LIS surgery scheduled

Finally having LIS surgery this week after 2 years of dealing with fissures.

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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LIS surgery scheduled

Postby NDMK312 » 22 Mar 2015, 07:17

My fissure story actually started even after this two year bout almost 6 years ago. I went through all the natural treatments and finally using mineral oil did the trick. At that time I only had one fissure. I went three years, one of which included being pregnant, without any issues. After having my daughter back in March of 2013, 6 weeks after her birth, I became constipated due to breastfeeding and, my guess, overall anxiety and stress of being a new mom. That is where my journey started all over again. I went through every natural remedy in the book, mineral oil, nitroglycerin, dailtizem (spelling?), and diet changes. I'm very regular going twice each morning. I'm active and thin with no other medical issues. I had a colonscopy done 6 years ago, which revealed no issues and a CT scan last year that revealed the same. I've now gone anywhere from two weeks with no pain or issues to 10 weeks, but they always come back. This last bout was the worst pain. I almost passed out it was so bad. That's when I said enough is enough let's nip this in the bud (literally) for good.

I'm seeing one of the best colorectal surgeons and the University of Penn medicine. She has done many of these surgeries. In fact, she said it is the most common surgery most colorectal surgeons perform…no kidding, look at all of us on this forum. The risk percentages are low, and at this point I'm willing to chance them. The doctor did not push the surgery on me, this was 100% my choice. She tried the conservative treatment first, but even she stated it really comes down to your quality of life and what your tolerance is for what is going on with this battle. She is right, and I have zero tolerance for it anymore. I did my research, I spoke with several surgeons and I'm convinced that she is the best, and that this is the right decision. A side note, for moms out there I did ask about having children after surgery and the surgeon said that should not be issue and that there is not a recommended timeframe to wait for that. This procedure relaxes the muscle, and if anything will help when you have all that pressure on that area. This was one of the primary reasons why I was holding off. I feared having another baby might not be possible.

I'm not necessarily here for advice, but to tell my story. I've been on here for years reading all the posts, recommendations, and stories. Many who have had the surgery and been successful don't come back, well, because they've been able to move and leave this world behind. That's great I hope I can do that but I want to help too. I'm going to promise to write about recovery and even the months following. This is something that has been part of my life, and many of yours for far too long. This is not a decision that comes easy to any of us, but I look at my child and husband and tell myself I want her mommy back and his wife back. I don't want this distant person living in this bubble of hell influencing and impacting their lives in a negative way. I want my daughter and husband to have a mommy/wife that is very present in all that they do. Living in fear of pain and wondering will I be in pain today, will be able to take her to her dance classes, have a nice night out with my husband, travel with my family, do my job well…I can't live with anymore!

My surgery is scheduled for this Friday and my commitment is I will be back and posting to inform and educate. My hope is this is the solution, but I'm also a realist and weighing the consequences and I'll communicate those as well and not give up that there will be a solution that fixes this. To me it's worth the risks for the hope of a better future.

More to come, and thank you all for your support. It doesn't end here.
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Re: LIS surgery scheduled

Postby Broncosgirl » 22 Mar 2015, 08:06

Thank you so much for your post. Congratulations on making your decision and I hope your heal once and for all!

As a new mom who developed a fissude aboit 10 weeks after delivery for similar reasons, it is encouraging to here that this surgery can be recommended for us as I've had one CRS discourage me because of it.

I had a question about your use of nitro and diltiazem. How long did you give them a try? Also, did you use them while breastfeeding at all? Thank you!
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Re: LIS surgery scheduled

Postby NDMK312 » 22 Mar 2015, 09:18

Hi Broncosgirl,

Yes, it does sound like we have had a similar experience. I was reading your posts and wasn't clear if you had surgery this week or not. If you did, please share your experience.

My obgyn said use of nitro and diltiazem while breastfeeding was safe. The reward outweighs the risk. Diltiazem gave me the best results. I had 10 weeks of no pain but as soon as I went off they came right back. This is what clued me into the fact that I might just be too tight down there and may need a more permenant fix.

My CRS referred to the surgery as the "gold standard" for solving fissure issues. It has a 95% overall success right, and her personal rate is even better. Sure there is a chance any of us could be in the 5%. My doctor said the main reason LIS doesn't work is if the CRS was too conservative with the incision. In most cases a second operation will fix it. She seemed confident thought that while conservative she knows he right amount to cut.

I feel like and hope that I'm in good hands. Keep the questions coming. I really want to help others. These things are a nightmare.
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Re: LIS surgery scheduled

Postby chachacha » 22 Mar 2015, 10:19

Thanks for your very informative post. I'm sure that it will help those coming to the forum in the future. I'm 9 weeks past a very successful LIS and it was the best thing I could have done. I consider myself very lucky and am still so thrilled to be living a normal life again. I can't imagine that I'll ever take this new, and totally pain-free life for granted.

All the best to you on Friday, and thanks too, for promising to come back and help others.
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 surgery scheduled

Postby Broncosgirl » 22 Mar 2015, 10:56

Thanks for your quick response to my question! I've been on diltiazem and then nitro for almost 7 weeks with no improvement. Actually, it's feeling a bit worse. How long did you use diltiazem before you had the 10 weeks pain-free?

