Lateral internal sphincterotomy and skin tag removal

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So I've been suffering with a fissure that was misdiagnosed as a pile for almost a year now. After being bounced form pillar to post and fobbed off with hemorroihd creams I finally saw a specialist who diagnosed my fissure as chronic. He prescribed me with rectogesic which he said works 70% of the time and booked me in for a surgery to remove my skin tag. He also said that during that surgery he would we if the fissure had healed and if not I would also have a LIS.

I'm currently on the ward now waiting to go in for my skin tag removal and possible LIS and I am nervous as hell!!! Not so worried about the surgery itself, mostly about the aftermath and healing time and process. I'm hoping it all goes well and will update you tonight or tomorrow on what happens.

Would love to hear if anyone else has had either or both procedures and what their experience was like.

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  • Posted

    Hi I've had both and surgery was all fine. Drink loads of water after if u can. Nothing to panic about, try really hard not to get constipated ! Good luck recovery for me was around 11months but everyone is different xx

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  • Posted

    Hi Tashaceecee,

    I recently had sphincterotomy on July 23. The recovery process is not as bad as I initially thought it would be. I did fear what would happen after surgery and I will tell you for me it was not as bad as I thought it would be. I only have pain and discomfort after a movement, which lasts from 1-3 hours and I don't need to take any pains medications. The healing process from what my surgeon said is from 4-6weeks. I will be 3 weeks post surgery and I am doing better than before the surgery. Mostly importantly is to remember to eat food high in fiber, fruits and veggies and a lot of water. I also take stool softeners and recently started Metamucil. for me I have to find a balance some days I have diarrhea changing between soft and formed stool.

    Good luck to you!

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  • Posted

    I am attaching a post that I put on somebody else blog. In this post, I was recommending to the person to get the surgery, as well as other methods to try to try to ease your pain. I hope this helps you out and never give up. :

    I would definately get it done, especially if you have dealt with it for a whole year. I had a chronic fissure, and after a month, decided to have the surgery. It was the best decision of my life. I am not going to lie to you, it is a bit painful right after surgery but if you can endure the pain of a fissure, it is not that much different. I posted this before....this basicallly explains how i felt throughout the surgery and after.

    I first want to give you a lot of credit for deciding to do the surgery...It is not an easy desicion, as there are some stories online that can discourage you from getting it, but in the end in my opinion it it better. 

    So basically, this is how it went down with my surgery. I had to fast the day before the surgery because they had to put me under anesthesia. I went in, waited, and then they put me under and the surgery was done. I woke from the surgery with morphine in my system, although once I woke up it had worn off for the most part. They basically told me I could get another dose of morphine, which would basically knock me out again, or I could stay up and move to the other room to wait until I was ready to leave. So, i skipped the next dose of morphine and went to the other room. As I was laying on the bed, the pain bagan to set in. The next part may scare you a bit and discourage you, but getting through this part is just part of the process of gettting better. So when the pain started to settle in, the paiin almost flt worse then the fissure pain itself. I was not only dealing with the pain from the fissure, but from the incision and cuts that were done form the surgery itself. This being said, you have to take into consideratino that the surgery is cutting into your sphincter muscle, so pain will come, but this is with any surgery. Unfortunately, with this surgery, it is in a very sensitivie area so the pain will be a little more intense. Some things I did in the hospital to deal with the pain was put ice on my butt, I bit down on a washcloth to decrease the tension that I would put into my butt area and to transfer the tension to my jaw biting into the cloth. They did give me percoset, but honestly it didn't help me a bit. I still felt the pain until I was able to fall asleep. The lady next to me said that the percoset made her feel that the ceiling was the floor and the floor was the ceiling, so I guess it affects some people differently than others. I also will recommend listening to music right after or watching a movie to distract yourself from the pain. SO that was basically it from the hospital. I couldn't leave the hospital until I could pee though,  which was not easy since I had so many drugs in my system and could  not really push to hard as it was painful and I did not want to upset the area.

    Eventually I peed and was able to leave. Then, I took some percoset that night and slept. The next day I felt no pain, as I did not poop at all, and as with before the surgery,  the pain  only comes when  you poop. 

