Lateral Internal Sphincterotomy (LIS) surgery for internal anal fissures

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Hello all. My name is jonathan and i have been suffering from internal anal fissures for almost a year now. I was hospitalized earlier this year (2018), with raging colitis infection due to severe food poisoning, and had such violent diarrhea for several days I ended up with some internal anal fissures. At first I was fine, but after a few days I developed severe pain when going to the bathroom, (burning and tearing feeling)! Pain was almost unbearable. I was told by the doctors at the local med express it was just my colon healing, but knew it was way more than that. It took several MONTHS for the pain to subside but I never felt normal. Recently the fissures returned and now living back near my family and better doctors, I have found and general practicioner who has diagnosed me with this chronic condition. I am trying BP meds and ointments, and hearing pads between my cheecks but the raw, burning feeling never goes away after my BMs! i have to take stool softeners and I am a very athletic guy, and eat healthy but nothing seems to work! It seems like surgery is my only option as my tears are further inside of me! I am nervous about the procedure but know if it can help me i would really like to have it done, so i can live a pain free life again!

Thoughts and experiences are greatly appreciated! Thanks and pray for my recovery!

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14 Replies

  • Posted

    Did you already try a dilitazem or glyceril trinitrate course? I thought that's nowadays standard procedure before a sphincterectomy is attempted. It's always better if you can avoid a surgical procedure.

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    • Posted

      I have tried just about everything over the counter and perscribed by my doctor, including those. My fissures are further "up" and not on the outside so it's difficult to treat. I was in severe pain for months after I got out of the hospital earlier this year, and the pain has returned so I am considering other meassures at this point.

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  • Posted

    been there before for way too long i was so scared of the procedure that i waited and waited all i did was waste lots of time had the procedure 2.5 years ago and in 14 days i was brand new and havent had a problem since if youre confident i your doctor and this is something hes done before then roll with it i think it can get so bad that nothing can fix it other than the procedure

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    • Posted

      Thanks for the encouragement. Yes, I have tried all kinds of medications to no avail! The pain and passing broken glass feeling always returns and makes it hard to work, sit or exercise. I'm an in shape guy but the pain can get bad! I am at the point where I am ready or surgery.

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  • Posted

    I TOTALLY understand your pain.

    I too am at my witts end..

    Rather than do LIS after botox twice Iam scheduled for the KENALOG oroceedure with Dr Feingold at Columbia Presbyterian hospital in New York..

    Kenalog is a little less invasive than LIS.

    Maybe you could look into this..

    Good luck.

    My surgery is scheduled for after xmass

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    • Posted

      Right now i am using nitro gel internally and taking hot baths 2-3x a day which is seeming to help. i sm trying everything my new gastro doctor is suggesting before moving to LIS or Botox surgery. Hopefully this condition will go away. To doublde check and make sure it is fissures they felt around inside me and want to do a colonoscopy in addition next month, so right now just following what my GI doc suggests because surgery is last resort. From what I read online nitro gel has about a 50-60% success rate so we shall see. the hot baths and nitro gel have helped some after only a few days.

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    • Posted

      How far (weeks) are you with the glycerol trinitrate therapy? Warm baths are a great way to relax the sphincter, which helps healing the fissure.

      One thing I would recommend, is try not to take up any long or even medium distance travel before your fissure is healed, and especially during the glycerol trinitrate period. A long-haul flight might cause an inflammation to flare up and interrupt the healing process. Also, avoid hot climate.... as much as you can.

      Why didn't your doctor start you on diltiazem rather than glycerol trinitrate? Diltiazem has a higher success rate. I know it's not available in some countries (I've visited one such country), but in all the more advanced places, diltiazem is the preferred approach.

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    • Posted

      I am about 3 weeks into treatment. The hot bath and nitroglycerin gel seem to help and i have nowhere near the irritation or itching as before, even after only a few days. Hopefully after a few weeks on this with some hot baths and general daily exercise i will be nearly healed again.

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  • Posted

    i would try and find 5 positive post about botox... good luck! its a temporary ordeal and its toxin!! my procedure took 25 minutes i said in 14 days i was brand new by that i meant in 14 days i was 100% like nothing EVER HAPPENED in 5 days from procedure i was pain free even during Bm i just took it extra slow to be safe botox can cause irreversible nerve damage look it up Lis is not a big deal to the right doctor!!! 25 minutes

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    • Posted

      LIS is no joke. Maybe for you it was very successful, but for me, even after 1 month the fissure is only partially healed. It's on its way to complete healing, but the post-op period was very painful. BM was hard to manage, and it required copious amounts of local pain management with xylocaine ointment, and oral analgesics.

      Sure, mine is just anecdotal evidence, but so is yours.

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