Anal stricture/ stenosis after hemorrhoidectomy

What are the options for treating anal stricture/stenosis conservatively?

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Anal stricture/ stenosis after hemorrhoidectomy

Postby tomrabbit25 » 20 Mar 2020, 08:37

Hi all,

6 weeks ago I had an open hemorrhoidectomy to remove my grade 4 thrombosed haemorrhoids. The haemorrhoids were all around the anal canal, so quite a lot was removed. Around week 3 I began having a hard time expelling stools. At times i was pushing and grunting and sweating, with involuntary spasms but nothing much was coming out. The surgeon did a sigmoidoscopy on me but asides from aggressive granulation around the anus, the canal seemed unobstructed. IN week 5, he performed anal dilatation under sedation on me, and while I was able to expel stools after, they were still narrow and it takes multiple BMs each day to get rid of them. But today I had a really hard time again, it felt like i was back to square 1, even if i was doing anal dilatation myself at home once a day. I forgot to take my stool softeners yesterday, and today it was a nightmare. I had to use a fleet enema in the end.

I’m wondering if anyone else has been through this, and could advise on what to do. I‘m so worried that this is going to be my life, and the worst would be not being able to do a BM despite all the pushing and straining. My surgeon says that if the self dilatation doesn’t work, then he would try Botox injections to relax the sphincter muscles. Has anyone done this for anal stricture/stenosis? Why would botox help with scar tissue that is reducing the size of the canal? He and i are reluctant to do a LIS.

Thanks for reading! Appreciate any suggestions.
Last edited by tomrabbit25 on 20 Mar 2020, 10:41, edited 1 time in total.
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Re: Anal stricture after hemorrhoidectomy

Postby chachacha » 20 Mar 2020, 10:06

I've not heard of either botox or LIS for anal stenosis before, but I suppose both/either could loosen you up a little, so that more could pass. There are surgeries specific to stenosis though, and while I'm not familiar with them myself, you could probably google them to see if you and your surgeon could go that route if need be. And btw, when I google anal stricture, I get nothing. I'm guessing that you mean stenosis, and am basing this response on that. Good luck.
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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Re: Anal stricture after hemorrhoidectomy

Postby tomrabbit25 » 20 Mar 2020, 10:40

Yes my surgeon said that strictures can lead to anal stenosis. I’d rather not do another surgery though if I can help it.
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