Lord's Dilation procedure

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Re: Lord's Dilation procedure

Postby Shantanu » 13 Jan 2014, 00:36

Hi
Going to visit my surgeon today, hope he doesn't dismiss my request tp examine the fissure as too soon.
One more thing I wanted to ask was have you heard of Proctalgia Fugax?
I suffer from it, although it's very mild, have it for a few seconds during day time once or twice a month.
My query was last night it was the first time I had it at night while sleeping(it's usually described as a fleeting pain which wakes up people at night lasting a few minutes) and I had just that.
Does my surgery have anything to do with it? I am tensed that the surgery has aggravated it.(I formed the opinion that anal dilatation would actually relieve my Proctalgia, but had it during the daytime a lot the past few days and last night lasted minutes)
Help would be greatly appreciated
P.S.- Bowel movements have been smooth so far no pain, some stretching on some days because of a big glob of stool(soft but like a snowball, sorry for the icky details). Reduced my dosage of Bisacodyl from 10mg to 5mg. And continuing Cremaffin.
Long post, sorry again!
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Re: Lord's Dilation procedure

Postby skumar » 13 Jan 2014, 06:40

Hi Shantanu. Yes in India stretching is quite common. Doctors do both Lis and dilation. I consulted a doctor in India via phone since I am not in India and have undergone Lis. He said use cremafin for a month. I can say that you are definitely doing great. Wish you a speedy recovery. Are you using Isabgol or any fiber pill? That helps to soften as well bulk up the stool which is needed.
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Re: Lord's Dilation procedure

Postby Shantanu » 23 Jan 2014, 04:53

Hello
It's been a while since I posted
As I mentioned above, I visited my surgeon, and he advised me to discontinue Bisacodyl and stick to just the Cremaffin syrup.
It's been about 5 weeks since my surgery.
Everything is pretty ok, BMs are uneventful. I have increased flatulence and some sort of discharge from the anus(not poop, but smells funny and appears yellowish white on the tissue), although it's very mild.
So is this the paraffin? And also, how long do I take cremaffin for? The moderator mentioned it takes 8-12 weeks for the fissure to heal completely. I am taking 15 ml every night. So should I taper of the dose gradually? How would I suggest I go about that?
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Re: Lord's Dilation procedure

Postby goyalonkar40 » 03 Apr 2014, 00:16

hi shantanu and others
yesterday, i had anal dilation with sentinel pile cut off. the pain has increased even more. im not sure if this pain comes from fissure or from smwhere else. previously i didnt have to take any painkillers. but now only painkiller pacifies me.
another notable thing is the injections applied to my anus for local anesthisation were extremely extremely piercingly painful. is this normal?
can these injections be causing pain now?
thx. pls suggest.
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Re: Lord's Dilation procedure

Postby jmak49 » 08 Sep 2014, 13:25

Shantanu wrote:Hi
Going to visit my surgeon today, hope he doesn't dismiss my request tp examine the fissure as too soon.
One more thing I wanted to ask was have you heard of Proctalgia Fugax?


Hi
In my expierience I had god relief of pain of both fissures and proctalgia fugax with anal dilatators or nitro. Obviously not all at the same time.
Proctalgia = to break an attack. (nitro or dilat, )
Fissures "train" daily with so big plug I could tolerate and then a little bigger. Interrestingly - to introduce a dilatator does provoke pain but done gentlty, deliberatly and left there 15-20 min - gives a big relief - from the first time.
Fissures kan be treated with nitro onky or can be combined with dilatations.
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Re: Lord's Dilation procedure

Postby Savaici » 08 Sep 2014, 13:49

I used self dilation too and it helped for me. Pediatric ones, gradually increasing in size over time v
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Re: Lord's Dilation procedure

Postby HJ22 » 16 Dec 2017, 08:25

Hi Shantanu... I've undergone Lords Procedure too (2 weeks ago)... but after surgery I came to know of LIS.. Now I am worried for the future fecal incontinence... What's ur status now... have u developed any complications?... Actually I also met two surgeons and both prescribed Lords procedure... any rply will be of great help...
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Re: Lord's Dilation procedure

Postby adnan5125567 » 15 Apr 2018, 08:07

I am suffering from chronic anal fissure since 4 months causing whole day pain and discomfort. My surgeon is saying to go for anal dilatation rather than LIS as it cause fecal incontinence causing life time shame. Please anyone guide me that which process among LIS ans lords operation creates more fecal incontinence. I just want freedom from post defecation pain. Please guide..??

Should i go for botox before surgery will it cure my pain and fissure..??
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Re: Lord's Dilation procedure

Postby patience_and_healing » 15 Apr 2018, 17:10

Lord's dilation is an outdated procedure, and it was abandoned specifically because it's uncontrolled and can cause incontinence. Your surgeons is promoting outdated practices. LIS used to be done at the posterior location, which could lead to a 'keyhole' deformity and subsequent leakage. However, it's now performed at the lateral location, and only 1/3 or so of the muscle is cut, reducing the chances of incontinence to gas or stool. I suggest you find a doctor experienced in LIS, and also ask about Botox which has helped some people to heal. Check that none of their patients have ever become incontinent from LIS, you have a right to know that information beforehand.

Ointments that reduce the anal spasm and increase blood flow are another option if you haven't tried them already, such as nitroglycerin or nifedipine.
8/16-12/16: Fissure due to antibiotics
5/17: Botox to sphincter, fissure healed
9/19: Trigger point injections and pudendal nerve block
11/19: Botox to pelvic floor
8/20: Botox to pelvic floor in new location.
On and off in pelvic physical therapy
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Re: Lord's Dilation procedure

Postby adnan5125567 » 16 Apr 2018, 02:53

Thank you so much for the reply. I have tried NTG and nifedipine for around a month. I am having a sentinel pile i.e skin tag. Will NTG heal this condition.

Moreover i have heard that Intermittent controlled anal dilatation is a modern technique in this. Where in this world is this performed please name the hospitals with the address.
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