Just had anal fissure surgery, advice needed..

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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Just had anal fissure surgery, advice needed..

Postby comfortablynumb » 18 Dec 2012, 16:19

Hi, Heres a summary of what i have been suffering with and also details about my surgery today..
For 6 months after ever BM been getting pain on opening bowels, blood and severe pain for up to 6 hours after BM.
Went to CRS and he tried to do a DRE but due to pain he was unsucessful.
Personally didnt think it was a fissure, thought it was hemmies ( as external one visable)
SURGERY TODAY ...
Went in for DRE under general anesthetic, told surgeon to do whatever he thought best and signed forms. Out comes the propofol and im out for the count. :)
Woke up in recovery, not much pain - loving the post op woosey feeling! ... i seen fairies! GREAT! :)
Blood all over bed and at first sight i thought i had poo pooed the bed - it was iodine - PHEW! :)
Informed I have a 3oclock & 9 oclock GRADE 3 hemmies and also a chronic anal fissure.
Nurse told me a Lateral Sphincterotomy was performed, when asked about the hemmies she said there is no mention of them being operated on in the surgeon notes, she guesses the surgeon just let them be and concentrated on the AF. I was told that the surgeon doesnt want me to return for a post op check up. I asked to speak to the surgeon but nursey nurse refused! She said "he wont see you". I felt a little bit let down as i wanted to ask him about the hemmies and about the fissure.
At home..
Some mild discomfort - to be honest the pain isnt that bad, ive read some horrific stories online and was really put off by having this done, but apart from mild discomfort im fine! been given cocodmol 30/500 and lactlose. IMHO the pain after a BM before the surgey was much worse than this!
Had a sitz bath and no problems, new dressing applied. Walking a bit like John Wayne :)
Passing gas - Well, only have to lift my leg and out pops a squeaker! clearly my anus has no control over my farts. Im a little worried about this as im a gassey person and worried ill be "letting rip" in public. Advice? permanent ?
Going for a poo - Aint been yet - DREADING IT! Hopefully the lactose will help even with me taking cocodmol. Advice?
Numb genitals - Im male! My genitals feel numb and have done since surgery - Any ideas? local anethetic they may have used?
It would have been good to speak to surgeon after op and find out exactly what was done and get a bit more info.
Anyway...you advice would be great :)
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Re: Just had anal fissure surgery, advice needed..

Postby Savaici » 19 Dec 2012, 13:54

Glad you are over your surgery, but amazed that your doctor does not want to see you for a post op check up. If you can't find out from the surgeon what he did, then ask for your records and look at it yourself. If you are in the US it is easy, and I think you can get them without too much bother in the UK. Don't be intimidated, just go for it. Some of these doctors think they are from another planet and we don't belong on it!
Good luck with your healing, and just make an appointment with the doc if you're not happy.
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Re: Just had anal fissure surgery, advice needed..

Postby comfortablynumb » 19 Dec 2012, 15:13

Thank Savaici! I will do just that.
Today has been quite painful, i have swelling purple lump next to my anus, is this normal????
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Re: Just had anal fissure surgery, advice needed..

Postby Lauren12 » 19 Dec 2012, 20:23

Hi comfortably numb. I don't know if a swelling purple lump is normal after the LIS. I had the LIS and didn't get one, but I was too scared to look at my anus for quite a while after the surgery so wouldn't know what was going on down there! Maybe they hit a blood vessel when they injected local anaesthetic and that's all it is. However, you say that yesterday was quite painful, so I would contact the surgeon and get it checked out. Just best to check it's not an abscess in my view.
I also find it really strange that the surgeon didn't want to give you a post op check up. Like Savaici, I don't know if you're in the US or the UK. In the UK it's done as routine, usually six weeks after the surgery.
Let us know how you get on.
All the best
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Re: Just had anal fissure surgery, advice needed..

Postby Lauren12 » 19 Dec 2012, 20:28

Oh, and as for the query in your first post, it's normal not to have control over gas immediately after the LIS operation, or even to think you're about to pass gas and a stool emerges instead! However once the swelling goes down and recovery get underway, that stops. I had the LIS op 20 months ago and because of my diet, I'm quite a windy person as well, but I don't have any problem with it in public.
I also had haemorrhoids as well as a fissure, however my haemorrhoids were treated by banding on a separate occasion 9 months before I had the LIS op, when I was having Botox injected (they tried to treat the fissure with Botox initially).
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Re: Just had anal fissure surgery, advice needed..