    So the day after that I had to go to the bathroom. The first time you go to the bathroom will be very painful, almost more painful than pooping with just the fissure because you are trying to poop through a fissure and a surgery, but that comes with  the territory. I will not hide that I felt like I was going to puke the pain was so bad WHILE pooping. I also recommend listening to music while pooping as this distracts the pain  and gives some motivation  not to be afraid. The reason on put emphasis on the WHILE is beause after the pain is very dull and nothing compared to the throbbing unimaginable  pain of an anal fissure. Within  the next two weeks, I progressively felt myself getting better, and by the 2nd week I went back to the doctor and he gave me the ok that I was all healed up.

    I never had any incontinence, although the only thing I still have is that its a bit harder to hold in my farts sometimes, but that is it....As far as the gauze, I only changed it because I would leak sometimes..I ended up just buying adult diapers at the store and used those until I stopped leaking. 

    As far as numbing injectino you asked about, the only  thing I was aware of was the anastesia I was on.

    As far as food after surgery, I just kept to a well balanced diet. I take metamucil fiber supplement every day since, and I squat on the toilet all the time now. Make sure not to take too much fiber as this can irritate the area.

    Hope this was enough information for you, and I really wish you the best of luck with  your surgery next week.....Noone should  have to go thorugh anything like this, but thank god we have means to take care of it with surgery....

    Also, this is another post i put that explains some things that you might want to try in addition to the surgery....

    I first want to say how sorry I am, and how much we al are that you have to go thorugh this. We have all been through the same type of pain, and can sympathise with your situation. A lot of the problem with an anal fissure is its not jsut a physical problem, but a mental problem as well. Thinking it is getting better and then to be in writihing pain the next day to through your hopes down the drain ruins your day and your hope of getting better. However, since we have all been there, we can probably agree that despite all of the downfalls that can occur, you will get better given time, rest, and proper treatment. 

    Here are some suggestions I have for you to help you through:

    1. Try somee zinc oxide in the form of calmoseptine which has menthol to soothe the area down there as well. Calmoseptine can be bought at almost any local drugstore and can be bought online too.

    2. Try squatting when going on the toilet instead of sitting. This is a much  helathier position and the poop sometimes will just slide out,  no pushing or straining involved.

    3. I would definately take a fiber supplement, specifically metamucil  is what I take evveryday,  in ordr to allow your stools to be soft and to allow them to pass thorugh easily. THis being said, with any fiber supplemetn, you must drink lots of water when using them, or they will not work veffectively. Also, do not take too much as too much fiber can irritate your bowels on the way  out and diarreah actually does worse down there.

    4. I would recommend getting a sphicteronomy surgery if htings dont get better. I waited it out, gave up, had the surgery, and was able to heal within about two weeks. I had a chronic fissure, so I knew where you are ocming from with v all the pain and discomfort.

    Try listening to music to distract your mind a bit, especially when going to the bathroom. If you are in writing pain, distract yourself with a movie or TV show right after. Also, to prevent myself from screaming and from putting more stress in the area down  there, i bit down on a washcloth in order to make the tensions with my teeth instead of my sphicter muscle.

    Good Luck!!!

    Sincerely,

    Myles 

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    • Posted

      Hi mmarcus151910

      I had my surfer at about 12pm yesterday under general and it went well. I didn't have the LIS as the doctor said everything was healing nicely on that front but I was told that he removed my external skin tag and one small one on the inside.

      After surgery there was no pain probably because the pain meds from the surgery were still in my system. After about an hour I started dmfeeling a dull ache down there that if describe as a 'headache in my anus' but this was nothing compared to some of the pain is endured during the past year. The nurse offered me cocodamol for pain relief but I declined as it can cause constipation so she gave me a 400mg tablet of ibuprofen which helped.

      In the next 30 mins I had eaten something and had a pee so I was told I could get dressed and was discharged. I removed the gauze during my pee on advice of the nurse and there was some iodine stains and a little blog so I wasn't too worried as this is normal. I also noticed that my anus had been packed with gauze but didn't dare try to remove this as it relieves the pressure down there and helps drain the blood and was told it would be expelled with my first bm... I was filled with dread.

      I was sent home soon after with cocodamol and lactulose to soften my stools. I had no intention of using the cocodamol unless the need was dyer so I popped into the pharmacy on the way home where I was advised by the pharmacist to take ibuprofen and paracetamol together for pain relief as needed every 3-4 hours but was warned that if I needed stronger relief and decided to take the cocodamol that I should stop taking the paracetamol.

