Debating LIS Surgery

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: Debating LIS Surgery

Postby countrygirl49 » 02 Mar 2021, 18:22

Saturday (day 2) started out ok as mentioned previously. Later in the day my appetite and state of mind decreased rapidly. I think from a lack of sleep, being overwhelmed and NOT EATING ENOUGH. My husband had to almost force me to eat some food before bed. It actually helped me feel a tiny bit better and I was able to really get ready for bed.

Even though I don’t want to have a BM, it is sooo important to eat. Puts me in a much better frame of mind to where I can handle everything better, even the pain from a BM.

Sunday morning (day 3) I was in a much better frame of mind. Had to BM before breakfast, and oh man, that was painful. Probably an 8 or maybe even a 9. Each subsequent BM was a little less painful. Pretty tired by bedtime.

Monday (day 4) was even better mentally. I actually cleaned the kitchen and went outside with my kiddo. Later in the day, quite a bit of residual pain down there (from everything still being swollen, stretched, big ‘roids and the stitch) but easily resolved with more pain relievers.

Today (day 5-Tuesday) doing well so far. Tired, though. Didn’t sleep really well last night. That first BM was painful-probably an 8. Most of the pain is still not from my fissure. In fact, I don’t even notice the fissure. More from the incision a little and spasms after going. I haven’t been using sitz baths. After I go, I take a quick lower shower and then “unload,” which is the term my PT gave me prior to surgery for laying on my back with my hips at a 90* angle and my legs up on the bed at a 90* angle with my feet together and knees apart. (Picture sitting upright, but actually laying down.) That seems to reduce the pain the best after 5-10 minutes.

Still doing 650 mg Tylenol followed by 400 mg Ibuprofen 3 hours later and then Tylenol another three hours later and so on. Though, today I’m trying to not take as much and so far haven’t.

Also, still no accidents. Bleeding is very minimal. PS. I’m not eating beans (or spicy food) because it’s hard for me to tell whether it’s just gas or a poop in there. Haha. Today I’ve had the feeling of a BM in there, but each time I sit on the toilet, I don’t have to go.

Thanks, Pzgre. The process is slooow going for me, but I know I’ll feel better eventually! Regarding your questions, my primary doctor referred me to my CRS. I didn’t really ask her any questions to stick with her. After meeting her a couple years ago, I liked her and her reviews online were good, so I decided to keep her as my CRS. She takes all the time needed to go over questions and doesn't make you feel rushed. Has a great bedside manner.
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Re: Debating LIS Surgery

Postby Rich44 » 02 Mar 2021, 19:19

Good to hear you had the surgery, and you'll get to feeling better soon. I can't really remember my recovery being too bad. I think it lasted a solid 7-10 days before I was feeling fairly normal and the bowel movements were not any worse than pre-surgery. One day at a time.
Chronic Fissure June 2014 - October 2020
Botox, skin tag removed - February 2015
Levator Ani September 2014 - February 2016 (caused by stress - left my job, cured!)
Lateral Internal Sphincterectomy, skin tags removed - October 2020
Fissure 100% healed!
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Re: Debating LIS Surgery

Postby countrygirl49 » 06 Mar 2021, 17:30

Hi! It's been a few days since I posted, so just wanted to do an update. Wednesday (5 days post op) the pain was definitely a little less than Tuesday. And on Thursday I saw my first glimmer of hope/the end! Since then I've only been taking two Tylenol each morning. Noticing daily improvement with things like sitting, laying on my back, moving around etc. So, seem to be well on the road to recovery. For a few days now, no blood and just the tiniest mucus at times. Pain just after BMS today was only a 4! But...

My biggest issue at this point is trying to figure out my FIBER balance. My doc said up the fiber, cut back on the Metamucil. I've done both, but my BMs are still like a 7-9 in softness (with 10 being watery)! Not formed at all and I even had one that was a solid 10 yesterday. So, cutting back even more on Metamucil today and cutting back a little on the Applesauce as well. I know I want the BMs to be soft, but I'm SO worried this is TOO soft and will cause my butt to get all tight all over again. OMG so stressful.

I have my first follow up appointment on Monday and that's going to be the first question/discussion out of my mouth--preventing more/future stenosis (?) and stretching things back out. And, what's the chance of things getting all tight again and how fast would that happen? Scary stuff. I've read about people needing a SECOND LIS, and I do NOT want to be one of those people!!
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Re: Debating LIS Surgery

Postby Rich44 » 06 Mar 2021, 18:46

Just make sure you are getting the right fiber. Soluble and Insoluble are different. One speeds up transit in the colon and one adds bulk and makes stool soft. You should try to get both.
Chronic Fissure June 2014 - October 2020
Botox, skin tag removed - February 2015
Levator Ani September 2014 - February 2016 (caused by stress - left my job, cured!)
Lateral Internal Sphincterectomy, skin tags removed - October 2020
Fissure 100% healed!
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Re: Debating LIS Surgery

