My Story so far

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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My Story so far

Postby FissureFighter80 » 19 Apr 2016, 14:04

Hi All,
I will start by thanking the wonderful people who run this site which is an immense base of information and comfort for all the sufferers like myself.

I am a 35 yo male based in London. I work in IT so sitting in front of computers all day is what I do.
My issues first started about 5 years ago when I got a bad AF and ended up in hospital A&E at midnight because of severe pain. At the time I was given some sort of ointment which didn't really do much and then one thing led to another and I ended up at a BUPA hospital where I was given Botox injections and also had haemorodectomy.

From that point onwards I was mostly pain free but say every 3 months or so would get a painful bowel movement and the pain would last from hours to a few days and then I would get on with normalcy. One thing I always noticed was that when driving long distances I would start getting pains in my rectal region just because of that posture for long periods. Its some thing to do with pressure which I have never completely understood. Anybody else has this?

So we get to about 6 months ago when I again got a bad AF most probably from diarrhea this time. Spent about 2 months in varying levels of some discomfort to absolute agony and eventually ended up in A&E once again. The doctor over there after examination told me the good news that I have AF once again. He prescribed Xyloproct Hydrocortisone 5% and some lactulose. It worked for a couple of weeks then pain came back. I think its also my stupidity of thinking that after being pain free for a week I would assume that the AF is healed and I would go back to my bad habit of eating junk food and not much water etc.

Then I saw Dr Carapeti in London Bridge hospital who prescribed me Rectogesic. It gave me horrible headaches but the AF pain was unbearable so I continued with it. The headaches that were initially quite bad became manageable after a few days. The doctor called me in for an endoscopy and haemorrhoid banding in a couple of weeks which I did and it all went smoothly. By this time I was quite pain free and thought the AF has healed or on its way to healing. But the doctor did warn me after examination that the fissure was still there but I was quite optimistic. Any hoo a week or so after the Endoscopy the fissure came back with a vengeance where once again I would have a BM and then lie down in my bed and roll around in agony for hours trying not to scream and scare my family. I tried working from home for about a week like this but then just took the next week off work. By this time I had had enough so I booked in for a LIS surgery with Dr Carapeti. Luckily I got the date in a few days so went there and got LIS done. By this time I was having thoughts about ending my life due to pain so when told that there is a chance of incontinence I was perfectly okay with it. Infact I went in the surgery mentally prepared to wear adult diapers for the rest of my life. It has now been about 2 weeks since I got LIS done and so far I have minor pain in the surgical wound but have not had the horrendous fissure pain again touch wood. The incontinence is basically soiling of underwear which I am fine with. I just keep some wet wipes in my jacket pocket and use these at work or public places as needed. At home I just wash or take a bath.
Dr Carapeti gave me some Sevredol 10mg(morphine based) pain killer tablets which I used for about first 3 days. These and almost all other strong pain killers cause constipation so need to be used with stool softeners and good dietary habits. NHS website says you will be back to work after 2 days of LIS. This is absolute bollocks and some one retarded wrote this. I was completely bed ridden for the first 3 days. Luckily I had a television infront of me and a toilet close by which is all I needed for first few days. If you are having LIS sleep is very important for healing. Try requesting your doctor for a few sleeping pills for first few days and strong pain killers. You probably wouldnt need them but just incase. Also for the first week or so I religiously took baths every day. After first few days even though I was in discomfort I tried walking around inside my flat as much as I could. It improves blood flow and quickens healing. Dr also said that my skin is just more prone to fissures. I guess its just bad genes. I am hoping that in future if I get AF's atleast they wouldnt cause spasms and heal by themselves. But in any case I am mentally ready for another LIS if and when needed. This time I will go to Dr Windsor to see if he does anything different. F*** fissures.

I found this to be really comprehensive guide on what to expect and do post LIS -> https://myhealth.alberta.ca/Health/afte ... wid=ud1292

After 2 weeks the issues I have are:
- when I walk I have this chaffing feeling + itchiness probably due to the discharge in the bum. I do have a shaved bum so its probably contributing to it. So basically I cannot walk for more than 15 odd minutes at a time. Any one else had similar experience?
- I feel some pain during bowel movements but nothing compared to a fissure pain.
- I have this very dry bum/sphincter feeling constantly. Should I use some sort of cream for this?
- I still have about 15 + 15ml of lactulose a day. Not sure how long I need to keep this going.

Over the years I have experimented with foods so sharing this info for benefit of others.
Foods that make my poo hard:
-nuts specially peanuts
-Junk food specially deep fried chips.
-coconut whether its raw coconut or coconut oil or some thing like a coconut biscuit.
-Too many bananas. I can eat about half a banana comfortably but more than that some times makes things difficult.
-Too much milk and caffeine. I try to stick to like 2 cups of mild tea with small amount of milk a day.
Foods that help me have a good smooth BM:
-Honey added to tea or cereal etc - too much of it causes diarrhea though.
-prunes.
-Figs.
-Fruits such as pears, Apples, Kiwis, plums, nectarines etc.
-Vegs such as carrots, lettuce, cucumber, peas, sweet corn etc.
And stupid amounts of water until my tummy makes funny noises. I find it a sign that its basically dissolving any thing hard in the tummy.

Thanks for reading ... Feel free to ask any questions.

