How do you know if LIS has failed?

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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How do you know if LIS has failed?

Postby aimonaali » 06 Mar 2013, 09:45

Well the obvious answer is that you know because your fissure does not close. But in my case the fissure did close and two months after the operation the surgeon said it was fully healed. Now, one month later it's apparently irritated a bit again. It's not fully open but it's not fully closed anymore either. It doesn't hurt but I can feel it now.
And I'm just terrified that it could open again and I'll have to go to have another LIS:( Does anyone know if that can happen three months after the surgery? I mean can LIS turn out to be a failure months after the operation even though it did heal the fissure at first?
If someone can ease my mind it would be much appreciated.
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Re: How do you know if LIS has failed?

Postby owmybum » 06 Mar 2013, 10:40

I'm sure I have read somewhere on here that after lis, you can still get fissures, but because the muscle is no longer so tight, they tend to heal up again pretty quickly.
I'm sorry I can't offer you any real advice... I'm sure someone will be along later who knows for sure.
Hang on in there and try not to worry about it too much. It's early days.
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Re: How do you know if LIS has failed?

Postby thisfissurecankissmybutt » 06 Mar 2013, 12:13

It took me four months to heal after my LIS surgery. At my two month post-op visit my doctor was concerned that he might not have cut enough muscle, so he put some silver nitrate on the fissure (which hurt like hell). Apparently, this gets rid of the granulated tissue, allowing the fissure to heal in circumstances where there is over-granulation of the tissue which is preventing the fissure from fully healing. He put the silver nitrate on the fissure again at my three month post-op visit (which hurt even worse since I knew what was coming - the first time was a surprise!). At my four month post-op visit, the fissure was fully healed! I believe the silver nitrate made all of the difference in the world. I am now almost nine months post-op.
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Re: How do you know if LIS has failed?

Postby aimonaali » 10 Mar 2013, 06:04

Thanks for your answers. It's now about two weeks since I got a little retear on the fissure and I can still feel it. It doesn't hurt but I feel a little burning reminding me that there's something wrong.
I'm using diltiazem but I'm not sure how much it is doing for me. Is it possible that LIS cured the "original" fissure and now I'm stuck with this new smaller fissure? I'm scared as hell that it will open more and more now that it has torn... If someone has some information about this it would be much appreciated.
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Re: How do you know if LIS has failed?

Postby Lauren12 » 10 Mar 2013, 10:14

In the few months after I had the LIS operation I developed occasional minor fissures. The CRS told me at that time that now I'd had LIS I wouldn't develop any more major fissures and eventually, I wouldn't develop any more minor ones either.
It can take the anus a long time to completely settle down after having a fissure and after surgery. For example in the early days, there's swelling from the incision site and from any open fissure site, which can narrow the anus, making it more prone to minor damage with bowel movements than it will be when all the swelling subsides. Scar tissue at an incision site is also raised for a while (a few months I think) before it goes flat.
The surgeon was correct, in that I stopped getting minor fissures after a few months. I'm 23 months post LIS now and for a long time now, if any minor damage happens with bowel movements (it can happen that I still get a few spots of blood with particularly large or wide stools) I don't really feel it. I can carry on as normal, even sit down immediately after a bowel movement. In other words, minor damage now is felt in exactly the same way as it would be felt by someone with a normal anus who'd never had any problems or procedures on their anus.
It took me eight or nine months for my anus to settle down completely and revert to normal.
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Re: How do you know if LIS has failed?

Postby coconut » 10 Mar 2013, 10:47

aimonaali wrote:Thanks for your answers. It's now about two weeks since I got a little retear on the fissure and I can still feel it. It doesn't hurt but I feel a little burning reminding me that there's something wrong.
I'm using diltiazem but I'm not sure how much it is doing for me. Is it possible that LIS cured the "original" fissure and now I'm stuck with this new smaller fissure? I'm scared as hell that it will open more and more now that it has torn... If someone has some information about this it would be much appreciated.

Why are you still using the diltiazin? That stuff is meant to relax your sphincter and after the surgery, your sphincter is unable to tighten the way it used to, so the diltiazin would be useless. It also has a high rate of causing irritation. So, how do you know that your continued problems aren't the diltiazin?
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Re: How do you know if LIS has failed?

Postby richibeno » 10 Mar 2013, 10:56

Hi Lauren
I'm 12 weeks post fistulotomy
Still get an achy feeling now
So yes I think you are right it takes months for your behind to feel normal hope and pray I'm on my way
Sore my crs on Friday said healing fine little marked or scratch on the scar
Here's to great healing
Health and happiness
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Re: How do you know if LIS has failed?

Postby aimonaali » 10 Mar 2013, 11:05

My CRS put me on diltiazin again because of the new tear. I had stopped using it a month before because the fissure had healed. Isn't diltiazin also increasing the blood flow so that the tear can heal faster? So I don't think diltiazin is causing the irritation. Or at least I know that there still is a tear where the fissure was and I recon that's why I feel the burning. I'm just hoping it would go away...
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Re: How do you know if LIS has failed?

Postby coconut » 10 Mar 2013, 19:02

aimonaali wrote:My CRS put me on diltiazin again because of the new tear. I had stopped using it a month before because the fissure had healed. Isn't diltiazin also increasing the blood flow so that the tear can heal faster? So I don't think diltiazin is causing the irritation. Or at least I know that there still is a tear where the fissure was and I recon that's why I feel the burning. I'm just hoping it would go away...

That's a nightmare to me. I did the surgery because I was reacting so poorly to all the creams. Yikes.
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Re: How do you know if LIS has failed?

Postby aimonaali » 11 Mar 2013, 22:30

Do you think it would be better not using any creams at all? My doctor told me to use diltiazem in the morning and white vaseline in the evening. But when I put on the vaseline it seems to irritate the tear and I feel burning. The BM's don't hurt but apparently the tear is not getting better. Does this mean I have to get another LIS? :( I also wonder why isn't this small tear healing but the whole fissure already healed once after the surgery...
Also I still have a little skin tag that the surgeon didn't cut when he did my LIS. HE said it's so small it wouldn't be a problem. But can it somehow keep this new tear from not healing?
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