Lateral sphincterotomy op today!!

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Lateral sphincterotomy op today!!

Postby Danalope » 17 Nov 2022, 04:09

So in hospital now waiting for spinchterotomy on chronic anal fissure, feeling very nervous!

Will record how it all goes & share over next few weeks, hoping for smooth recovery.

History behind is have suffered from fissures for over 10 years on and off, but over last few years they’ve become increasingly resistant to creams & home treatment. Had a history of constipation and forcing poos out in my younger days that led to the issue. Still have issues with slightly hard poos now, especially 1st one of the day (go twice a day usually).

Did have a fissure free period in early 2021 but then an operation in May led to constipation and that led to a new fissure. This one resisted treatment. Nearly had op in early 2022 but fissure temporarily healed while on holiday in Barbados - warm carribean sea did the trick I reckon. It was back again a few months later though!

Since then it’s been fairly constant though waxes and wanes in terms of discomfort level. Generally pain is about 4 - 6/10 so not too severe compared to others. Going to toilet not to uncomfortable it’s more afterwards with the spasms feeling like a hot poker up the bum, and it lasts hours!

Worst still I keep fit and do a lot of running including half marathons, and boy does it hurt after one of those as sweat I guess gets in the wound.

So finally decided to get it sorted, saw a Colorectal surgeon via private medical insurance and after he took a look & heard the history suggested going straight for the sphincterotomy. Said Botox would probably not work for me longer term & he tended to use it on higher risk patients in terms of incontinence risk.

So fast forward 1 month and here I am waiting to go in, full of apprehension on what lies ahead when I wake up. The 1st post op poo being the 1st hurdle I guess! Annoyingly fissure has been better this week, little or no pain having a poo and reduced discomfort afterwards. Did mention this to surgeon and he said he’d have a good look but given my history would likely still proceed with op. I don’t think it’s fully healed personally, can still feel it a bit.

Worried about tendency for a harder morning poo, especially first bit and impact that may have on healing. Keeping away from harder foods for 1st week at least.

Wish me luck!!
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Re: Lateral sphincterotomy op today!!

Postby Danalope » 18 Nov 2022, 03:48

Well op was done yesterday. Have to say service at Spire was excellent, so so lucky that thanks to works PMI I didn’t have to use the NHS.

Was in a bit of state pre op, very nervous but nurses were excellent, especially 1 who was very reassuring & gave me a blanket prior to the anaesthetic as was shivering!

Worst part was the anaesthetic going in which felt like it got a bit blocked as it went in, hurt a bit & was about to say something when the lights went out.
Next minute I was in recovery, felt good, no pain & Surgeon said op went well. The fissure was still present so they proceeded with sphincterotomy, said there was a small skin tag also due to fissure but he left that alone.

Back in ward had a great lunch - omelette followed by tuna sandwiches on wholemeal, was ravenous. Discharged about 4pm, no issues & practically zero pain.

Rest of evening okay also, still little/no pain, had painkillers & antibiotics, plus a Movecol later in evening. Dinner was chicken bits with spinach, kale & advocado. Pudding nuts, chia seed, flax seeds & green yoghurt. Reckon must’ve had nearly entire recommended daily fibre intake in that 1 meal alone!

Slept poorly, not due to pain more just mind was too alert worrying about post op BM.

Breakfast was high fibre bran, nuts & yoghurt, lots of chia again. Really recommend chia as great fibre supplement, very healthy & 2 tbsp’s give you 10g of fibre.

Felt rumbling & realised a BM was imminent, so ran bath, took painkillers & got onto the toilet, gently praying for not too much pain! Packaging/gauze literally fell out before I sat down even, good start & little/no blood or mess on gauze, which was encouraging.

BM was uneventful, was lovely & soft and fully formed, the perfect poo. No pain on passing, though incision area stung afterwards & there was a little blood on poo & when I wiped up, nothing eventful though.

Since then had a bath & all currently is good. Will continue to have sitz baths today & suspect I’ll have another BM at some point as generally go twice per day. Overall though very uneventful so far, stinging now pretty much gone & pain level 1/10!
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Re: Lateral sphincterotomy op today!!

Postby Danalope » 19 Nov 2022, 04:26

Day 2:

No idea if anyones reading this but I’ll keep waffling on anyway, good therapy for me!!

So overall still progressing okay. After the triumph of yesterdays BM, had a tricky afternoon, pain wise still just the incision really 2/3 out of 10 so no big deal, but was very windy! Not much coming out at first but could feel it all gurgling around in there, at first I mistook it for the dreaded spasm, then I thought I needed a 2nd poo, but nope just gas!

Think the gas caused the slight increase in soreness, little bit of blood on sanitary towel also but nothing to worry about.

Woke up on day 2 with just a little soreness 2/10. Had breakfast followed by poo, then straight in the bath after poo. Again no pain on passing though took longer to all come out, albeit poo wasn’t hard at all, just took its time, made sure I didn’t push though, just deep breathing.

Bit sore post poo, up to 3/10 soreness, nothing from original fissure though, all just the incision. Hoping to get out and do a walk today, nice & sunny outside so hoping for a good day. Feeling positive about it all still, just want to fast forward a week or two!
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Re: Lateral sphincterotomy op today!!