Hope you get well soon :)
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Re: My Story so far

Postby Hopeful1 » 21 Apr 2016, 13:16

Hey there,

"I still have about 15 + 15ml of lactulose a day. Not sure how long I need to keep this going"

My CRS advised me to stay on the Lactulose (and Laxido sachets) until I'm fully healed. He told me 3 months. So I'd advise you to stay on it for as long as you think you need it
Haemorrhoids: for about 8 years - lived with it
Rubber Band Ligation: Spring 2015
Anal Skin Tag Removal: Summer 2015 (missed sentinel pile)
Fissure diagnosed: Aug/Sep 2015
GTN unsuccessful
LIS: 17 March 2016
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Re: My Story so far

Postby FissureFighter80 » 27 Apr 2016, 13:23

Hopeful1, Thanks for the tip. I have reduced lactulose to 15ml one dosage a day as I was scared of becoming used to it. But its all good as I take a big portion of fruit and veg every day + tonnes of water.
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Re: My Story so far

Postby FissureFighter80 » 27 Apr 2016, 13:37

Yesterday I had a 3 week post LIS follow up with Dr Carapeti. He says that the wound is healing too quick for his liking as too fast healing can cause fistula. So in order to re settle the wound he put like a plastic tube thing up my bum which felt quite uncomfortable but as long as it helps proper healing then its good.

He also suggested that I still have an extremely tight sphincter but with any luck even if I get fissures in future they should heal quick enough as LIS is a really good procedure. He recommended that I wash my bum with Epaderm(moisturiser) for a year or so once or twice a day to keep it moisturised.

For info sake my surgical cut for LIS was 1cm long. Dr advised that this is dependent on how big the fissure is but generally considered a standard size cut. He also mentioned that post surgery the swelling within the canal is at max after 2,3 weeks and it takes a good few months for every thing to heal properly.

The leakage/discharge in my bum is now at a minimum. I don't see anything solid in there just a few bits and pieces which are easy enough to wipe off.

So all in all I am quite content with the results. And I also quite like Dr Carapeti. He is very good at explaining things and generally quite a pleasant person.

I will do another update after my next appt to log every thing. Any questions then please feel free to ask.

Thanks,
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Re: My Story so far

Postby Skiponzo » 28 Apr 2016, 09:53

Glad to hear FF80, though the tube up the bum doesn't sound too great. :roll:

I am now at 5 weeks post LIS and everything has been pretty much a linear progression toward full healing until last night. I somehow slightly reinjured myself. There's really no pain to speak of (mainly just a pinching) but it's still a bummer after going about 2 weeks feeling just about totally normal. Oh well, stay the course and let it heal itself up.
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Re: My Story so far

Postby brokenbottom » 11 May 2016, 12:09

I don't like the sound of that tube either! Also the idea that you could heal too quickly is alarming! I haven't got a follow up appointment for another month (that'll be 8 weeks after the op) so I hope all's behaving down there... I've been gradually improving until the last couple of days when I've had pain after BMs that feels like someone has kicked me. No explanation for it - eating and processing things just the same. Who knows eh?

BTW your comments on what the NHS site says about going back to work after two days made me laugh out loud FF! Thanks for that! BB x
Suffered acute AFs since about 2010
2015 Chronic AF diagnosed
18/2/16 Botox (unsuccessful)
12/4/16 Lateral anal sphincterotomy and removal of polyp and two tags
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Re: My Story so far

Postby Hopeful1 » 11 May 2016, 12:53

Wishing you a quick recovery Brokenbottom. I've had so many ups and downs now, it's been one hell of a roller coaster ride and it doesn't feel like there's an end in sight!
Haemorrhoids: for about 8 years - lived with it
Rubber Band Ligation: Spring 2015
Anal Skin Tag Removal: Summer 2015 (missed sentinel pile)
Fissure diagnosed: Aug/Sep 2015
GTN unsuccessful
LIS: 17 March 2016
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Re: My Story so far

Postby brokenbottom » 11 May 2016, 17:23

Thanks Hopeful1! I know what you mean; sometimes it feels endless. But surely there must be some kind of peace at the end of this. Fingers crossed for all of us! BB x
Suffered acute AFs since about 2010
2015 Chronic AF diagnosed
18/2/16 Botox (unsuccessful)
12/4/16 Lateral anal sphincterotomy and removal of polyp and two tags
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Re: My Story so far

Postby Skiponzo » 12 May 2016, 08:36

I don't mean to get all religious or metaphysical about this but I am convinced there is a larger reason behind my getting this ailment. Something other than m,\y diet sucked or I've got a tight ass. Lol!

God was/is trying to teach me something here and it's my lot in life to try and figure it out.
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Re: My Story so far

Postby FissureFighter80 » 02 Jun 2016, 15:52

Hi All,

I am here to do my 2 month update as I had another consultation with Dr Carapeti beginning of this week. I also received a couple of emails by members of this forum which I have no idea how to respond to but thanks very much for that.

So symptoms wise I can poop without any problems. The very first motion in the morning is a tiny bit uncomfortable and also if I sit on hard surfaces like a park bench etc I feel a bit of pain. Probably means the wound is still healing. The size of my poop has become more thinner since I have had LIS, I think its the wound healing and the anus tightening up once again. Dr said to stop Lactulose and start using Fybogel which will make the consistency of motion better. I haven't tried it yet.

All in all I am quite happy to be out of that excruciating pain. It seriously was pain/injury wise the worst thing I have ever had.

After having BM if I go for a walk etc then I feel that I get a bit of discharge down there. And I have to to to toilet again after about 45mins to an hour of BM to re wipe things. I see minimal amount of residue and I guess it should heal one day fully as Dr said that men sphincters are tighter and can heal fully. But I don't really care. Infact I don't want it to heal fully as I have a micro anus. Dr has used this term a few times which made me feel quite bad about myself but this time he said that its not as uncommon as you would think. Anybody else has it? Any recommended surgery / medical procedure to heal this? Dr said that LIS should loosen things up any way but I am still scared.

Any questions fire away :)
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