Has anybody had a Sphincterotomy?
Posted , 102 users are following.
Hi All, I've been advised to 'seriously consider' a Sphincterotomy following Botox, which doesn’t seem to have worked. Although I'm booked in for a second round of Botox, my consultant advised me to have the 'risky' op The risk he says could result in incontinence and this is what scares me. Has anybody had this procedure, what was the recovery time and did it work, without the incontinence? Thank you.
4 likes, 260 replies
rich21608 ianee
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Hi all. Very helpful posts; thank you. Has anyone had a sphincterotomy after resection surgery for rectal cancer? My surgeon says the procedure is 90+ percent successful for fissure patients generally, but hard to tell how prior radiation and rectal surgery will affect the odds. Botox/meds haven't worked and I'm getting desperate. Any guidance will be much appreciated! Thanks!
Nishikidude ianee
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Hi everyone,
My reply is specifically about post op recovery time and diet.
I had hemorrhoids for months in summer '16 and recovered with suppositories and cream, but developed fissures in September '16. After mis-self diagnosing as hemorrhoids for 3 months, I finally saw Dr Szeto in Little Rock, AR, who knew immediately it was fissures and scheduled me an immediate sphincterotomy with anesthesia.
My surgery on Dec 3 went well and they found tw fissures. My first BM after 3 days post op was easier though painful, as I was constipated after 3 hydrocodones. Now I only take Tylenol which doesn't stress GI like ibuprofen.
Though my surgeon predicted 3-4 weeks recovery and said I should continue a regular diet, solids still hurt too much to pass. I asked another doctor friend if I could eat a liquid diet while my surgery wounds heal and he said that's fine. I never asked the surgeon, maybe I should have. But I'm following the logic of, if it hurts, don't do it.
It's been 2 weeks and 2 days post op now and my main diet is soup and juice. My sphincter feels relaxed and wider now and can pass harder stools, but such BMs leave me sore and itchy for hours. Left over stool in my rectum also presses against my anus, and I assume my fissures, and causes discomfort until I can pass the leftover stool too. This makes me strain to pass these bits which also makes me worry. I'd hate for hemorrhoids to return...
I'm going to stick to a liquid diet for now. After a dinner of soup, my morning BM is bearable especially after a shower (warm and cold water on butt feels good) and a short lie down. I'm already back to work, though I'm a painter and work on my feet. My energy is low because of low calories in my diet, but I can at least be social and work. Still no coffee or alcohol though. Just all liquid box soups and juices. Though now I'm concerned from reading here, does the acidity of the juice cause pain?
I'll let you all know once I'm back to 100%! I have hope for all of us. I know this is hell. I'm even vegan and eat very well for over 2 years. I think this has a lot to do with staying hydrated and relaxed.
Thanks again everyone.
graham82620 ianee
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russel69537 ianee
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I am a week post surgery, and while I don't have that 15/10 worst pain ever feeling I am still very sore after a bm. I do feel there is a 5% improvement day by day but these last 8 weeks have been absolute hell with the discomfort.
Nishikidude russel69537
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I felt like I was getting better little by little as well, but the other day after an over night trip out of town where I ate only liquids to be safe, I finally broke down and had some solids on the drive back and ever since then I've felt worse than before. My BM that night was very bulky, though smooth, and took a lot of effort to pass. I'm still sore from it and it was 4 days ago... I'm curious, what's your diet consist of Russel?
russel69537 Nishikidude
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Nishikidude russel69537
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Amazing... I'm only eating soup and lately some apple sauce. Trying canned spinach tonight... Baby steps.
MarkH201 ianee
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Hi Everyone, I had a fissure for about 6 months, horrible and dabilitating, I believe it started at a colonoscopy that I had...Rectogesic and Diltiazem Hydrochloride did nothing, When I saw the surgeon he booked me in for a sphincterotomy the next week, after surgery was ok until the drugs wore off then it was very painful for a day, bowel movents were still painful but not compared to before the operation, stinging, in the first 5 days bleeding, but then things started to get a bit better, no pain between BMs, and quicker recovery from when I went, then at about 2 weeks things started to get so much better, now at 16 days i feel almost entirely recovered, some itching, and I do not dread going to the bathroom anymore, I can't say how much my life has improved. Still not 100%but well on the way. Oh and try psyllium husks in a glass of water morning and night for smooth BMs.
