LIS. To cancel or not?

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. To cancel or not?

Postby Mommaof1 » 29 Sep 2013, 08:35

I just posted in the general discussion, not knowing this topic was here. Sorry.

I have had a chronic extremely painful AF for almost 10 months and FINALLY I have LIS surgery booked in 3 weeks.

However, 3 weeks ago I discovered a laxative that actually works for me and my stools have been amazing and pain free. I *think* things may be healing up in there. I don't want to go off the laxative. I missed my dose last night and this AM, my BM was back to its usual firm/hard gross self. Fortunately it didn't hurt that much. So my question is,

Do I cancel the surgery and keep taking the laxative? Or should I go ahead with surgery anyways? I am wondering if it will still be beneficial, considering things are healing up down there? Im torn at what to do. I can't find any info on this surgery other than the fact that its intention is to stop the spasms so the fissure can heal. Does it benefit you in the future?

Thanks for reading :)
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Re: LIS. To cancel or not?

Postby bumtastic » 29 Sep 2013, 11:11

Hi Mommaof1
I am too early in my recovery phase to give you any solid advice and also different people are different. But i think the surgery will help you in the wrong run. The reason i opted for surgery after three months of suffering was i didnt want to go through this hell (Watch what you are eating, spend 2-3 hours everyday pooping and taking care of your bum and the pain from the spasms...).
If you are unsure and have time on your hand, you can postpone your surgery by a couple of weeks and see if there is any improvement. But you have to realise that even with the right diet and right stools the recovery is usually a slow process. Even with surgery it takes a few weeks to recover.
The surgery does reduce spasms and also improves the blood flow to the area thereby making the healing process faster and also the recurrence rates are lower after the surgery but there is a small associated risk of incontinence.
There are lots of material online and on this forum about the surgery.
for starters:
http://en.wikipedia.org/wiki/Lateral_in ... ncterotomy
Make sure you have enough support for atleast a week of two if you are going ahead with your surgery.
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Re: LIS. To cancel or not?

Postby pinpin » 29 Sep 2013, 12:15

Million dollar question....

Some of us had immediate success with LIS and only regretted they had not surgery earlier.
Some of us but very little left incontinent due to surgeon or another obstacles, and will regret decision they made till end of the life.

So surgery is something you can opt anytime later or sooner, but since you did it you cannot revert it back. This is surgery from "ectomy" category, so it removes something, which never can be restored.

I personally would postpone surgery to heal naturally, but of course it is completely your decision to make.
07.02.2013 - got open hemorrhoidectomy, leaded to slow healing wound. Link to story
11.12.2013 - LIS surgery
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Re: LIS. To cancel or not?

Postby richibeno » 29 Sep 2013, 12:59

If you can heal naturally go for it 'a lot of us on here could not keep up the fluids and stool softners eat well '
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Re: LIS. To cancel or not?

Postby dent1 » 29 Sep 2013, 14:17

The surgeon I saw does not do LIS on any one who may have other pelvic floor damage so I had a VY advancement flap repair instead which seems to have done the trick without the risks of LIS.
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Re: LIS. To cancel or not?

Postby Ever the Optimist » 29 Sep 2013, 15:08

Hi Momma,
I think the question you might also need to ask is what laxative have you been taking? Some laxatives are not designed for long-term use although generally things like movicol/ lactulose/ metamucil (fibogel) can be used quite safely for long periods of time. Stimulant laxatives like Dulcoease/ lax/ Exlax/ Senokot are much harsher and can cause issues with longer term use. If you have been using the latter you will need to stop using them at some point (sooner rather than later) and would your issues then recur? It's really difficult to say!....What other methods have you been trying for healing in the meantime ( as in creams such as Nitro or Diltiziam?).......In your position, I would possibly try to delay the surgery option for a few months more and see how it goes because if you can heal without it, then probably best, but if you continue to have major issues, then I would definitely rethink the surgery route again. It might be really worth a chat with your CRS to see what they think......All the best with your decision!
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Re: LIS. To cancel or not?

Postby Deleted User 2950 » 29 Sep 2013, 16:48

Hi Mommaof1

Sounds like your fissure may have been the result of pregnancy and those hard stools. If you cancel the OP, then that would mean you have to be really careful to keep those stools soft even after you stop taking the laxative.

So another question may be is do you try to do everything possible surgery or not to keep your stools soft. And that would be a yes right? As you say, sounds like if you can just keep your stools soft then healing commences.

There are many here that have the LIS because they are too tight down there and their sphincter muscles always seem to spasm making healing most difficult. Do you think your in this category?

For me if I continued to spasm even with soft bm's and I saw no improvements over the weeks I would probably opt for surgery. But as you say if my "spasming", (if indeed you were spasming much of the time) stopped with soft bm's then yes I too would probably wait to see if natural healing takes place.

Please try to do all you can to minimize hard stools through diet, exersise, water intake, etc. The decision is ultimately yours but a good regime of even heathier practices can go a long way in to avoiding surgery.

GL to you...
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Re: LIS. To cancel or not?

Postby Mommaof1 » 29 Sep 2013, 17:47

Hey! Thanks for all the responses. To answer a few questions:

Ever The Optimist: The lax I am taking is the polyethylene glycol powder (Clearlax in Canada). So obviously if I have to take it long term, I will. Its quite expensive. :( I had tried every cream I could find in the pharmacy, as well as diltiazem which did nothing. I drank H20 ++, other stool softeners/lax (mostly sennakot & colace) both of which did nothing.

Buttastic: I have a bad diet and I KNOW this. I drink water but not nearly as much as I need too. But this is nothing new, which is why I can't understand why all of a sudden I am having this issue with hard stools. I am definitely finding it hard to keep up with a perfect diet. I didn't have any issues before my pregnancy, and I didn't have any hemorrhoids until I pushed that beautiful baby out. lol.

On a side note, I am in Canada and even getting a referral took 10 months, which I finally got after begging my NP to try harder. Which is why it kills me to even consider cancelling.
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Re: LIS. To cancel or not?

Postby Mommaof1 » 29 Sep 2013, 17:48

Also to add: I am 31, a nurse, and not sure if I will be approved for the time off afterwards. Which infuriates me. <---- makes me consider holding off on surgery.
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Re: LIS. To cancel or not?

Postby Deleted User 2950 » 29 Sep 2013, 18:29

Hey Mommaof1

I think our avatars are cousins hey; LOL.

Anyways, I said the same thing as you did, that my diet was the same before I started having hard stools and developed a fissure. I think fissures may just kick in at a certain time or age which seems to be different for every person for whatever reason.

Wow, no time off even after surgery, that's not gonna be fun. Lets hope you get approved right?

GL
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