Had surgery three days ago

My experience so far post-op

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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Had surgery three days ago

Postby trillo » 31 Mar 2019, 09:41

Seven months ago I began to feel intense pain when I moved my bowels. I assumed that I had a bad case of hemmies, but all the OTC creams I tried just made the pain worse. A few weeks later I went to a CRS who told me that the pain is from two anal fissures. (I had never even heard of such things.) I tried diltiazem but it burned like hell so I had to stop after a few days. Same thing with nifedipine. Afraid of surgery, I then tried various OTC creams. The only one that lessened the pain was Emuaid. Over the next few weeks I was optimistic that the fissures are healing, since I was feeling almost no pain. But then the pain returned and became bad again. I tried Panicura for a few weeks but the pain only got worse. I went to a different CRS who confirmed that my two anal fissures were deep and looked chronic and will never heal without surgery. I agreed to surgery.

On March 28 (three days ago) I had a double fissurectomy and an open LIS. I was told that the Percocet they gave me will probably make me constipated for a couple of days. But late that night I moved my bowels. I was pleased that it did not feel very painful. Over the next 12 hours I pooped about seven more times. This was very surprising because it was not diarrhea, they were all formed and substantial. I had not been constipated before the surgery, so how did I have so much poop in me? I guess I had been constipated without knowing it. Anyway, each BM was more painful than the previous one. And the pain between BMs got worse.

I have been alternating Percocet and ibuprofen. Percocet is more effective for the pain, but I'm afraid of being constipated from it. Plus, I don't want to keep taking a narcotic if I don't have to.

I didn't have another BM until early this morning (third day after surgery). It was excruciating.

I had been taking Miralax which made the BMs soft, but now I'm dreading the next one, so I added a fiber supplement this morning. I always drink lots of water and I am continuing to eat a high fiber diet.

I talked with the surgeon's PA on the phone yesterday. I told her that the pain feels like it is in the areas of the fissures, not from the sphincter. She said that makes sense because the two fissurectomies I had involved much more cutting than the LIS. No one had warned me about that. In consulting with the surgeon he had said that whatever pain I feel in the days after the surgery will be less than I've been feeling till then. Not true! The pain I am feeling now is much worse than before.

I do several sitz baths and/or tub baths each day. That is the only thing that helps with the pain, other than Percocet.

The PA said to expect terrible pain for "a few days", then it will start to get better. I hope she is right and that it really will start to decrease soon. But I don't know whether to believe that.

The main thing is that I hope this surgery really will heal the fissures. It will be much easier to live with this pain for the next days or weeks if I know that it will eventually subside and I will be healed. I'm just worried about whether I actually will be healed.

I don't want to have a negative attitude. I know that having a positive attitude helps in healing anything, so I'm trying to stay focused on the fact that statistically, most people who have this surgery do get their fissures healed from it. I know that even after they are healed we still need to be vigilant for the rest of our lives about drinking lots of water, eating a good, fiber-rich diet, avoiding straining on the toilet, and avoiding stress in general as much as possible. But I will feel so grateful if I reach that point where the fissures are healed and I can have my life back.

I'll post updates about my recovery process.
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Re: Had surgery three days ago

Postby PurplePangolin » 01 Apr 2019, 09:14

Best of luck to you! I have my own surgery (fissurectomy w/LIS) scheduled in a few weeks, and I'm somewhat anxious about it.
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Re: Had surgery three days ago

Postby trillo » 01 Apr 2019, 18:29

PurplePangolin wrote:Best of luck to you! I have my own surgery (fissurectomy w/LIS) scheduled in a few weeks, and I'm somewhat anxious about it.


I hope that I will be able to give you a very encouraging report on my recovery before you have your surgery. Right now I'm not in good spirits. After my first post which was yesterday morning I got a terrible bout of diarrhea which is still not resolved. I can't count how many times I've moved my watery bowels, and each time has been extremely painful. I don't know whether my addition of a fiber supplement yesterday could have caused all this, or whether it's my stomach reacting to the antibiotics which I am on for one more day, or I caught a stomach bug somehow unrelated. I called the surgeon's office this morning and asked to speak to someone who can give me advice about what to do and was told that everyone is at the hospital today but that someone will call me back later today. No one called me back.

I've been drinking lots of water and I drank coconut water for the electrolytes. All I've eaten today is white rice and two bananas. I've spent a lot of time in the tub, which is the only thing that brings me real relief - between bouts of diarrhea. Sitting in the sitz bath helps too, but not as much as in the tub. Percocet helps with the pain but I've been alternating it with advil because of fear of constipation. But tonight I'll take just Percocet because maybe I NEED some constipation at this point. It seems like a yo-yo where I'm either constipated or the opposite.