I did not have the surgery yet. Each time I see my CRS they say "give it another month". I just want this to be over with, but I have only been suffering for 9 weeks as opposed to years. I don't know how long one waits before deciding surgery is the option, especially when there had been no improvement on meds in 7 weeks.
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Re: LIS surgery scheduled

Postby Luka » 22 Mar 2015, 11:01

Thank you for your post. I am considering LIS myself after going through this for over two years now. It comes and goes and this last flare-up has been particularly bad after getting constipated while I was sick with a cold and flu for a few weeks. I'm just getting so tired of it all. My issue is that I don't have health insurance currently (trying to fix that) and my CRS will not answer all my questions about the surgery and won't spend the time to really talk to me about it. He also does fissurectomy along with the LIS, which adds to the recovery time. I've heard adding this along with LIS can make for a brutal recovery, which scares me so much. Will your CRS be doing fissurectomy as well as LIS to remove the scar tissue?

You are very lucky to have found such a wonderful and highly skilled CRS. I am trying to do the same after not being totally satisfied with mine and wanting a second opinion. Please keep us all posted on your surgery experience and journey to being completely healed. I wish you luck! :)
January 2013 - Diagnosed with fissure. Eventually turned chronic.
History of IBS and anxiety disorder, along with fear of using bathrooms other than my own caused it.
Tried Diltiazem, but eventually developed a rash.
LIS surgery scheduled August 26th.
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Re: LIS surgery scheduled

Postby NDMK312 » 22 Mar 2015, 13:54

Hi all,

I apologize if duplicate posts appear at some point. Apparently the site logs you out while responding and then doesn’t post from time to time.

Chachacha – Thank you for posting! I’m so glad to hear you have your life back. Those are the exact words I hope I can say after all of this is over. The CRS said that the incision should heal within 10 days and the fissures before that. I have “kissing fissures” as the CRS says, which means there is one in the front and one in the back. Ugh…it’s brutal. Do share your recovery experience if you can!

Broncosgirl – I actually just got out of pain before starting diltiazem ointment. The CRS recommended staying on it for 6 weeks, but suggested going until 8 weeks slowly weaning off. She said that most fissures should fully heal within 6-8 weeks on these treatments. I went off of it a little past week 8 and then within a week or so was back in pain again. Like I said, this was the turning point for me to say I needed something to relax the muscle better.

There isn’t a recommended timeframe to wait before surgery. They say if it does not hear within the 6-8 week time frame that it might be a chronic, which is what mine became. I was hell bent on curing this the natural way again, but it just doesn’t seem to be happening this time. Probably because I have more than one, and once one opens that area tightens up and then opens the other. Not a fun cycle. I’m actually feeling pretty good right now, and have been for almost a week, but I know they’ll be back so I’m not second-guessing anything even though I am feeling comfortable.


Luka – It does sound like we’re in a similar boat. My CRS does not do a fissurectomy with the LIS. She said the LIS alone should heal the fissures. The previous surgeon that I saw also did not mention doing this with the LIS.

My recommendation is to get a second, and maybe even third opinion. I can’t stress enough that this is a decision you need to come to on your own terms. The doctors aren’t necessarily going to tell you it needs to happen, because it’s not necessarily required, it’s all about your tolerance and what you and the doctor together think is best. The first surgeon I saw wanted to cut me open right away, and gave me a sales pitch of, “don’t you want to eat pizza again without worrying about what it will do to you tomorrow.” That was too aggressive for me, I wanted to make sure I had exhausted every natural remedy possible. I feel that I have at this point.

Ask lots of questions, specifically what their success rates are and how the handle post-op treatment if surgery doesn’t work. As I said, you need to do what you need to do to fee comfortable and confident in this decision. No one can do that but yourself, but you have to ask the right questions to get there.

All - Thank you all for your posts. I will definitely keep you updated. Keep the questions coming. The best thing we can do on here is offer support for one another along with educating and informing.
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Re: LIS surgery scheduled

Postby chachacha » 22 Mar 2015, 14:16

Hi again NDMK312. I posted my success story here about a week ago:

lis-success-for-me-t9369.html
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 surgery scheduled

Postby Luka » 23 Mar 2015, 11:32

Thank you for the quick reply, NDMK312, and for letting me know you're just getting LIS and not fissurectomy as well. I really don't understand why so many CRS's do just LIS and find it heals the fissure(s) just fine, while others also do the fissurectomy, which just adds to post-op pain and recovery time. My current CRS said there's usually scar tissue which needs to be cut away to allow the fissure to heal fully along with the LIS. Other CRS's seem to think that's unnecessary, so it really is confusing to me how CRS's differ so much on that aspect of the surgery. I don't want extra pain during recovery if it's totally unnecessary. :( It seems like I do indeed need to get a second or third opinion as soon as I get some medical insurance in order. I'm just not fully satisfied with my CRS and not totally comfortable with him.

I wish you well with your surgery. Please keep us all posted on how it goes. We're all rooting for you! : )
January 2013 - Diagnosed with fissure. Eventually turned chronic.
History of IBS and anxiety disorder, along with fear of using bathrooms other than my own caused it.
Tried Diltiazem, but eventually developed a rash.
LIS surgery scheduled August 26th.
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Re: LIS surgery scheduled

Postby Broncosgirl » 26 Mar 2015, 20:06

I just wanted to tell you that I hope all goes smoothly tomorrow and that recovery is quick. Thank you for keeping us updated.
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