if there was anything sinister going on and had some biopsies taken. Everything came back normal but my fissures are obviously still here and a massive bane of my life. After a BM my whole anus swells up and there is often blood. I currently have 1 chronic fissure which is the original one and 2 newer ones that have mainly developed within the last year. I'm at the point know where the depression is real with this so am considering the sphincterotomy. Can anyway who has had this tell me if its worth it especially for fissures this chronic? I'm scared nothing is going to be able to heal them or i'll become permanently incontinent.

hi, had mine 10 days ago. Bit worried about the recovery, everything seemed good at first (painful from the op obviously) but then the last two days I've started to get the itchy, quivering, prickling feelings I had before.

Has anyone else had this? I'm just wondering if the fissure is still healing?

i had a sphinchterotomy and skin tag removal 1 week ago exact. let me tell you google lies. the pain is 100 times worse after surgery and doesnt get better in a week. i had the procedure on a tuesday. i passed my first rocket turd on friday. it hurt beyond description while going but all pain left suddenly after. but i got nauseaus and vomited for all of friday and saturday before going to er for fluids. they stopped the vomitting for a few hours and sent me home. when i got home i started again thru sunday. sunday i went back to er for more iv fluids.. monday my doc gave me pain pills. i took one and got bloated and gassy and started vomitting again. i talked myself down. now its tuesday i still wasnt able to poop so i took the softners and prune juice. i dont feel an urge to poop just severe pain. i sit on toilet it hurts but i squirt. now i have the runs. the pressure is emmense and severely painful. i continue sits bath and sh*tting in the bowl. changing the water and squirting as much as i can. after about 5 hours of that i feel well enough to warn others. if you have the operation have a plan for keeping your stool the right consistancy. too hard hurts more at the time but the pain goes away when empty. too soft and youre in pain until empty which is way worse. if i had known what i know now i would have lived forever with the fissure