Has anybody had a Sphincterotomy?

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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.

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  • Posted

    Hey Guys. 10 days in and I'm pretty sad with my progress. I'm still wearing a panty liner which is soaking up any leaks. Tonight I noticed fresh blood in my BM and I'm not feeling much better. In feel that there's a scar or sore about an inch from my anus and when I wipe it bleeds. It's getting me down a bit. I'm mostly pain free but am having to take co-codamol a couple of times daily. Does this sound normal?

    • Posted

      It’s not normal.  You need to go back and see whoever operated on you.  But you seem pain free, which is good.  I was punching the walls, literally.
    • Posted

      In any case you should have a follow up for them to check healing.  Did you really have a sphinceterotomy - cutting a section from sphincter - or did they just cut the rind from the edges of the fissure to stimulate ggrowth?  
    • Posted

      Hi Norbie,

      All the suggestions below are good.  I am know 5 weeks post op and I will be honest I am not 100% but I am much better than before.  Taking the fiber is very important but I was taking it before the surgery without enough improvement to prevent the surgery.  The one thing that you mentioned that would concern me is that you said you are wiping.  It is very important that you be carful with this.  Till today I go into work late and stay late.  The reason I go in late is because I have my BM in the morning.  Immediately use the SITZ Bath with warm water for 10 - 15 minutes then I will dab the area.  After the SITZ bath the area is very clean that the dabbing not wiping produces nothing on the tissue.  Also.  The doc had on Dulcolax laxative one pill before bed which help me go pretty quickly in the AM.  I took 1 stool softner in the AM, 2 before bed plus the dulcolax.  I also did the fiber Psyllium Husk once during the day.  I will also tell you that my first two weeks I would not only use the SITZ batch immediately after but I would get in a tub of warm water and relax for 20 minutes.  Between the SITZ bath and the tub I was much better.

      Lastly is it possible that the doc also removed a "Skin tag"  I found out that my doc removed a skin tag which was exterior to the rectum.  When I first saw that with a small mirror it scarred me but because I thought the incision came open.  The doc explained that this was a skin tag removal. 

      The SITZ bath did not work for me before the surgery for years but now post-op it is amazing.

      Best regards,

      trriz

    • Posted

      Hi Graham. I had both and skin tag removal. I mentioned the lump to my surgeon on the day I went in, it feels like a haemmoroid but goes up and down in size and is always tender to touch
    • Posted

      Hi Trriz, thanks again for your thoughtful reply, glad to hear you're also on the mend. I'll take your advice re: wiping as I have been using wet wipes on the area. Luckily I'm not back to work for a week so this should help.

      Have you or anyone else noticed that your BMs aren't round? Last few days I've slowed down with the Movicol and am having less violent movements but I've noticed that my stools are flattened. I had been hoping the op would allow my anus to open correctly but it feels as if it might still me misshapen. Follow up is 8 weeks post op (thankfully as there's no way is welcome an examination at the moment)

      I've just noticed a loose crown the last couple of days, presumably from the oral tube they stick in during surgery. Oh joy! Another thing to contend with

  • Posted

    Are you doing the fiber? Psyllium Husk seemed to be the best for me. It has been almost a year and I will keep doing the fiber as long as I live. I probably wouldn't have had the issues in the first place if I knew that would solve it. Your bowel movements have everything to do with your recovery and future progress. We  are all different and it is up to you to get your diet right and maintain it to suit your bodies needs. I myself recognize the foods I don't digest very well and prepare for it. I just wish that a doctor had told me sooner about the fiber and what it would do for me. Talk to your surgeon. He wants you to be well.

    • Posted

      Thanks Terry. I've been taking some psyllium husk but not religiously. I need to make it my morning routine

  • Posted

    Hi,

    ?Thought I'd add my experiences to this discussion as  someone who hasn't the op. I was scheduled for it, but while waiting , my fissure became infected. Very painful  . Anyway, this lead to an appointment with a really good GP and I was put on up to 8 sachets of laxido/movicol  daily. Now I had been prescribed this for years, since being diagnosed with a fissure nearly 20 years ago, but I was told to only take 1 or sometimes 2 sachets a day.

    ? The GP said as an alternative to the op, I could keep taking the laxido/movicol. I had a meeting with the consultant and she said that was ok too, and added  lactulose to my list.

    ?So  2 years on, I take on average 2 sachets with lactulose daily, sometimes less, but if things start going hard when passing stools, I up my intake and try to eat better , ie, cut out processed foods.

