3.5 months post LIS update

Ongoing leakage issues and more

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3.5 months post LIS update

Postby Worrier12345 » 19 Feb 2015, 08:36

Hi everyone. I thought I'd give an update of my situation as I really don't know what's going on any more and I've had some trouble dealing with things on the whole.

Had LIS for my anterior fissure in Oct 14. I never had too much pain with the fissure - mostly discomfort, difficult BMs and blood every few days - but I'd had it for nearly 18 months, tried the creams, botox and in the end had LIS (didn't have any pressure tests as the surgeon said the muscle was clearly in spasm when he examined me).

The surgery itself seemed to go fine, and recovery wasn't too bad, barely any pain and minimal bleeding. The main problem, however, was with stool leakage after a BM. I'd never had this before LIS, and I could quite clearly see the LIS incision had created a new groove in my anus which seems to be where the stool leaks through. My anus is now more like a zigzag than a straight line. After a BM, if it is soft, stool will ooze out of the groove - making cleaning up almost impossible without a mirror and wet wipes. Even if I get myself spotlessly clean I will get leakage of liquid/solid stool throughout the day.

The only thing that I have found that helps is cleaning out my rectum after a BM by using a small enema bulb syringe to squirt some tap water up there and expelling it. I doesn't take a lot - only about 50-75ml - but this clears out any stool left in the rectum (the amount of which varies considerably depending in the BM consistency). If I do this, I can generally be safe from leakage for the rest of the day.

I struggled with this a great deal at first - I never thought I'd be doing this at the age of 32. I even made myself an emergency "pooing away from home kit" containing a mirror, wet wipes and a small enema bottle - not an ideal thing for a man to carry around, but at least it gives me peace of mind.

I think perhaps I could deal with this if it was the only problem I faced post-LIS. But unfortunately I still experience soreness on a daily basis. This is more apparent after sitting for long periods (I have a desk job) or walking (I don't own a car). Whether this is due to my enema routine or not, I have no idea. I also experience many uncomfortable sensations from my anal region. I often have an uncomfortable feeling of fullness, sometimes the muscles feel sore, and quite often the skin feels sore/burning too.

I really thought that LIS would have helped me to stop thinking about my arse and shitting. But it seems to have had the opposite effect in my case - it is quite literally the only thing I think about some days. It has fuelled my anxiety issues (see my recent post in the fistula forum for evidence of that) and I long to be free from it all.

Go get medical help, I hear you say... well on that front: I saw my surgeon 3 weeks ago for my follow up. He inspected the are from the outside and did a digital exam (he did not use a scope). He said that he thought the fissure had healed - considering that he could easily do the digital exam, which had always been a problem when my fissure was playing up. He said he couldn't feel any deformity in the muscle and nothing looked particularly wrong, but he thought that my squeeze pressure was a little weak. He said that the leakage was clearly a problem though and he would book me in for some tests - if the muscle was weak he said that physiotherapy may be the next step.

So that's where I am. Waiting to have tests (do you think that will be manometry and ultrasound? anybody had those) and then maybe physio (does anybody know if this will help?), every day I don't leave the house until I have had my 2 BMs and done a rectal irrigation, the rest of the day I go about my business feeling uncomfortable and generally miserable.

If anyone has any thoughts on my situation I would be grateful - especially in regards to the cleaning routine, the tests that I will be having and there potential outcome, and the ongoing feelings of discomfort post-LIS. If anyone has any advice or can relate it would be very helpful to me.

I don't really know what the hell is going on any more. I don't know if I was an idiot to push for the surgery. I don't know if there is any hope that things will get better. I don't know if my need to keep clean is exacerbating any problems. In general, it seems there are just a lot of things I don't know.

Thanks for reading and good luck to you all,
Worrier
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Re: 3.5 months post LIS update

Postby Worrier12345 » 19 Feb 2015, 10:08

Just realised how long and meandering that post was. To sum up, does anyone have any advice/input on the following?

- does anyone have any similar experience of discomfort/soreness/stool leakage at 3 1/2 months post-LIS?
- has anybody had manometry or ultrasound tests (pre or post-LIS) and can tell me what to expect?
- has anybody had physio for incontinence issues? What can I expect
- does anybody have any tips for managing these problems on a daily basis (bearing in mind I'm a 32 year old man)

Again, thanks in advance, any help would be great.
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Re: 3.5 months post LIS update

Postby Worrier12345 » 23 Feb 2015, 07:48

Well, I've got my anal ultrasound booked for Friday, and manometry booked in the week after. Hopefully that will shed some light on my issues.

Did anyone have any input they could offer on my situation? It would be greatly appreciated.

Many thanks,
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Re: 3.5 months post LIS update

Postby owmybum » 23 Feb 2015, 11:31

Hi worrier,

I have had both those tests. They are not too bad, don't worry. Hopefully they will shed some light on your situation. The ultrasound may be able to detect and weakness in your muscle that may be causing the stool leakage. The dr that performs the ultrasound may be able to tell you what he sees there and then, but the manomentry tests take a couple of weeks to get analysed and come through.