Postby comfortablynumb » 20 Dec 2012, 03:26

Thanks Lauren, I'm based in UK and I will defo chase it up with surgeon, I haven't had a BM yet :( it's been 3 days now, I'm taking lactulose,nim trying not to take cocodomol but the pain is quite bad so I've taken a couple - the codeine probably isn't do me any favours. I'm thinking of taking a senokot tablet, I'm really scared incase I can't have a BM, I can feel my tummy gurgling but no need to go for a BM - how long will it be before it becomes dangerous for me? Should I see my gp? It's been 3 days now without BM .
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Re: Just had anal fissure surgery, advice needed..

Postby Lauren12 » 20 Dec 2012, 07:59

Hi again
I don't think it'll become dangerous for you, but if you can't pass a stool, yes, see your GP.
I had three surgical procedures at different times (first was botox plus banding of haemorrhoids plus removal of skin tags, second was botox alone and third was LIS procedure). After the first procedure, I couldn't pass a stool either. I went to the GP. When I phoned, they only had emergency appointments left but I mentioned I'd had surgery two or three days previously and the receptionist gave me an emergency appointment - so if you have difficulty getting an appointment, it should persuade them when you mention you had surgery a few days ago!
I was already using Lactulose and prune juice prior to the op. When I couldn't go after the op, the GP prescribed Movicol as well. Movicol is actually available over the counter, you don't need a prescription for it, but I didn't know that at the time. It softens the stool even if the stool's already hard, if I remember. So speak to your GP about it - he or she will tell you what to do in addition to what you're already doing.
Codeine, like all opiate containing painkillers, slows down the motility in the bowel, which leads to constipation. Speak to the GP about other prescription painkillers which don't have this effect. I was prescribed Diclofenac, which is a NSAID. As with any NSAID, I had to take it on a full stomach. There are certain medical conditions which will prevent you taking something like Diclofenac (asthma is one I think), so discuss with the GP what pain relief regime to follow. You can also combine one type of painkiller with a different one. For instance, I took Diclofenac together with over the counter paracetemol. Discuss it with your GP so that you know what's safe. A word on Diclofenac though, I eventually developed a queasy stomach with it and can no longer take it (or any NSAID, even over the counter Ibuprofen) because it affects my stomach - but I was taking it for a very long time with the fissure - well over a year - which since you've now had surgery is not a situation that will likely apply to you.
Also, get your GP to have a look at the purple lump. Another thing that occurs to me, since you mention you have piles, is that it might be a thrombosed haemorrhoid. I used to have haemorrhoids, and a thrombosed external haemorrhoid does look purple, and is extremely painful!
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Re: Just had anal fissure surgery, advice needed..

Postby comfortablynumb » 20 Dec 2012, 08:38

Ive just been given some Macrogol by my dad, his GP gave him some when he was taking strong pain killers for his bad back. I will try this for a couple of days before i see my GP - i think its similar to movicol.
Thanks for your advice Lauren! Will keep you updated!
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Re: Just had anal fissure surgery, advice needed..

Postby comfortablynumb » 20 Dec 2012, 08:43

ooops.,.. just googled macrogel and its the same as movicol :)
With regards to pain killers, I cant take NSAID as i had a stomach ulcer a few years ago, im just trying to get by on paracetamol now
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Re: Just had anal fissure surgery, advice needed..

Postby comfortablynumb » 21 Dec 2012, 06:27

Splash Down!
Well, ive managed to release the beast from my butt! A very large, fat beast at that!
Such relief after and not much blood, only a tiny bit and it want bright red, more of an orange color. It wasnt pleasant having my first BM but it also want as bad as i thought it might be. I took a hot bath after and cleansed the area well. Im in some discomfort now but nothing like the INSTENSE feeling i had before the op. :)
Many thanks again to Lauren who has responded to my posts :) ...The movicol works! :)
I feel Im possibly over the worst now, hopefully I will be fine for xmas day :)
Now i have to venture into town to do a bit of last minute xmas shopping, this is going to be a challenge!
Merry xmas all!
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