LIS scheduled... nervous but hopeful

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: LIS scheduled... nervous but hopeful

Postby chachacha » 17 Dec 2014, 13:30

I have diahhrea with every movement, but only move my bowels every three or four days.

I can't even imagine using someone else's toilet, but will wish you lots of luck on that front.
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
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Re: LIS scheduled... nervous but hopeful

Postby zippitydoodah » 17 Dec 2014, 23:15

Oh, that sounds tough. =( I struggled with diarrhea more in the first couple months but am mostly calm and regular now, unless I eat something to set it off (e.g., uncooked broccoli). It's a blessing most of the time (in that I can predict and plan around it) but occasionally a curse (when I start waking up early with a dread of the morning routine - and the panic that I get on days when things don't go as expected). Occasionally I wish to go to back to the early days of quick, urgent BMs but I know that that's hard on your bum (and what caused my fissure in the first place, we think) so I try to be as happy with the state of things as one can possibly be.

Did they find anything with your sigmoidoscopy that could be causing your troubles? Or are you still waiting to hear back? I hope whatever they tell/told you is good news.

And thanks for the luck-wishes! I'm a little sore after spending the whole day sitting, and I didn't do a great job of eating right today, so I'll take all the luck for tomorrow that I can get. Hopefully the trip will be more relaxing than stressful and will give my body a much-needed rest.
-Fissure since August 2014 after diarrhea and antibiotics
-Using diltiazem, baths, ibuprofen, magnesium, high fiber diet/supplements, probiotics, coconut oil, cleaning with water & wipes only
-LIS & skin tag removal scheduled for late January 2015
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Re: LIS scheduled... nervous but hopeful

Postby chachacha » 17 Dec 2014, 23:47

I have had the fissure for about 7 years and the diarrhea for about a year. Diet has never made a difference to either the fissure or the diarrhea, and believe me, I have eliminated and added every single component of my diet this last year, and tried four different probiotics too. On my last visit though, the CSR brought up the possibility that I am producing too much bile acid, and that he may try me on a drug to correct that after we get the fissure procedure out of the way. And no, the sigmoidoscopy only showed a healthy rectum and lower bowel, other than the fissure. Interesting that eating certain things make it harder or easier for you.

I really hope that you have a great time and can just relax and enjoy your trip.
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
chachacha
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Re: LIS scheduled... nervous but hopeful

Postby zippitydoodah » 18 Dec 2014, 15:36

Oh man! 7 years consistently? Or off and on? Either way, you're due for some relief and hope it's the LIS that brings it to you! I have never heard of the bile acid thing before... that's really interesting. It's worth a try to treat it, at least. Glad to hear you're otherwise healthy down there, though.

Today's BM wasn't as bad as expected. I think I probably didn't have a full one but what I did have was fairly quick so that's a plus. My cold is a little better today and am expecting to even better tomorrow. I am ready to rest and enjoy the weekend! I hope yours is relaxing, too.
-Fissure since August 2014 after diarrhea and antibiotics
-Using diltiazem, baths, ibuprofen, magnesium, high fiber diet/supplements, probiotics, coconut oil, cleaning with water & wipes only
-LIS & skin tag removal scheduled for late January 2015
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Re: LIS scheduled... nervous but hopeful

Postby chachacha » 19 Dec 2014, 22:11

It was off and on for the first 6 years, and only constant for the last one. I used the diltiazem cream from years 5 to 6, but to be perfectly honest, I have no idea if it helped or not. In those days, the fissure seemed to heal and then re-tear over and over again and I had a schedule of about 6 weeks on and 6 weeks off. Since the CRS said that the diltiazem took several weeks to work, I don't know if when the fissure healed, it was because of the cream, or just because it was going to heal then anyway.

I hadn't heard about he bile acid over-production either, and everything I'd googled about chronic diarrhea pointed to other causes. When I saw the CRS last week though, and he mentioned that my small intestine was probably producing too much bile, it was very easy to google that instead, and it clearly was a very likely cause of the diarrhea. I have to admit that I'm really worried about the acidic diarrhea though, because of so many people saying that diarrhea made them scream post-surgery. When I have a bout, every few days, I scream too, and am back to the toilet at least 6 times over a period of a couple of hours. Can a newly created incision really withstand such "action"? I also have not had a response from anyone with stage 3 hemorrhoids, about pushing the mass back up inside the anus after surgery. If my tissues around the area are going to be tender and swollen, how on earth will I be able to get those massive hemorrhoids back inside? I have a terrible time already, both getting them back in at all, and causing a lot of extra pain because I also have to push on the sore fissure.

