Will Likely Have Lateral internal sphincterotomy Soon - Need A Friend :)

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I am scheduled for examination under anesthesia soon during which is it likely that they'll make a 'game time' decision to do LIS for a chronic fissure that has failed Diltiazem and Botox (been dealing with this since May). So - anyone who has been down my shared road of failures (LOL) and has had the LIS want to be a friend and walk me through what to expect, and your outcome? Thanks in advance.

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11 Replies

  • Edited

    I also went through the same thing. I tried both rectogesic and antrolin creams for months and then I did botox. My fissure never fully healed so I got LIS surgery done almost 5 weeks ago. They also removed the skin tag.

    I was put under General Anesthesia. I woke up in the post-op room pretty groggy. Had some pain so they gave me more meds. I wasn't nauseous though as I thought I would be from the GA. My surgery was in the early evening, like 5:30pm so I ended up staying over night and left around 8:30am. I probably could have left earlier, but didn't need to rush and I paid for a 24 hour hospital stay anyways which was the minimum. I was pretty groggy from the morphine until like 2am, so made no sense to leave then. I started getting pain again soon after, and was given Targin (which is oxycodone-with-naloxone controlled-release. The naloxone is supposed to help opioid induced constipation). I was prescribed this for 10 days. The first week was pretty awful for me. I pretty much laid around the entire time. For me, the pain meds only lasted maybe 3-4 hours before wearing off, and I supplemented with over the counter meds since the doctor said not to take more than once every 12 hours.

    My first bowel movement was really rough. I highly recommend starting to take extra fiber and drinking tons of water supplements the week or more before the surgery. I did not do this and I think this highly contributed to a painful bowel movement, which came on the 3rd day post surgery. It was very compacted and dense and was not easy to pass. It took hours. I ended up having to go into the bathtub. The second week was also pretty rough, but a little better than first week. I would say the first 2.5-3 weeks were pretty bad for me. I wasn't able to stand very long and it hurt to really do any kind of movement. Then after that it got better and could function more.

    I had a follow up appointment at 4 weeks. The surgeon said the fissure was totally healed. The incision wound was open, but he said it looks how it should and it would take another 2-3 weeks to heal fully. I also still have stitches from the skin tag removable that should dissolve. I had stitches at the incision site as well, but that one came off one time when I wiped at about 3 weeks post-op. Surgeon said it was fine.

    I'm doing much better now, and can go out and do things. I look forward to being fully healed. I had my fissure from September 2019.

    • Posted

      Thank you for the detailed reply. I appreciate it and I hope that you continue to improve quickly. It gives me hope that you're up and about now. And thank God the fissure healed -what good news. Take care of yourself.

    • Posted

      Hi. I have two more questions for you 1. Did you have someone stay with you for the first few days/week -is it necessary? or will I be ok on my own? And - 2. I live in a townhouse, do you think the stairs will be a problem? Thank you - just trying to plan for my surgery.

    • Posted

      Hello! Sorry I only saw the notification now. I hope it isn't too late. I definitely recommend someone staying with you. I personally needed a lot of help for about 2 weeks minimum. I'm married and my husband had been working from home anyways because of corona so he was able to be around the whole time to help and go out to get things when we needed it. I live in a one floor apartment so I didn't work with stairs. I had a hard time standing up, sitting down, laying down, rolling over. I also couldn't stand for too long so I wasn't able to really make myself food. I think I had a harder recovery than I've heard other people having. I couldn't really bend down to pick things up so well.

      Once you're standing, stairs might not be an issue. Its really the getting up and sitting down/laying down. I had to do like a rolling maneuver.

      Let me know if you have any more questions!

      I also recommend that you start on fiber before the surgery because the first bowel movement was horrible (the doctor said it wouldnt be an issue, but it definitely was!). I now take psyllium husk twice a day and try to drink loads of water. I put the psyllium in foods like oat meal or cereal. It says to take in water, but I have a hard time swallowing water with pieces. It really does help, i just wish I started before the surgery and not afterwards. I was also given paraffin oil which really helped as well. Highly recommend. It has a greasy texture but I just chased with water. I took that for about 3 weeks almost.

    • Posted

      Hi There. We spoke about a month ago and I thought of our conversation a lot these past few weeks because I remembered how rough you said your recovery was. I was really glad you were honest with me because it is the only thing that has comforted me lately - I had my LIS surgery on Sept. 1st. And while I had hoped that I would be 'like everyone else' who bounced back a week later - I have been struggling really hard. It's been exactly 2 weeks today that I had the LIS and I am still pretty miserable.

