Have any of you had LIS to prevent a fissure?

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: Have any of you had LIS to prevent a fissure?

Postby Katie » 05 Dec 2017, 12:38

Home now and the lis is going a head my fissure is very long and deep and she thinks it's the right thing now after years and years of trying everything and nothing working but she did say she would talk to other surgeons to tell them my case! I'm looking at the new year to have the op as did not want it before christmas!!! I dont have any probs she just don't like doing the op as I'm a woman and our muscles are not as long as men and she worryed about my losing control after the op or in later life etc but I'm doing it just hope it works as she also said it does not work in all cases!!!! :cry:
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Re: Have any of you had LIS to prevent a fissure?

Postby NickF » 05 Dec 2017, 13:25

Hopeful, depending on what country you live in, it isn’t always that easy. When I was living in the UK, you generally couldn’t get an appointment with a colorectal specialist in less than a month on the NHS. I even walked into ER (UK version of accident and emergency) and waited 6 hours only to be seen by a general doctor and not a specialist. He had to do a very painful scope exam in the middle of a flare up without aesthetic just to diagnose it cause it was outside of his speciality.
I came to live in America just to get proper healthcare for my fissure. While they are amazing here, it can still sometimes take a week to get an appointment. So for those of us who have a tear for 3-7 days then heal for a couple weeks and repeat, it can be very hard to get this timing right. And even when you do, they tell you it’s “acute”. At least US doctors acknowledge that acute fissures are every bit as painful as chronic ones. UK doctors seemed to overlook this fact.
The point is, constant acute fissures are treated as a lot less serious than chronic ones (despite being every bit as debilitating) and from my experience doctors don’t want to do surgery on them cause they don’t know what will happen.
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Re: Have any of you had LIS to prevent a fissure?

Postby NickF » 05 Dec 2017, 13:30

Katie, that’s great that you have got a plan. I’m really pleased for you :)
I’m a little surprised that after all this time they were so reluctant to do a LIS just because you are a woman. The literature does state that it is slightly more risky for a woman than a man, but it is still seriously minimal in the absence of any other conditions. Have a wonderful Christmas and I hope that come new year you will have a happy and pain free life.
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Re: Have any of you had LIS to prevent a fissure?

Postby NickF » 05 Dec 2017, 13:33

And last thing, your doctor has to tel you that it might not work. But the LIS has an incredibly high success rate. The lowest I’ve read across studies is 90% success. Some have shown 97%+ success rate. Of course nothing is perfect, but that’s pretty good odds.
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Re: Have any of you had LIS to prevent a fissure?

Postby Hopefull123 » 05 Dec 2017, 13:41

This is so frustrating, Nick. But I think the doctors have to admit that a few weeks calming period doesn't mean the fissure has healed. If it keeps reopening every few weeks that means that it can't fully heal. Full healing takes at least 2 months if not more for the skin to gain elasticity. If relapses occur every few months this is a different story.
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Re: Have any of you had LIS to prevent a fissure?

Postby NickF » 05 Dec 2017, 13:50

Couldn’t agree more hopeful. Usually I tear once every couple weeks. But I managed to go 10 weeks once without a tear. It was heaven and I thought I might have healed. But a slightly, and I mean slightly harder movement tore it open again. I think if your fissure hasn’t healed by itself for several years, it’s fair to assume it won’t.
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Re: Have any of you had LIS to prevent a fissure?

Postby Hopefull123 » 05 Dec 2017, 13:59

oh no, this is a living hell, Nick. Do you experience any pain or spasms, any sensations at all during the calm periods?
Have you requested a surgery yet?
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Re: Have any of you had LIS to prevent a fissure?

Postby NickF » 05 Dec 2017, 14:11

For the first two days after the fissure closes, I'm raw and achy but no spasms. 3 days after fissure closes, I am back to normal as if I dont have a fissure.
I'm booked to have my LIS on December 22. I'm having another sidmoidoscopy and more biopsies done first on December 12. As long as my inflammation levels arent too high, my surgeon will go ahead with the operation. We are going to meet just before the operation to discuss how bad the inflammation is and what risks she is willing to accept as a surgeon on my behalf. If inflammation is too high, she outright wont do the operation cause she says the risk of uncontrollable bleeding would be too high. I have already signed the consent form accepting all other risks of the operation and I dont need to discuss those with her again.
I don't want this post to scare anyone away form the operation who might read this. So I just want emphasise that I am an unusual case and these aren't risks that most people will face.
How about you Hopefull? I see that you only just joined the site. Would you like to share your experience? It's absolutely fine if you dont want to! Please dont feel any pressure.
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Re: Have any of you had LIS to prevent a fissure?

Postby Hopefull123 » 05 Dec 2017, 14:31

I'm glad both you and Katie has ops scheduled. Good luck to both of you, fingers crossed everything to go well!!!
Currently, I have jumped to a no pain stage for two weeks after 4 weeks of nitro, magnesium citrate and lower carb diet which makes my stool thinner. Sadly I cant eat any bread or cheese because they harden and bulk my stool even if I take more magnesium. I tested this on Thanksgiving and I suffered afterwards. My fissures began 6 months ago after a prolonged stomach flu. My behind was so irritated and these 7 days of extreme diarrhea set my muscles into spasms. I didnt know much about fissures back then though and I thought everything will go away on its own, but then I had to take many antibiotics due to lower GI infections because of the diarrhea and that caused loose stool followed by constipation due to dehydration. But I finally realized i must keep my stool soft and thin and now it has been well. I am just afraid of relapse and I dont know when should I test again hardening my stool to see if retore will happen. I think I will wait for at least two months, but I am miserable with this strict diet, especially now with all the holidays, cookies, hot chocolate, etc. The interesting thing is that I am feeling some stiffness down there and occasions feeling that I have to have a M, but I know that I dont have to. I think my muscles go into spasms but there is no blood or pain. The spasms at this point are not painful but just the pressure feeling. I hope this will go away. It's interesting that I dont have this sensation when I bleed sand I have pain from the wounds. I cant explain that. Perhaps when the fissure starts closing the skin pulls and I have that stiffness and fullness sensation. When the fissure is open that makes the canal looser. I dont know.
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Re: Have any of you had LIS to prevent a fissure?

Postby NickF » 05 Dec 2017, 15:01

hmm, that is interesting. Ive never heard of someone who had spasms without pain. The spasms are usually indescribably painful. I'm a 28 year old man and Ive cried on the floor like a baby many times from the pain of this. Its worse than when I had second degree burns and my skin was bubbling. I would ask your colorectal specialist what he makes of that.

I know the eating thing can feel miserable to begin with but it will get easier to eat that way in time. Your taste buds adjust but it can take a long time. I eat a whole-food, plant diet and it took many months to get used to. Especially not eating any sugar, bread etc. Eliminating cheese was definitely a good idea and I'm sure it will help you a lot!
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