3.5 months post LIS update

Ongoing leakage issues and more

Are you having, or have you had a Lateral Internal Sphincterotomy (LIS)? Please share your experiences here, or ask any questions.

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Re: 3.5 months post LIS update

Postby Worrier12345 » 31 Mar 2015, 05:17

Hello all,

Life seems to have become unmanageable again. My morning routine of rectal irrigation does not seem to be working like it once did. On average I only have 1 or 2 days a week where there is no leakage or discomfort.

After irrigating the anal area feels sore and irritated but I load up the area with coconut oil and this generally dies down after an hour or so. I still constantly check throughout the day due to anxiety, and for a few hours the anal area is dry with no sign of leakage.

However, usually by the early evening my anus start to feel uncomfortable, itchy or slightly burning with a horrible feeling of wetness. When I check at this point, I usually find that the area is moist and kind of sticky to the touch. The anal opening also seems a little more open than usual. The issue is that since I have irrigated in the morning, the leakage is small and not stool-like. It seems pasty and pale - although sometimes it certainly has a pale brown stool colour, and it collects about 1cm inside the anal opening.

Sometimes I think I am going mad, and that this is an obsessive level of cleaning and checking. But the residue is there, and it is difficult to clean. I sometimes make myself very sore trying to clean it properly, but once I do the discomfort lessens.

None of this makes sense any more. And I don't think that any healthcare professionals will help me - I'm sure they will just chalk it up to anxiety and/or depression.

I know that my muscle is weak as my surgeon's notes from my check up mentions the "hypotonic" muscle (I find putting coconut oil inside my anal opening utterly crushing now, as my finger just seems to slip in with very little resistance - this is not how an anus should be, no wonder I'm experiencing leaking). I know there is an LIS defect between 1 and 5 o'clock on the internal sphincter (this sounds big to me) and I know that the surgeon cut up to the dentate line.

What I don't understand is how can I still have leakage problems after I irrigate each morning? Is the leakage stool or mucous or both? How can such a small amount of leakage cause such discomfort? What the hell can I do to help this situation? If I clean too much I get sore, if I don't clean enough I get sore. I am going insane, I can no longer trust my own perceptions, and everything feels out of control and hopeless.

I have no hope for this to get better. It's coming up to 5 months since my LIS and things are getting worse, not better. People keep telling me that I will get through it, I shouldn't look back as I can't change what has been done. I should focus on the present and be positive about the future. This is all well and good, but I am consumed with regret about the decision I made to have surgery, the present is filled with disgusting cleaning and checking routines, and I feel nothing but fear about the future and guilt for all the misery I'm causing all those around me.

I have become so pathetic and weak. I have phoned the Samaritans nearly every night for the past two weeks. I am incapable of helping myself, I am squandering the help of my friends and family, and I know that medical help is not feasible. I cannot go on feeling like this, and there doesn't seem to be a way out that won't hurt people. I feel like I have trapped myself in a corner and the only choices I have left will cause hurt to those around me.

I feel terrible posting this on here, but with the endless wait for NHS appointments I can't get any help with these issues from anyone with any knowledge on the subject except for you all.
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Re: 3.5 months post LIS update

Postby suzyljank » 31 Mar 2015, 05:31

Stop using any type of lubricant inside the anal opening. This is allowing any stool to slip out more easily. If you are irritated try something like zinc oxide as a barrier between your skin and any leakage. There is a flap surgery that may be able to help. It does not involve cutting the muscle. Just make sure you have a good surgeon. Try putting a piece of soft gauze over the area after you have a BM. It will absorb and fluids and you can discard it and use a fresh one easily when needed.
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Re: 3.5 months post LIS update

Postby Worrier12345 » 31 Mar 2015, 09:04

Hi Suzy,

I only put oil in the first 1-2cm as this area is irritated. The leakage only reaches the anal verge - and it is inside the anal canal near the opening where the irritation is felt.

I don't think flap surgery can help. My problem is now that the internal sphincter is too loose. There may be some issue with the LIS incision causing assymetry of the anal canal which means that it no longer has a function watertight seal.

The leakage seeps into the anal canal and causes discomfort throughout the day - I don't let it get out on to the perianal area as I check and try to clean often. But the area is constantly moist and the irritation from inside the anal canal drives me mad when walking or sitting.

I don't understand how I'm meant to deal with this. I try not to clean to much but if I leave it too long the leakage causes irritation inside. I can't imagine there are many other people out there who have to clean out the inside of their anus though - so I realise that my cleaning is excessive. But there doesn't seem to be any other options.

Either my body is screwed or my mind is. Either way - it's the same result and I am struggling to deal with life on a daily basis, and I've had enough.
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Re: 3.5 months post LIS update

Postby suzyljank » 31 Mar 2015, 09:26

You're still adding lubrication thats making it easier for stool to slide out so go lightly on that. One thing about LIS, in the beginning it does loosen the muscle but over time the muscle does tightened up again. Not as tight as you started with but it does heal and gain some of its strength. Maybe in time things will settle down.
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Re: 3.5 months post LIS update

Postby May » 03 Jan 2016, 13:20

Hiya,

I have just seen this thread, and seem to be in a ver similar position. I had a fistulotomy and now have leakage after BMs. I am due scans and pressure tests to find out what is going on. The weird thing is, I was fine after my surgery for just over a month, then I got food poisoning for four days and the leakage started.

I was wondering, Worrier, whether you ever got some relief for your condition? I am at my wits end and don't know what to do.

I suspect I may have a keyhole deformity, as the fisulotomy wound never really looked like it 'filled in' - I can still see and feel the groove up my anal canal where the scar is.

(I also have a chronic fissure which never healed. I ignore it as it causes no pain.)
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Re: 3.5 months post LIS update

Postby Sarah8818 » 31 Jul 2018, 18:13

I read your post as was looking ag irrigation as way of cleaning an infection, it made me sad as I know only too well how this condition and the crap that goes with it ruins Your life. It totally absorbes you. I hope since your post is old that you are all better now x
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Re: 3.5 months post LIS update

Postby sitibu » 14 Aug 2018, 02:18

I noticed that leakage problem after LIS is under reported and surgeon most of the times did not inform patient on the risks.

I hope this forum can raise more awareness to avoid ppl go through this unnecessary surgery if possible.

If you have done LIS before

1. Please state number of years of your surgery
2. Do you have leakage problem?
3. When the leakage get started?
3. If yes, how does the leakage problem happened? is it after pass motion?
4. When the leakage happened, are you aware? or you do no know until you find out during next toilet visit?
5. How frequent the leakage? Daily? or intermittent depending on the stool
6. If you don't mind, please state your age, sex, married, any child birth delivery
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Re: 3.5 months post LIS update

Postby chachacha » 14 Aug 2018, 08:51

You need to start a new thread for your question, rather than adding it to existing ones.
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
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