Postby missy moo » 14 Mar 2021, 01:58

Hi countrygirl49 my fissure started after my first child 7. 5 years ago now i have 3 kids all up my newest 1 is only 2wks old and my fissure has been on an off since it first started its really painful after having each bavy im happy you had lis maybe if i did after my first baby this fissure wouldn't of stolen the happy times from me bonding with each of my babys. Im super depressed today had 3 bms through out the day an each has given off more an more pain. Ive tried everything except lis i did 2x botox but not a final fix for me it helped here an there but im still suffering. How have you been since you last posted?
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Re: Debating LIS Surgery

Postby countrygirl49 » 17 Mar 2021, 01:04

I have been meaning to do another post for over a week now!
The weekend of the sixth and seventh was really actually a pretty good weekend! Still some pain, but not from the fissure. Come to find out after my follow up appointment that it’s more of a muscle memory spasm that I have been having. It has actually greatly improved the past few days. I went to the chiropractor last week twice and that seem to help a lot.
I had my first follow up appointment on Monday the 8th. The doctor said I was healing up super well! At that time, the stitch was still in. All she did was an external visual exam. And answered a bunch of my questions. She said I did not have stenosis.
One thing I was really concerned about was the consistency of my BMs. On the Bristol scale they are usually about a 5 or 6. She said that she would be fine with that forever. I was concerned that it would cause me to have more tightness without my butt opening more during BMs during healing and then causing more tightness down the road, but she said it shouldn’t be a problem.
Of course she confirmed the fact that everybody’s "looseness" down there is different. I may just have a small, tighter opening for the rest of my life. And to keep my poop soft! I also will probably have to take me a Metamucil for life. Trying to keep up on lots of both kinds of fiber in my diet as well.
She also said that she has never had to do a second LIS, so that alleviated those concerns some.
Speaking of which, I don’t know what happened, but on Saturday the 13th, I had a BM that would not come out. And I was seriously not going to try to strain harder to get it out. I had read some thing about removing it manually and that was literally my only choice. Fortunately, I got it out and I did not bleed! I know, that is super gross and hopefully isn’t too much information, but hopefully it can help someone else.
I’m pretty sure my stitch fell out over this last weekend because things felt less itchy and pokey down there. And I’m pretty sure I do not feel it anymore. I have literally not looked down there since prior to surgery. LOL.
So, all of that said I am feeling super good these days! A few days ago I had a tiny bit of blood on the toilet paper, but I have no idea where it came from and it was only one time, so I didn’t worry about it. Literally no pain from the fissure for about a week now. Definitely feel pretty much back to normal (and doing all of my normal activities again) aside from the knowledge that I have to let things heal more and keep the fiber coming!
My next follow up is at the end of April.
Missy Moo- I can totally relate. I remember when my son was very little and just sitting and trying to feed him was just agony and it was hard for me to focus on him, I just wanted to stand up and have it over. Hugs to you! It’s possible that if you had an LIS back then it would’ve solved everything, but like my doctor said, another can happen in six months. The only difference is, if it does, we know what to do! I will call her right away and get nifedipine to stop it in its tracks and not let it get worse. I understand going three or four times a day as well. I think I will probably do that for the rest of my life because I need to keep things soft and that’s just how it moves through my system. But when you have a fissure, each one is definitely worse. My doctor basically told me to get an LIS without even trying Botox. The only other thing she said was that if I was going to have any more kids she would be more hesitant to give me an LIS. Because that weakens things down below and delivering vaginally can cause some damage if you have an LIS? Something to that effect. Though, she said if I was going to have "eight more kids." Ha ha. My son is going to be the only one. The first week of recovery was the worst and I would definitely recommend having a helping hand around for the kids. I'm lucky I have an awesome husband and get to work from home. I did kind of part time work that first week. And then things rapidly improved for me. Everyone recovers differently, but if it were up to me I would tell you to get the surgery as soon as you can! Especially if you were not planning on any more kids. I hope that helps!
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Re: Debating LIS Surgery

Postby Rich44 » 17 Mar 2021, 09:51

Great to hear countrygirl! I use a squatty potty now and that seems to help my BM come out easier plus I noticed when I use it and I relax my body does the rest. Amazingly my stool has typically been a 4 most of the time which has been ideal. Sure I have tough days where it's not perfect but so far so good.
Chronic Fissure June 2014 - October 2020
Botox, skin tag removed - February 2015
Levator Ani September 2014 - February 2016 (caused by stress - left my job, cured!)
Lateral Internal Sphincterectomy, skin tags removed - October 2020
Fissure 100% healed!
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Re: Debating LIS Surgery

Postby missy moo » 17 Mar 2021, 17:08

Thanks countrygirl I've had no pain during bms for about 4 days or since my last post which has been a true blessing but i still get random pain probably spasms when i sit for to long like when baby is cluster feeding at night for hours im still working on breastfeeding so always use the same feeding position so cant change that till everything is toughened up nipple wise lol thanks for all the onfo and im happy your doing well. If this fissure keeps coming back an giving me a hard time i will definitely see abother crs i mite even need to pay an see a private crs they are extremely expensive but would be worth it i would be much more at ease seeing 1 crs an paying for a quality job. Will keep you updated and let me know if anything changes.
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