How could LIS help me with inflammation?

Considering LIS, but not sure it can help

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: How could LIS help me with inflammation?

Postby pinpin » 29 Nov 2013, 07:00

I think it depends on CRS, I got LIS offered right away, and doctor told he would not do Botox for me, as thinks it will be waste of time and money. This was in London.
07.02.2013 - got open hemorrhoidectomy, leaded to slow healing wound. Link to story
11.12.2013 - LIS surgery
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Re: How could LIS help me with inflammation?

Postby rio » 29 Nov 2013, 09:42

Hi Rachael, I ve been reading your posts and I see you are in troubles too :cry:

Here we have two small clinics dealing with anorectal disorders and performing outpatient procedures. One of them offers botox for fissure but I think it is not very common and is not covered by general insurance. The usual treatment when spinchter is tight is nitro in a form of 0,1% ointment made in Austria and named Percutol (I think diltilazem or nifed. are not in use here as I was not offered alternative for my nitro sensitivity). Self dilatation is usually prescribed in combination with nitro ointment or xylocaine or olive oil. Besides the self dilatation, it is advised to massage the anal canal with your finger (if it is possible) to increase the blood flow and use only natural oils or gel with hialuronic acid (I tried it but the pain was much worse). They try to avoid LIS especially with women from well known reason (smaller spinchter and risk of incontinence).
A clinic in neighbor country Croatia makes dilatation (with some device I think) and advertises good healing rate, but here, it is not performed.

At my first visit in may I was prescribed hydrocortisone suppositories because my spinchter was not tight then, but on the other visit I was told that it was a bad idea, was useless and never to use it again and was offered self dilatation with nitro (but I got huge inflammation from that). then I went to the other clinic to see a nice CRS who made the examination without any pain (using pediatric anoscope). He is considered the best CRS (he is the one who does botox, but he did not offer it to me). He said he would stitch my fissure together, make a small cut in spinchter and remove a skin tag. He is a proctologist and cosmetic surgeon so I decided to trust him when it comes to that, but I will ask about botox too.
Disabling burning, drilling pain in anal area for almost a year, started after UT infection. Small anal fissure diagnosed, turned out it is probably not the cause of pain, MRI shows no inflammation or fistula. Grateful to forum members for support.
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Re: How could LIS help me with inflammation?

Postby Rachael 1984 » 01 Dec 2013, 07:33

Hi Rio,
It sounds like you have to make the decision what to go for, I guess you want an end to all of this. I would go for LIS if you are confident with the surgeon. I know my CRS is reluctant to do LIS because of the reasons you stated. But I want to end this too..... It is draining on a daily basis having to cope with this. Good luck to you and I hope you can be Fissure free sometime soon..... Xxx keep us posted....
Hem Banding sept 2012
2Fissures
Nitro- Effective short term
April 2013-Botox-Effective short term
Diltazem-No effect, developed Rash
July 2014-Diagnosed High Resting Pressure
LIS performed on 17.9.14
Ongoing pain/re-tears. Awaiting pressure test results.
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Re: How could LIS help me with inflammation?

Postby rio » 01 Dec 2013, 13:12

Thank you. It is becoming pure misery and is taking my life from me. I am not afraid of the incontinence, because frankly, I just need to get rid of the pain and I will accept some minor problems.
Do you know Rachael how big (long) is your fissure? My CRS published short description of LIS procedure and I understand from it that a cut in the spinchter is made in the same size (and in the same hight) as the fissure is. If your fissure is not too long you will probably not need a big cut an there will be enough muscle left to prevent long term incontinence.
I think you are younger than me. I was told that it is much more risk for incontinence for older women than for younger. But I do not know much damage can occur during childbirth. My concern is slow or non healingwound after the surgery and more pain :affraid: , I would go for LIS tomorrow if I would be sure that after few weeks of pain I will be o.k. for sure. Thanks to many positive LIS experiences I have some hope left.
It is a though decision for us and we are unfortunately pushed by the pain we can not take for much longer.. :verysad: :verysad:
I know I am repeating myself. Just need to vent. Thank you for reading this.
Disabling burning, drilling pain in anal area for almost a year, started after UT infection. Small anal fissure diagnosed, turned out it is probably not the cause of pain, MRI shows no inflammation or fistula. Grateful to forum members for support.
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Re: How could LIS help me with inflammation?

Postby rio » 01 Dec 2013, 13:26

igrik1986 wrote:I think it depends on CRS, I got LIS offered right away, and doctor told he would not do Botox for me, as thinks it will be waste of time and money. This was in London.


It is so inconvienient that you must go to London to get LIS, but hope you will get really good service and no complications and that this will be a final solution for your problems.
Disabling burning, drilling pain in anal area for almost a year, started after UT infection. Small anal fissure diagnosed, turned out it is probably not the cause of pain, MRI shows no inflammation or fistula. Grateful to forum members for support.
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Re: How could LIS help me with inflammation?

Postby Rachael 1984 » 02 Dec 2013, 17:01

Hi Rio,

Not sure on the length or size. All I know is I am sure that this is a reoccurrence now my muscle has tightened again after Botox. So much inflammation and pain today, horrible glass feeling on BM. This hasn't happened in a long time, so I am mega sad. ;((((( I just want this to stop so I can get my life back..... I am 35yrs of age, my CRS said he is reluctant to do it because of incontinence risk, but hasn't suggested any other method of surgery... Maybe I need a new CRS? Mine doesn't seem to be telling me a lot of info!. Maybe I need to go in with a list of 100 questions?
Hem Banding sept 2012
2Fissures
Nitro- Effective short term
April 2013-Botox-Effective short term
Diltazem-No effect, developed Rash
July 2014-Diagnosed High Resting Pressure
LIS performed on 17.9.14
Ongoing pain/re-tears. Awaiting pressure test results.
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Re: How could LIS help me with inflammation?

Postby rio » 03 Dec 2013, 12:33

Hi Rachael!
It is so strange that you get another fissure after the old chronic one has cured with botox. As I understand you were not constipated after botox - you did all to keep your stool softer. So I why is this happening :evil: (you can take it as retorical question). And I find out from your diary that you are sensitive to Rectogesic which is nitro and helped so many other people with fissure, so unfortunately you can not explore that very promising option. I am very sad that we can not use nitro. Hope you have at least some good days.
Disabling burning, drilling pain in anal area for almost a year, started after UT infection. Small anal fissure diagnosed, turned out it is probably not the cause of pain, MRI shows no inflammation or fistula. Grateful to forum members for support.
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Re: How could LIS help me with inflammation?

Postby Rachael 1984 » 07 Dec 2013, 08:42

Hi Rio,

Thankyou, I pray that I can heal on day, however it may be.... Yes, the Nitro, I could feel it working as soon as I applied it, but couldn't take the reaction soreness... On Dilt now, but that is stinging like hell! Drat. Agh I hate damn Fissures.
Hem Banding sept 2012
2Fissures
Nitro- Effective short term
April 2013-Botox-Effective short term
Diltazem-No effect, developed Rash
July 2014-Diagnosed High Resting Pressure
LIS performed on 17.9.14
Ongoing pain/re-tears. Awaiting pressure test results.
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