    ? I don't know if it would have been better to have had the op. In my case, the problem is that along with the fissure, my anus is so tight it's hard to even insert my little finger up there, like I had to try in the days of GTN .

     I know I'll have to keep with my daily meds for life and I don't know what problems will arise in the future, but it's worked for me so far. I will be 60 in August and I've lived with this for nearly 20 years and remember the pain from years ago, but have been pain free for over 2 years now. Mark.

     

    • Posted

      It's good that worked for you, but I would not recommend anyone with this problem rely on a GP, in my experience their knowledge is really poor, my GP incorrectly diagnosed my fissure as haemmorhoids and sent me for a appointment with a junior doctor, who in turn sent me for a colonoscopy, I felt no confidence in the junior doctor so paid privately to see a colorectal consultant who immediately saw it was a fissure and said just about the worst thing you could do would be a colonoscopy.  It was only then I told him the name of the junior doctor who turned out to be under his pupilage.... going directly to a specialist consultant was the best £200 I ever spent.

    • Posted

      Hi,

      ?I know what you mean about GP's. the first one to examine me years ago diagnosed Proctalgia fugax  after ramming her finger up my bottom ! The GP who put me on to the laxido was highly respected in our area. Shame that she has now retired, and as I said the consultant also said to carry on with the laxido if I wanted. She did say when she first examined me that she could help with my condition by doing the op, and I have found out that she has a very good reputation but she was happy for me to follow this course and just said to get in touch with her if I had problems.. I suppose I was so afraid of the operation and possible after effects that I took the easy way out. Just wanted to add my experience to this discussion as an alternative, and at the very least to say to anyone experiencing the pain that I used to, when and after going to the toilet, that large doses of  movicol or laxido can help enormously ,if you having the op or not.  

  • Posted

    I am scheduled to hsve this surgery 2 days from now. I have been feeling much better though latley & thinking about cancelling. I have been pain free for over a week. I just dont see the point in going through all that post op pain for a few weeks when im feeling vetter on my own...Am i making the right decision?

    • Posted

      How long have you had fissure? I would have a few good days but it ALWAYS came back. I wish I had surgery sooner than I did. It is SOOOO worth it. 

      Good luck!

    • Posted

      Thanks for responding. The 1st time i had a fissure was about 6 years ago or so. After dealing with it for a couple if months i saw my dr & he sent me to a specialist. Saw the specialist & he prescribed me nitroglycerin cream and sold me a fiber drink. It went away for years. I ate a really bad diet for years but it finally started catching up to me last October. After a 6 year hiatus i had another fissure. Went to see that same specialist but he was not there on my day off so i saw someone else in the office. He perscribed me the same cream & again upped my fiber & i started eating much healthier. I was feeling better. Went for a follow up & was fewling good but dr did exam when he put his finger in my butt it didnt hurt but it was just normally uncomfortable & i grimaced & dr said its not healed i need surgery. I said no because i felt better. Exam didnt even aggravate it. Then the holidays came around. After a few christmas parties eating baked pasta & desserts topped off by drinking A LOT on new years i became constipated & pushed too hard & fissure was back. This time it stayed around for about 6 weeks & went away. Again a month later i started eating fast food & unhealthy & it came back. This time i went to the specialist & asked for the surgery but due to my insanly busy schedule i set it up for a little more then a month later. After going back to eating healthy it started getting better again. Now it has felt perfectly fine for about 3 weeks & i am keeping up the healthy eating. I never gave myself the chance to heal on my own this time like i did 6 years ago. I cant help but think if i keep my diet up for a long time the fissure will continue to heal. I just dont want to go through the post op agony for weeks or more like ive read in these forums until im sure my body wont heal itself. Surgery is always an option but for me last resort. What was your recovery like?

    • Posted

      You have a chronic fissure and all the diet changes in the world aren’t going to cure you. You should schedule the surgery. The recovery is not bad, much easier than dealing with a fissure. I’m so happy I did it. 2 years pain free, no complications.
    • Posted

      I am seeing a surgeon in a few days and trying to gather all of the info possible.  I have chronic fissure with a skin tag. Also battle with IBS.  Have tried meds, diet, fiber... pain gets more tolerable then extremely bad.  I see you did Botox and then surgery.  I am traveling out of the country in 6 weeks and trying to figure out what my options are. Wondering recovery and at what point would travel be "comfortable"... 

      Should I try Botox first or will that even be an option with the skin tag? I also worry about the incontinence issue.

      I would greatly appreciate your opinion.

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