Postby Danalope » 19 Nov 2022, 04:33

P.S forgot to add, feel like even at this early stage I’ve got reasonable control of wind & definitely full control of solids still, so that’s a big positive, don’t think incontinence will be an issue.
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Re: Lateral sphincterotomy op today!!

Postby Danalope » 20 Nov 2022, 13:03

Day 2/3:

All reasonably okay still after Thursdays op. Soreness has increased a bit last 24 hours, I think due to 3 x BM yesterday, all bulky & soft but do have feeling of needing to go most of the time which is annoying & although no pain passing does up the post poo soreness. Hitting a 3 or 4/10 yesterday PM & today.

Had 2 more BM today & think another one likely before bedtime which is annoying. Might cut movicol dose to half a sachet this evening just to put a stop to it tomorrow. That said how much of it is the bowel disrupted by the op & possibly antibiotics? Not sure but don’t want to do anything too sudden in case it leads to harder poops. Any ideas on this?
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Re: Lateral sphincterotomy op today!!

Postby Danalope » 21 Nov 2022, 07:53

Day 4 still struggling. Up for much of last night with bad gas pains in abdomen, went to toilet at 2am & lots of gas came out. Fissure behaving thank god, still no pain passing BMs, had 2 more already today, but very sore afterwards, discomfort from incision site now a steady 4/5 out of 10 so becoming more unpleasant now & is lasting all day.

Spoke to nurse at hospital I had surgery at and she agreed with me it’s the antibiotics - Metrodinazole, which she said is a harsh one on the body & upset stomach/diarrhoea is a common side effect. Suggested probiotics which I’ll get.

Frustrated by setback but got to roll with it I guess, only good news is I’ve only got 4 tablets left to take, finish antibiotics course tomorrow, can’t wait!
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Re: Lateral sphincterotomy op today!!

Postby curious350 » 21 Nov 2022, 10:55

Hi Danalope!

Thanks for your follow-up posts! Any tips on keeping the area clean? I want to do everything to prevent an infection/abscess and planned to use a bidet, wet wipes, sitz baths, shower head and blow dryer in that order after a BM. Then, will place a sterile gauze to catch any discharge. What have you been doing?
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Re: Lateral sphincterotomy op today!!

Postby Danalope » 22 Nov 2022, 12:14

Day 5:

Disappointing day so far today.

Started great, woke up & pretty much no pain just a bit of very mild soreness from incision area. Thinking positive, worst now past? Wrong.

Had 1st BM after breakfast as usual, noticed bit more of a sting as poo went past incision but nothing too bad. Wiped/dabbed but made mistake of wiping bit that I thought wasn’t the incision area, wrong if was. Cue sharp pain, worst so far, got in bath & thankfully subsided to 3 of 4/10, took painkillers & back to 1/2 an hour later.

Did a walk then had 2nd BM after lunch, again sharp pain at end of poo as it went over incision, ouch that hurt a bit more than this morning. Then severe pain 8/9 out of 10, WTF is going on? All BMs prior to today, no real pain or issues at all, till today.

Luckily pain subsided quickly, got in sitz bath and back to 3/10 20 minutes later. Spoke to nurse on phone who thinks I just aggravated incision area a bit this morning, hence sharp pain. Hope so but fearing 3rd BM likely due later.

I’m wondering if it is that wipe or in fact one of the dissolvable stitches has dissolved or popped out? Day 5 after all perhaps that might be behind it??

On upside didn’t take any painkillers & 4 hours on in minimal discomfort. Also pain though severe literally lasted minutes only thank god.

Other news, antibiotics now done, good news & hoping can get back down to 2 BMs a day now. Really want to see that incision area heal a bit quicker now so using alternating hot/cold packs to try & swelling down & improve blood flow. Still having light amounts of blood on sanitary pad, nothing alarming but hoping this starts to diminish over next few days.

Bit worried still by spasm like feelings, not painful just like needing to go to the toilet all the time. Not sure if down to gas or just all the disruption down there but would hate for them not to have cut enough sphincter after all this?

Will update later if I have a 3rd BM later (please God no). Otherwise update tomorrow.
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Re: Lateral sphincterotomy op today!!

Postby Danalope » 22 Nov 2022, 15:44

Had 3rd BM…4th day in a row, pain less severe than earlier but spasm since, basically feeling like I need to go the toilet all the time, has been an increasing feature of last few days due to number of bowel movements. Weeping a bit more than before also.

Feel like operations been a failure, due to spasms, will be gutted if that’s the case, invested so much into this, told 90/95% success rate, just my luck to fall in the 5% it fails for, what’s the point in carrying on.
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Re: Lateral sphincterotomy op today!!

Postby patience_and_healing » 23 Nov 2022, 11:29

Hi Danalope, have you talked to your doctor about the spasms? Maybe he can prescribe something to help you get past this stage. Don't lose hope, your body may be going through an adjustment phase after the surgery, and will settle down with time.

Take lots of probiotics to lessen the number of BMs. I think they're making the area hard to heal. Take care, and try to stay hopeful.
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.
On and off in pelvic physical therapy
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