MarkH201
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Well another 17 days on so almost 5 weeks since the operation, it is all pretty good, would not say perfect, I don't have any pain with BM at all, occasionally I see blood when I wipe on one or two occasions.
It is still a little itchy at times but in general it is excellent and a huge relief. I worry occasionally that it will come back but it is not in my thoughts constantly when I had the chronic pain. Seeing the surgeon for a follow-up next week.
MarkH201
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About 3.5 months now, and all is amazingly good, no pain at all, don't think about it at all.
The one little side effect which is weird, after a BM about a minute or two my spincter does a little pucker like movement, it doesn't hurt, it is just strange, anyone get the same thing?
mercy90318 ianee
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Despite being a thread over a year old, I still decided to write a reply for those considering the surgery. I had mine on Friday the 13th, because superstition is no match for the promise of anal pain relief. My doctor couldn't even do a regular exam for me on the 12th because the pain was to great. I had assumed I was just dealing with a thrombosis, but he felt that since my pain began back in October and had been slightly driving me more and more insane since then, it was far more likely that I would have a fissure that was reluctant to heal. Either way I was scheduled to be put under
mercy90318
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(Apparently if your child's school calls mid text, it will post your completely unfinished reply leaving you to finish with a reply to your original comment)
So they put me under on Friday with the possibility of a sphincterotomy. Anything to ease my pain. I would have said yes to a study drug I was so desperate. During the anesthesia addled exam, the doctor found two problematic hemorrhoids and the dreaded fissure. He surgically repaired my anus and closed me up. Now, I'm not sure why I did it, but I Google the procedure and let me try to tell you now. Don't do it. It looks like the most terrifying thing ever! It's been about 72 hours. The general ache is less after every nap (I sleep more than I am awake because I've been blessed with a husband who is able to let me do so) but there is a constant fear of having my next BM. I've had 1 a day and they do not come easy or pain free. The pressure builds and I'm never sure if it's just a fart or if I should be ready to cry for an hour. A recurring issue after each BM unfortunately for me. If I even think a BM is coming on, I grab my pain med and pop the max dose. My diet is worse than a bird. If it's not a prune, head of broccoli or pure fiber, I won't touch it. I've taken more than the recommended amount of stool softeners. I'm convinced eating is over rated though my doctor seems to think it could slow the healing. Short term gain long term loss. What I find odd is the amount of time I need to sit on the pot waiting for even gas to come out. Maybe it's my fear, but I seem to have the absolute opposite of incontinence. It's an effort even to pee half the time. Copious amounts of sitz baths seem to help with that, but it's not like it's easy to get in and out of a tub these days. I hope the rest of my recovery (and anyone else's for that matter) goes quick and mostly pain free. Here's to the hope of a semi-normal poop some day.
russel69537 mercy90318
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mercy90318 russel69537
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russel69537 mercy90318
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mercy90318 russel69537
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Despite drinking lots of water, eating high fiber foods and taking stool softners (with success of loose to soft stools) it has been over a week and I am able to void without shooting pain, but immediately after, I feel a painful pressure in that whole area. I have no idea how normal or not normal that it. I've called the doctor only to be given a stronger dose of pain medication. No actual education otherwise. I'm not straining to go. I'm not constipated. My tub and I hang out more than my husband an I do anymore. I'm drinking water like a fish. I'm just not really sure if I'm healing properly or if I've formed a problem along the way with healing. I'll be sure to update on this. Maybe it's just me. I was really hoping that pressure was normal after a week.