I wish I had a better report. I hope that in the next few days I'll be able to report that the worst is over, the pain is subsiding, and I'm confident that I'm healing.
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Re: Had surgery three days ago

Postby patience_and_healing » 01 Apr 2019, 19:13

I suggest you get on some high quality, high count probiotics asap. I don't know which country you're located in but in the US I've found biok probiotics (50 billion) to be very helpful when taking antibiotics. I've used VSL for heavy duty stuff and that can sometimes be found at pharmacies.
8/16-12/16: Fissure due to antibiotics
5/17: Botox to sphincter, fissure healed
9/19: Trigger point injections and pudendal nerve block
11/19: Botox to pelvic floor
8/20: Botox to pelvic floor in new location.
Currently in pelvic physical therapy
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Re: Had surgery three days ago

Postby trillo » 02 Apr 2019, 06:41

patience_and_healing wrote:I suggest you get on some high quality, high count probiotics asap. I don't know which country you're located in but in the US I've found biok probiotics (50 billion) to be very helpful when taking antibiotics. I've used VSL for heavy duty stuff and that can sometimes be found at pharmacies.


I've been taking probiotics regularly both before and after my LIS, but maybe I haven't been taking enough. Maybe I should raise the amount while on antibiotics. I see in your profile that antibiotics caused your fissure. Darn. Thanks for the reminder to make sure that I'm taking enough probiotics. I was only given a 5-day prescription for antibiotics after my LIS, so fortunately this morning is my last dose. (Yes, I live in the US. Your question prompted me to add location to my profile.)

I read your earliest posts and see that you had been scheduled for LIS in April of 2017. I scrolled to see how it went but could not find posts about it. If you don't mind saying, how did it go for you? Or perhaps you can link to your prior posts about it? Thank you!
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Re: Had surgery three days ago

Postby patience_and_healing » 02 Apr 2019, 10:43

I'm not sure which posts you read but I've never been scheduled for surgery. I've been running away from those who suggest surgery actually.

How many probiotics are you taking? I take 400 billion and above when I'm on antibiotics, divided throughout the day. I only use refrigerated ones because I'm not sure the room temp ones actually do anything. Whole foods has a good collection if you ever shop there. Make sure to separate the antibiotics and probiotics by 2 hours. That's advice I've read on the NHS website.
8/16-12/16: Fissure due to antibiotics
5/17: Botox to sphincter, fissure healed
9/19: Trigger point injections and pudendal nerve block
11/19: Botox to pelvic floor
8/20: Botox to pelvic floor in new location.
Currently in pelvic physical therapy
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Re: Had surgery three days ago

Postby trillo » 02 Apr 2019, 15:23

My mistake. That post was by GilmoreGirl.

400 billion? Wow! I take 25-50 billion per day, but I frankly miss days, so maybe 2 out of 3 days. I guess I should take a lot more during antibiotics. I usually take them in the form of Green Vibrance powder.
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Re: Had surgery three days ago

Postby patience_and_healing » 02 Apr 2019, 18:47

I only take that much when I have to use antibiotics. Although I had a stubborn bout of food poisoning last week and I took upwards of 500 billion. It did the trick and stopped the stomach upset after 4 awful days. Probiotics on regular days cause constipation for me so I don't take them. I hope you start to recover better from your surgery now that the antibiotics are done.
8/16-12/16: Fissure due to antibiotics
5/17: Botox to sphincter, fissure healed
9/19: Trigger point injections and pudendal nerve block
11/19: Botox to pelvic floor
8/20: Botox to pelvic floor in new location.
Currently in pelvic physical therapy
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Re: Had surgery three days ago

Postby trillo » 02 Apr 2019, 19:27

I'd be interested to read your story so far in dealing with this, but I don't want to ask you to repeat yourself. Would you mind linking me to a thread where you discuss it?
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Re: Had surgery three days ago

Postby patience_and_healing » 03 Apr 2019, 10:47

I don't have a thread with the whole story but in short I can tell you what happened. I developed a skin condition called hidradenitis more than 2 years ago. Dermatologist prescribed antibiotics which messed up my BMs, causing major constipation. I tried using flaxseed to solve the problem which made it worse, ending in acute fissure. That healed, but opened up some months later due to muscle tension & diarrhea caused by anxiety over my skin.

I used nifedipine, had Botox after a few months, and supposedly healed (according to the doc) but still had pain. She suggested physical therapy so I found a different PT to help me because the one I was seeing at the time wasn't good enough for this. I also began using small dilators to help open things up. The new PT was helpful but still I had pain, and when she left the city a few months later she referred me to a different lady. So finally I found the person who has helped me tremendously. She referred me to other practitioners to help work on past trauma, help make my skin better and basically began looking at me as a whole person rather than just focusing on the fissure.

I still have pain despite the muscles not being in spasm all the time so I'm now seeing a CRS who also specializes in pelvic floor. I'm scheduled for a couple of tests so she can decide if pelvic floor Botox would be a good solution. I'll update on this board after I get the test results.
8/16-12/16: Fissure due to antibiotics
5/17: Botox to sphincter, fissure healed
9/19: Trigger point injections and pudendal nerve block
11/19: Botox to pelvic floor
8/20: Botox to pelvic floor in new location.
Currently in pelvic physical therapy
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