      Everything was fine when I got home, slight discomfort but again a 2 on the scale so it was manageable. I had water and a cup of tea to keep my fluids up and I also took a recommended dose of lactulose (15ml).

      At dinner time I felt well enough to cook so I took the pressure off my friend who wad looking after me to make some minute steaks. I had mine with a huge side of salad and a little brown rice and my friend had hers with chips and they looked so good but I'm so determined to keep my diet clean, low in fat and high in fibre to prevent straining or constipation. I also took a soluble fibre supplement after my meal.

      Was done for the rest of the evening and took a salt water bath about 10pm to soothe the area and relax the muscles back there. The bath worked to relax my muscles and I passed gas a lot after the bath but still no BM. My pain also went up to about a 4 but subsided soon after when I took another ibuprofen and paracetamol. Kept up with my fluids and also took another dose of the stool softener.

      It's quarter to 7am right now and I woke up in pain down there needed a wee. There was immediate relief after the wee but pain was at a 5 soon after and I had to stand up for 5 mins by my bedside because getting back in bed was daunting. I took another paracetamol and ibuprofen and that's helped. I'm feeling no pain right now as I lie down typing this. Hoping to have a few more hours of sleep then wake up and have some breakfast with my fibre supplement and some lactulose soon after. Still no BM and the farts have subsided but hoping to go today as I usually go every other day and my last bm was Wednesday. Will also make sure to keep my water intake up (2-3l) so as to keep my stools soft and prevent constipation.

      Feeling optimistic but really dreading that first BM as not only will I have to push out the gauze but will also be pushing out the BM over tender wounded skin. Please wish me luck.

      I'll be giving daily updates so keep your eyes peeled for an update either tonight or tomorrow and thanks for all your tips and for taking the time out to reply to my message. Means a lot knowing I'm not alone xx

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    • Posted

      No problem. Glad to help.

      And yeah, the first BM post surgery is the worst just because you really don't know what to expect. I would definately balst music when you have to go and also squat rather than sit like I recommended. I wouldn't be super worried that you didn't go yesterday as you probably fasted before the surgery and so you probably didn't have to go poop yesterday because of this.

      Anyways good luck and yeah, keep us updated!!!

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    • Posted

      UPDATE!!!

      after my last update all seemed fine, pain was gone and had a good few hours sleep until about 10:20am. Had some breakfast (omelette, brown toast and orange segments) then had my fibre supplement & stool softener.

      Everything was fine but I was passing a lot of gas so I knew a poo was brewing for the day lol. At about 3pm I could definitely feel one coming on so I took a paracetamol and ibuprofen and went into the bathroom and sat on the toilet. I took your advice and put on some music to focus my attention on and once I relaxed nature took its course.

      I expelled the gauze that was inserted in my back passage first then did my business as usual. The poos themselves were soft and a bit runny I think due to the stool softeners but we're not violent like diarrhoea so all was good down there. Took me about 10 minutes and two sittings to complete the BM and it was definitely uncomfortable but I wouldn't say painful. After the BM I was very sore so I waddled to the tub and used the shower head and warm water to clean the area off which actually felt quite soothing. After that I disinfected and cleaned the tub and filled it with warm water and added some salt and soaked in it for about 20-25 mins while I watched part of an episode of sons of anarchy lol

      After the soak I took a bath and got out of the bath, got dressed and got into bed coz the whole ordeal and build up to it was exhausting. I was soon asleep and just woke up about 45 mins ago. I've got no pain at the moment and the area is feeling quite normal. Just waiting on my boyf to bring round some groceries so I can make a healthy dinner, have my next fibre supplement and dose of stool softener and then chill because I won't get any sleep tonight due to my long nap.

      I'm so happy the first BM is out of the way and that it wasn't bad at all, no where near the level of pain I was expecting. If they carry on like this and if they infact improve then I'm definitely feeling optimistic about my recovery.

      It's only 1 day since my surgery but I am feeling optimistic. Hoping to leave my house tomorrow and make a short appearance at a friends bbq. Laying in bed all day is good but I want to try get back to normal as soon as I can especially coz I'm freelancing and can't afford to take a lot of time off work.

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    • Posted

      Im so happy to hear you feel improvement. 

      I would still take things easy, at least for the first few days to week past surgery, but overall you sound like you are on your way to recovery!

      COngrats!!!