russel69537 mercy90318
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terry91101 mercy90318
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It definitely is a time thing. You've been cleaned, prodded, cut upon, stretched, cleaned again, maybe sewed on. There is trauma there. In my post I did not mean to be cold about dealing with it. It is a chore. You are already feeling better. It takes time. I just had a septoplasty 4 weeks earlier. No picnic either. These things take months to fully heal. My advice is stick to a good diet of at least what works for you normally. I tried to eat what I ate before the surgery that gave me the best results later. The sphincterotomy is to loosen the muscle and allow you to pass a full stool. That keeps the flesh from stiffening and developing fissures. So full meals and complete stools are a good thing. You will be relieved when you eat normally and get regular. Avoid things that pass undigested as they can be a nuisance coming out. PrepH wipes are and have been a godsend for me. No dry paper. Diaper rash ointment if you get burning afterwards. I bought mens pads b sure to use after every bm to keep it dry. I tried and try to keep my time on the bowl to a minimum to keep the pressure off. It takes a few eeks to get close to what normal may be. Be positive and this will go your way.
mercy90318 terry91101
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Well, over two weeks post op and I've been feeling MUCH better. That being said, I've noticed another slight abnormality. I am still a little sore after a BM, but the doctor narrowed it down to muscle spasms and prescribed a good muscle relaxer and stronger pain relievers. All good things for my issues. But now that the pain has subsided, I've noticed a hard lump near the incision site, but not directly under it. It's about the size of a small grape and it's very stiff and tender to the touch. Sitz baths and cold packs don't change its size at all nor does anti-inflammatory drugs. Has anybody had this happen to them? Is this part of healing? It's completely under the skin. No open wound with it. I've never read about this sort of thing post surgery. Doctor is out until feb 13, and I'll be sure to talk to him then, but should I be seen sooner by someone else for this? Or Has ANYONE else Had this?
terry91101 mercy90318
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I had one of those lumps smaller. Maybe the size of a cranberry. Doc said it was a hemorrhoid. It was almost gone by the next week. Hope yours disappears like mine. No pain just weird. I'm not perfect yet but OMG this is heaven compared to all of those years of "not normal". Diet is everything.
michele_93317 terry91101
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Hi Terry,
I had a sphincterotomy July 22, 2016 and the pain was not as bad as I had anticipated. Prior to having the sphincterotomy I also had Botox injection On July 15, 2016, which did not work at all. After the sphincterotomy I had to eat a high fiber diet and drink plenty of water and I was taKen 300mg of stool softeners this regimen was working until November 2, 2016 when the stool was to large and the fissure reopened (I don't think it was healed 100%) and had to get hospitalized for the third time. The GI surgeon refered a colorectal surgeon who examined me verified what I stated the fissure was never healed and the little bit that healed opened up. The colorectal surgeon did not want to perform another sphincterotomy for the fear of incontinence; therefore he added Miralax daily and told me to increase my fiber intake to 25-30 grams daily plus 80 ounces of water and 100mg of stool softeners with each meal. I am glad I did have the sphincterotomy because this pain is nothing like the pain I was experiencing prior to the surgery. the healing time is a slow process and will require strict dietary habits and patience. Today is February 10, 2016 and I still have slight pain some days not unbearable and I do not need to take any pain medications. so in short have the surgery and get some relief. Best of luck to you.
mercy90318 terry91101
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Had a check up. I developed an abscess behind the incision. It's draining on its own and I'm on antibiotics. The doctor tells me about two weeks of this yet. At least the fissure and the sphincterotomy itself are not giving me any other grief.
mercy90318
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Update: I had a sphincterotomy on Jan 13th. Today is Mar 19th. I was one of the unlucky ones that had a complication come up during healing. I formed an abscess. About the size of a golfball. I ended up having an I&D under anastasia a few weeks ago, which didn't change my sphincterotomy recovery at all. The abscess has actually been a bigger "pain in the butt" then anything. All that being said, I can tell there is still a sensation where the sphincterotomy was done. Sometimes it's just a pressure. Sometimes it's a poking feeling. Sometimes it's an ache feeling. It seems to be intensified after a BM, but relieved by heat from a sitz soak or from a heat pad. No need for pain medication. From what I've read from people on this discussion forum and many others, it's normal to have those sorts of discomforts for a few months yet. The good news is that there is no pain even close to the fissure pain.