1 wk post Lateral Internal Sphincterotomy and hurting bad!

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1 wk post Lateral Internal Sphincterotomy and hurting bad!

Postby jillybean » 07 Jul 2017, 10:17

Hello. Thanks to all of you who post - I have found this site very helpful as I navigate the frustrating and painful world of anal fissures! I have some questions and am not well connected with experienced professionals so I am hoping to gain more insight from you guys!
A bit of history...
A hard BM gave me my first fissure 3.5 years ago. Have had them on and off (every 6 months or so), since then and Nitroglycerin and sits baths helped me heal when it would flare up in the first 3 years or so.
Last 4 months have been different - nothing seems to be working to heal the fissures (pretty sure I have on external and one internal) - diltiazem, high fibre diet, lots of water. My BMs are not hard so I don't feel that it's a case of continuing to damage it from hard stool, but rather a high resting pressure that makes healing very difficult.
I had a LIS 1 week ago and am surprised and disappointed with how crummy I feel. Surgeon made it sound like I would be good to go after a couple of days, but I feel worse than before the surgery! First 2-3 days weren't bad as I was taking Tramadol and didn't poop lil day 3. Now, every morning is the dreaded BM and pain (1-10 I would give it a 9.9), that has me in tears and in the bath immediately. Spend the next 4 hours or so with heat pad in bed, then get it together to parent my kids and try to be normal for the rest of the day. Surgeon says I shouldn't be on Tramadol anymore but Advil doesn't seem to do much. Husband got me CBD oil and have started trying this...not able to comment yet on whether it is helping or not.
My pain is deep and throbbing after a BM and for much of the day. I can feel a bit of a bump on the left side of my anus entry - mentioned it to surgeon yesterday and he said it could be a hematoma and to use lots of salt in my sitz bath.
Pain is definitely more on my left side - when I insert a gloved finger with Diltiazem (painful), I can feel what I think is a fissure at the posterior/left near the end of my anus/start of rectum. Btw - colorectal specialist I saw a few years ago said to do this to apply the diltiazem so it gets way up there to promote healing. This current Dr I am seeing says not to do that and only to apply it on outside of anus...anyone have information on this???
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Re: 1 wk post Lateral Internal Sphincterotomy and hurting ba

Postby Rosco9 » 07 Jul 2017, 14:52

I would listen to your doctor, however I have been told the opposite, that it should be applied externally only, it works indirectly to relax the muscles.

If you haven't already, get your diet on point first...
lots of fiber rich foods from now on. Beans, whole grains, rice veggies, fruits, etc. Limit red meat and nuts, popcorn, seeds, etc.

1-take Miralax daily, along with magnesium citrate, these are safe osmotic laxatives that will keep your stool like soft serve ice cream no matter what you eat, and can be used long term if desired.

2) put petroleum jelly in your bum with your finger before every bowel movement, this will lubricate and prevent tearing of the fissure. Squat over a handheld mirror.

3) squat on the rim of toilet or buy a squattie potty, this straightens your digestive tract and makes you not need to push or strain as much.

4) buy desitin 40‰ zinc oxide cream and start applying with a q tip directly into the fissure cut itself (very important) after bowel movements and before bed. This speeds up skin renewal significantly and will heal the fissure in just a few days (seriously) if you also follow the above steps.
If your fissure is to the muscle, or if spasms are a problem when going, then use diltiazem 10 min or so before bowel movements, then use the petroleum right before. Breathe deep and concentrate on relaxing, don't strain at all.

Continue with the poletroleum jelly every bm for a few months atleast and you shouldn't have another fissure. Start wiping with water soaked toilet paper, don't use soap or alcohol based wipes anymore on your bum these will dry out the Anus.
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Re: 1 wk post Lateral Internal Sphincterotomy and hurting ba

Postby Mypoorbutt » 08 Jul 2017, 06:53

Hi,
I think quite a few people feel worse after the LIS, I certainly did.
I tend to think it's the people who have had a fissure the longest that seem to feel worse after LIS. Possibly because the area has become so sensitive and tender that the op itself can cause pain to increase which increases the spasms and hence more fissure pain too and then more spasms...vicious circle unfortunately
But please don't lose hope I was convinced at week 5 that my LIS had failed and made it worse by week 7 the spasms had stopped
You are only on week one most CRS say that you will be fine in a week mine was honest and said it would be a very hard recovery due to my crohns but did say that lots of people can take a month for the area to settle down.
I applied my cream internally as that is what worked best for me
I'm sure in a week or two you will be feeling so much better
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Re: 1 wk post Lateral Internal Sphincterotomy and hurting ba

Postby jillybean » 08 Jul 2017, 09:20

Oh thanks so much, Mypoorbutt and Rosco9!

Truly needed these encouraging words! I am unimpressed with the lack of information from my surgeon and grateful to have found this forum to gain insight and encouragement.

Funny - I took the advice of Rosco9 to use Miralax (we have a different name for it here in Canada), last night (never been recommended by any of the Drs I have seen), and vaseline just before my BM and am thrilled to say that the BM I just had was mellow compared to all from the last month! I am sitting in my salt sitz bath and feeling so grateful!! Haha - the things one can say on here!
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Re: 1 wk post Lateral Internal Sphincterotomy and hurting ba

Postby Mypoorbutt » 08 Jul 2017, 11:29

So glad you feel a bit better. It's always recommended to apply some form of barrier cream before a BM as any residue left in the fissure will burn and sting until the body cleans the area
Sitz baths are great too and you can also add coconut oil to help soothe
If the pain gets bad you could always ask for some gabapentin as that works well on spasms but I'm sure you won't need to do that
Good luck
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