Good to hear that your BM wasn't as bad as you had expected it to be! I hate when I don't feel like I've done it all though, and get that aspect completely.

And great that your cold is getting better too.

I hope that you have a great weekend, and that you don't have a bad episode while you're away.
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
chachacha
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Re: LIS scheduled... nervous but hopeful

Postby msimon » 20 Dec 2014, 01:08

Chachacha, what does your Doctor say about your hemorrhoids? I would think they would want to take care of them at the same time. I don't think it is a good idea to be pushing on wounds that need to be undisturbed as much as possible to heal. I don't have any personal experience with that though. I am thinking that with the looser sphincter you may not be able to push them back in and have them stay...just a thought. As for the diarrhea, I am always rather loose and had some pretty acidic BMs post LIS and it really burned but got through it and the wounds were healing for a while through that. I have since had a setback though. I think it will be possible but will probably take longer. What does your Doctor say about that?
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: LIS scheduled... nervous but hopeful

Postby chachacha » 20 Dec 2014, 09:52

I discussed the diarrhea issue with the CRS last week, but it was in the context of "what is the point of having the surgery now, if diarrhea may cause the fissure to return"? He told me that once the sphinter was permanently loose, the chance of diarrhea causing another one was remote. He also said that he would put me on a drug for the bile acid, but, "Let's get the sphincterotomy done first". About the roids? When I asked if they would get in the way during surgery, he answered that they wouldn't be a problem, and that he'd never do the two procedures at once. He is also very anti-hemorrhoidectomy, and I imagine that is because he has been doing them for a very long time, and may have seen too much trouble for the patient afterward (extreme pain, and perhaps many who just have them recur again soon after), so only will do one when there's no other way out (grade 4 perhaps?). I did not discuss the hemorrhoids with him recently though, but years ago he knew that they came out and had to be replaced with difficulty. Maybe that is something he has currently forgotten about though?

I really have to ask my new questions though, but it's very hard to just get an appointment with him. I was thinking of maybe going to see my GP (even though I have a new one whom I've never met yet), and seeing if she can give me some advice. I really need to know the answer to those two questions before I go ahead.
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
chachacha
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Re: LIS scheduled... nervous but hopeful

Postby msimon » 20 Dec 2014, 13:11

There can definitely be issues with hemorrhoidectomies causing anal stenosis, and if you already have a fissure he may be feeling extra cautious with you. I am just concerned about issues that will happen after the LIS. I wonder if they are small enough that they could be ligated/rubber banded?I think that technique takes less tissue and it was less painful. I know they can't do this for grade 4, but maybe grade 3?
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
msimon
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Re: LIS scheduled... nervous but hopeful

Postby chachacha » 20 Dec 2014, 14:29

I had several banded a few years ago, but the ones at the dentate line can't be.
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
chachacha
Moderator
 
Posts: 1068
Topics: 19
Joined: 16 Jun 2013, 16:00
Location: Canada
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Re: LIS scheduled... nervous but hopeful

Postby zippitydoodah » 21 Dec 2014, 23:15

Wow, chachacha, it sounds like you've got quite a bit going on there. I'm sure your CRS knows what he's doing (and probably keeps great notes so he can review his patients), but I think it's super important to be able to ask questions so you can be sure he has heard your concerns, and so you can understand why he is making the decisions that he makes. Does your provider have a secure online messaging system? My GP is hard to get an appointment with so anytime I have a question that either doesn't warrant a visit on its own or is urgent, I send her a message on there and she has always gotten back to me within 48 hours (even on the weekend). It might be worth a try.
-Fissure since August 2014 after diarrhea and antibiotics
-Using diltiazem, baths, ibuprofen, magnesium, high fiber diet/supplements, probiotics, coconut oil, cleaning with water & wipes only
-LIS & skin tag removal scheduled for late January 2015
zippitydoodah
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Posts: 66
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Joined: 11 Dec 2014, 15:47
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