Good luck and keep us posted!

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Re: 3.5 months post LIS update

Postby Worrier12345 » 23 Feb 2015, 11:35

Thank you kindly for the reply OMB.

Quick question - do you know if the ultrasound can detect other abnormalities of the rectum like fistulas or prolapses? Or is it just a visual examination of the muscles?

Also, are these tests likely to causes any damage? I'm pretty sore down there and not sure if the fissure is healed yet. What size 'probes' are we talking about?
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Re: 3.5 months post LIS update

Postby owmybum » 23 Feb 2015, 14:32

I'm not sure what it can actually detect.... But just ask whilst you are there, I'm sure they will be happy to chat through things with you!
No.... Nothing is big enough to hurt you. The manomentry is just a tiny width tube with a tiny soft baloon on the end which they inflate using warm water to imitate stools in the anal/ rectal region. Its all over and done with pretty quickly. The ultrasound probe is not too big either, and gets covered and lubricated. Just make sure they know you have an active fissure, and to be extra gentle, and things will be fine.

OMB x
fissure after hem banding and tag removal feb 11
Pelvic floor therapy
Diltiazem
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Nitro
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Re: 3.5 months post LIS update

Postby boodles » 23 Feb 2015, 22:59

I just noticed that you are only about 4 months post LIS, and thinking back, I think I had problems for about 5 months after my surgery. I think it takes time to heal, the sphincter has to probably adapt.

:) Now it just so happens that I am here today for the same problem, leakage and using wet wipes and burning. But I don't think it's necessarily due to my LIS three years ago, because my husband who has not had the surgery has the same issues. I hope to find some advice because stool leakage is not fun! Your "kit" sounds like a good idea as well as using a bulb to clean in there. That kind of gives me the heebee jeebies, but it's a good idea.

Hope you feel better soon and get the answers you need!
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Re: 3.5 months post LIS update

Postby Worrier12345 » 24 Feb 2015, 11:03

Hi Boodles,

Thanks for replying. Could you give me a little more information about your leakage? I'd really like to know more so I can understand what's going on with me.

Did your leakage clear up after a while? Did it cause discomfort? How much leakage did you get? Did you ever speak to your surgeon about it? Was it solid or liquid? Did you have problems cleaning as well?

Not sure if I understand what has happened - has the problem come back? Any idea why?

Please feel free to ask me any questions about my "routine" and clean up operation. It's about the only use I have these days. Feeling pretty miserable about the whole thing and regret having the surgery done.
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Re: 3.5 months post LIS update

Postby boodles » 24 Feb 2015, 13:29

Sorry Worrier12345, I'm a little confused as to when you had your surgery. If it was 3 months ago or 3 years ago.

In my case, if I remember correctly, I basically had pain and leakage (liquid) for about 4 or 5 months after my surgery, which was in June or July of 2012. But mostly for all this time I have been "normal" with the occasional leakage due to diet- this leakage is a very soft solid. I clean with baby wipes, and tp, but as I do things I feel pain and burning and itching and sure enough when I go clean with wipes again, there is feces on the wipe. Sometimes it seems clean but the burning is there. I wouldn't say it's a lot of leakage, but sometimes when cleaning it takes a few wipes and tp to make sure it's clean. This is kind of embarrassing, but sometimes I leave a baby wipe folded near my rectum to soak up any additional leakage and to soothe the area. If I'm out and about sometimes I have to just put my underwear in there to try and clean it.

As I mentioned in another post, my husband who has stomach issues more than rectal issues also has leakage and does the same things I do. So it may not just be due to the LIS. Did you ever have the problem before your surgery? Is this something you have had all the time for years? If so, I can see that it would be quite distressing, as it is very distressing even on an occasional basis.
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Re: 3.5 months post LIS update

Postby Worrier12345 » 24 Feb 2015, 16:43

Hi boodles,

Sorry if I wasn't clear - I had LIS 3 1/2 months ago. No, I never had any leakage issues before surgery. Even when my fissure was playing up and the skin tag was swollen I never had any issues with cleaning up and staying clean. That's probably why I'm struggling so much now. It all just seems a bit much for me to handle - especially as I suffer from ocd as well, so even when I'm not leaking I constantly have to check which just irritates things down there and increases my anxiety.

You say your leakage is due to diet - does this mean they you experienced leakage before lis? I'm having ultrasound and manometry tests in the next couple of weeks so hopefully I'll get some answers as to what is going on. I was kind of hoping that the leakage might improve over the months as the muscle is meant to regain strength but it to doesn't seem like this is always the case - your experience seems to protect very this.

I'm trying to get used to the idea of cleaning with a syringe bulb after every bowel movement but to be honest I absolutely hate doing it. I've been doing it every day since Christmas and ive had enough. The alternative, however, of leaking stool throughout the day seems much for worse though.
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