       

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  • Posted

    4 DAYS POST OP

    Things are looking good for the most part and I've been able to do most of my day to day stuff as normal. I'm just making sure to take things easy.

    I've also stayed on top of my healthy eating and have not had any alcohol. I've not needed my pain killers much and I've also kept uk with my fibre supplements and stool softeners.

    I've had a BM today, 3 days since my last one and it was a lot firmer than my last but soft enough that it did not require any pushing or straining. There was a drop of blood in the bowl after and a little pain (5 on a scale of 1-10) but I used a shower head to clean off and soothe the area and also took a couple pain killers and that helped.

    Finally squatted over the mirror to see the situation down there and it wasn't pleasant, I literally have an open wound by my anus which bleeds and seeps. I've been taking salt water baths to help heal the wound and also been trying to keep the area as clean and dry as I can to prevent infection and foster healing. Also noticed a little lump but I'm hoping that's due to swelling and that it will disappear as I continue to heal.

    Still optimistic and hoping for the best.

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    • Posted

      Hi Tashaceecee,

      It gets better day by day. I am 3 weeks post-op after sphincterotomy and I am doing great. No pain during or after BM. Make sure you keep eating foods high in fiber and drinking a lot of water. Continue taking stool softeners and maybe add Metamucil daily. As for pain medications I was taking Ibuprofen, no narcotics. You have to heal and the incision will heal and after surgery I was sore for a few days. Everything will return to normal soon don't rush things take needed rest breaks.

      Just know relief has begun.

      Michele.

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    • Posted

      Thanks for sharing your experience.

      I'm 10 days post op today and still some pain after my BMs not so much after. How long did it take till you noticed that you weren't experiencing any pain at all?

      The pain of describe more as a feeling of tightness and pressure in my anus and discomfort, not so much that 'ouch' type of pain. I'm trying to time how kin it's taking the pain to subside each time after a BM just to see if there's improvement. Before my BMs and on days I don't go I'm absolutely fine and don't feel no pin whatsoever.

      Keeping on top of the salt baths and wound cleaning and also with the stool softeners but have slacked somewhat with my fibre drinks but will start taking those again and try to finish this 30 pack that I have. Pain killers I only take after a BM and they seem to help with the pain and discomfort.

      Just hoping it improves with time. Looking forward to the day that I can have a 100% pain free BM coz it's been so long since I had one of those! Over a year! The saga continues and will keep everyone updated X

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    • Posted

      Hi Tashaceecee,

      I am 4 weeks post-op as of August 19th and after a BM I do not have any pain or discomfort. During week 3 I did have some pain but I did not need to take any pain meds. In the beginning and week 2 I did have pain and I also felt as if I was not completing my BM's. I could not sit after a BM, but as the days went by things got better. I continue to take stool softeners and eat a high fiber diet. I did not have pain on the days I did not have a BM either. I still take sitz baths after a BM. Tashaceecee, just know your suffering will end one day soon. I know I must continue with eating high fiber foods and taking stool softeners. To answer your question about when did I notice no pain at all, we'll I haven't had any pain in the last 6 days. I can't say I won't have any pain but so far so good. Just remember keeps the stools soft.

      You on your road to recovery!

      Michele.

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    • Posted

      Thanks Michele!

      I've been keeping up with my stool softeners, water and fibre supplements and just taking it a day at a time. Had pain/discomfort after my BM today but haven't had any pain killers and not feeling too bad. Hopefully things just keep improving X

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    • Posted

      Hi Tashaceecee,

      I finally go back to work tomorrow and I cannot wait. I know this will be a lifestyle change as far as eating healthier, which includes high fiber foods, drinking a lot of water, and exercising. Let's not forget stool softeners.

      I am so glad I had the LIS surgery done, after trying to Botox injection that lasted only 5 days. I recommend the surgery, it definitely has helped.

      Remember one day at a time because the healing process takes time. Be patient.

      Take care,

      Michele.

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    • Posted

      Hi tash just wondering how you are doing now please? I've had surgery 9 days ago...included removal of internal growth, kind of like a polyp, reopened a badly healed fissure and removal of 2 external skin tags.

      I am dealing with the pain ok...still some days are worse than others and I find it very hard to get cleaned up with shower after. Not much blood, still some but it smells bad down there.

      What's making me the most depressed is how I look sad there is still small lumps which I really hope would have been gone by now sad but 9 days later and 2 lumps still remain. I hope they can are these away sad

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