      Like you, I had a skin tag removed as well. My spasms have stopped and I do feel a little bit better than before the LIS - but honestly - it burns so bad and itches so bad every day and feels tight when I move or bend over or get up. And it's really upsetting me because I feel like it's not working and I'll be like this forever...especially when compared to most people recovering from LIS. My surgeon says to 'hang in there' and she thinks I'm just having a tough recovery. I am having BMs fine with no pain and using stool softener/laxative daily so that's going well. I just don't feel good.

      That's why I am reaching back out --did you ever feel this way during your recovery? hopeless? or did you just assume it would work? How are you feeling now? (I think it's been about ten weeks for you now). I guess you just stuck in my mind because I feel like we have/had a similar recovery - rougher than most. I hope you are well and enjoying a pain-free life. Any encouragement you have or advice is welcome. Thanks a million.

    • Posted

      Hello! I'm so sorry for my delayed response. I really hope things have gotten better. I also felt like something was wrong because it seemed everyone else online had a much easier time. I just had my 3rd? follow up with my surgeon (4 months post surgery) and everything is healed. It took a long time for the incision to heal and for the skin tag stitches to fall off which i think created an uncomfortable situation. I did have burning and itching for a long time especially after a bowel movement. It was weird thought because it felt like my skin on the outside had a 3rd degree burn even though that's not where the surgery was. I wondered if it was just the nerves that maybe were effected by the muscle being cut. I still don't know what caused it, but I got an aloe plant and cut it into pieces and put it into the freezer. Then after a BM I would rub it around on the skin and it provided relief because it was cold and aloe is good for skin regeneration. The doctor said originally it would take 2 months to fully heal, but at that point my incision site was still not healed and was what was bothering me the most. Apparently the fissure itself healed within the month after the surgery, which was surprising. I really didn't believe it until the next appointment haha. The incision just took a long time to heal but now at 4 months (I had it July 8th) everything is basically normal. I take psyllium husk 2-3 times a day and have to really focus on water intake and having enough fruits and veggies (which i'm not the best at). I make sure to have almost everything whole grain.

      My doctor also said I had a tougher recovery but he really reiterated that it was within normal and have nothing to worry about. Before my surgery, my dad had said after I get the surgery, I will have wished I got it done earlier. It took about 3.5 months until i felt that way haha I just wondered if my incision site was going to fully heal strong enough to not be opened again and if the fissure would really not come back because not all BMs are the same and some can be more dense or larger and I can feel the stretch. I really really really have to focus on letting my body push out the BM rather than me push excessively. Psyllium husk and water makes a huge difference in this area because this is the best way to have a BM. There really should not be much effort. I'm not perfect and i do have those BMs that require more effort or I have to get up and come back (walking around helps move things along as well) and I just pray it ok, but so far its all good!! My only concern is when I have a baby, it won't be a problem (pray for me!)

  • Posted

    Hi there,

    I got my LIS done exactly 4 weeks ago, the first BM I didn't notice anything, no pain no nothing! for the second one I got diarrhea which made it horrible to go, pain was 10/10! so I stopped taking stool softener and laxative. just prunes which each meal. as soon as my stool got firmer the pain decreased to 3-4/10 during BM. during the day for the first week the pain was so manageable , most of the time it was 2-3-4/10 not more. I only took one Tylenol during recovery. second week I felt much better almost zero pain during the day and during BM pain was like 2/10 I would say. by day 16th post surgery no pain during BM but felt a bit discomfort. sitz baths is so important and also walking for faster healing. walking also prevents pneumonia after surgery. wish you very smooth and fast recovery.

  • Posted

    I am so happy i found this thread! I had surgery Sept 11th. i had chronic fissures for years and finally had enough and decided to have the surgery. my dr didnt explain much and i stupidly didnt ask many questions. i had a rather huge hemmaroid removed and repaired fissures as well as the rectal flap procedure. the first few weeks were Hell! Severe pain etc. a Few weeks ago i was finally where i wasnt hurting during BM but then had a bad bout of diarhea and omg the pain is back! My fissures werent caused by constipation but by chronic diarrhea. im almost 2 months out from surgery and im Still having really painful BM during And after. It feels like im pooping glass. i had a checkup a few weeks ago and the Dr said I was healing good but l'll admit im worried im not due to all the pain. Any ideas?

  • Edited

    I had my LIS plus skin tags removed in late October 2020. I didn't have a tough time recovering. I would say I was moving slow for about 3-4 days and after a week I was fine. I never even bothered filling my painkiller prescription because the pain from the surgery was nothing compare to the fissure I had for 6 years. The surgery was 100% successful. I could've danced to my post-op appointment which was 3 weeks after the surgery. I am so grateful for my surgeon and I think of his smiling face everytime I go to the bathroom without pain like I used to!

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