After surgery questions... sulfadiazine?
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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by missy moo » 25 Aug 2018, 16:32
Maybe speak to your doctor about it my problem is having random hard stools ay certain times of the month. Good luck mate
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by Vdawg » 26 Aug 2018, 09:58
Same problem here. Not able to find the balance between diarrhea and constipation.
I'm 5 days post op (laser LHP and LIS). On day 3, I passed hard stools and had pain. So decided to follow prescription and took 15ml MoM and 2 dulcolax. The next day ended up with diarrhea because I also overdosed on fibre (veggie salad and prunes). After 12 times and mind numbing pain, crawled back to the pain killer - Ultracet (which I had planned to stop on day 4). Now totally confused and worried if I damaged something down there because of the diarrhea. Any of you guys found the right formula for the immediate post op days?
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by PreggoAF » 27 Aug 2018, 05:02
I struggled with the saw thing for some reason and I think it may have had something to do with the pain meds and my attempts to balance those out with too much Miralax. I highly recommend not overdoing the fiber and using a combo of Miralax and magnesium citrate to make everything soft and easy to pass. That’s been my magic formula.
Chronic fissure: January 2018
Diltiazem since Feb 2018
Miralax and Magnesium
LIS, tag removal, hems banded: July 2018
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by PreggoAF » 27 Aug 2018, 05:05
Also just so you know I was thoroughly miserable and depressed early after surgery because I worried that maybe I would never get better but I’m so much better now at nearly 7-weeks post-op. I’m not 100% but there’s no pain. Just more of a light scratchy burning feeling that’s getting less as time goes by.
Chronic fissure: January 2018
Diltiazem since Feb 2018
Miralax and Magnesium
LIS, tag removal, hems banded: July 2018
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by Vdawg » 28 Aug 2018, 01:42
Good to hear that PreggoAF! That gives me hope. I'm on the 6th day post op and there is still significant burning pain after BMs. I went for the first post op visit with my CRS yesterday and she said I'm healing well and the burning pain is because of the laser which will heal gradually and 'settle' in the next 10 days.
She has asked me to stop all laxatives and just be on healthy food and lots of water.
Doc asked me to not do the sitz bath too many times to keep the area dry to avoid infection. Did you have any yellow discharge early on?
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by missy moo » 28 Aug 2018, 02:29
Vdawg
All 3 of the surgeons I've seen and about 5 different doctors have all told me not to use stool softners as it just gets the muscle used to not working using stool softners treating the symptom not the cause the issue is the muscle not a stool problem if you had a stool problem you would know about it you would have hard stools your entire life and have lots of issues not just a fissure its fissure treatment (stool softeners)that creates a muscle issue it's that basic rule if you don't use it you lose it you want to be having a natural stretch of the anal muscle everyday to keep it used to normal bowel movements so if you use stool softener forever one day you may have one random hard stool an retear that's not solving the problem that's just delaying it from birth we all have different sizes and consistency of stools from one day to the other from the day of birth then one day either due to an extra large store or stress or bad diet or lack of water or childbirth we get a fissure then we try to treat it with stool softeners therefore tell the muscle we no longer need it to stretch, it just needs to handle toothpaste consistency then one random day for whatever reason we have a normal sized bowel movement what causes the fissure to retear because the muscle wasn't prepared for normal it was prepared for toothpaste what we need to do is fix the hard large random stool which is likely a once and a lifetime event by going back to regular normal formed stools on a Bristol chart size of 3 to 4.. please Google Bristol stool chart to see what is a normal healthy stool size and consistency. If a friend of mine got a Fisser tomorrow I wouldn't advise stool softeners I would advise to continue to be regular by drinking lots of water eating healthy fibre filled food keep your anal muscle normal don't change your anal muscles normal exercise because it got a little tear from a one-off hard stool if you still can't get regular then add a fibre supplement and more water for a week and see how you go. I've had a fissure for 5 years I know it's not a fun experience I wish everyone the best of luck on this define what works for them on the tuff journey x
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by Vdawg » 28 Aug 2018, 19:52
Thanks a lot Missy! That helps me understand. I am off all laxatives. The doc did not prescribe any during my 5th day post op check. However I forgot to ask about psyllium husk. This morning I've had BM twice - while it's not rock hard, it gets stuck after a little bit (I know some more is there but it doesn't come and I don't wanna strain). I have no option but to stop and go again in sometime. This is a little tiring and annoying. Will psyllium help this situation?
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by JaiShriRam » 28 Aug 2018, 20:19
Hi Vdawg, have you been prescribed any anesthetic ointment ? My CRS gave me Diltiazem to apply before a BM. That relaxes your external sphincter, which in turn AIDS in complete evacuation. Sucral Ano is the ointment. However, sometimes it still does get stuck. You can also try buying an enema douche from Amazon. It really helps. Boil some water and let it cool down to a moderate warmth. Then use the douche. It will give you that complete feeling. Hope this helps.
Are you prescribed any antibiotic ?
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by Vdawg » 29 Aug 2018, 00:02
Thanks Jai... looks like we've both had the same laser procedure. My doc had prescribed Lox 2% jelly (looks like something similar to but not Diltiazem). I did not get to use it in the first 3 days properly as I knew only at the last moment I have a BM coming and have to run. I will try it out today or buy the one you used.
I have gone 6 times today and it's always a small amount and stops. I come out and within an hour I feel another coming. I'm also leaking stool because of this which is super annoying. I am also worried about the wound healing as it's frequently getting wet.
I'm eating South Indian diet with lots of veggies and fruits. No laxatives as of today. Do you think any intake of specific food/supplements will aid a complete evacuation?
Also, I'm exactly a week post op. When did it start improving for you?
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by JaiShriRam » 29 Aug 2018, 09:58
Yes V, we had the same procedure. I had a Skin Tag removal too. So I will give you a brief on my recovery till date. I just started by 6th week today.
Week 1: One word - Horrible ! Crazy pain and burning during BMs. At least 5 to 6 BMs a day. I used to get such sudden cramps that even before I reach the bathroom door I would have soiled my clothes. Even a cup of tea would trigger of a BM. I asked my doc about this and he said it's all normal. I was confined to bed most of the time and felt this is never going to work. Took heavy fiber diet with stool softener and laxatives.
Week 2 : Slight improvement. BM frequency reduced to 3 a day. Cramps reduced a bit. But pain and burning was still there. Sometimes it used to 4/10 and many times it used to be 9/10. Could never understand why the fluctuations. Diet was again same heavy fiber but no Psyllium Husk as it bulks the stool. Bulky stool will cause more muscle cramp and pain.
Week 3: Cramps went away. I could sense when I want to go for a BM. Frequency reduced to 2 a day but those 2 we're within a span of 2 hours. Due to incomplete BM, I used to drink 2 glasses of warm water immediately upon waking up. Then a BM. And again 2 glasses of warm water followed by a tea. This used to trigger the remaining shit in the colon. And before going to office I had emptied everything. Pain was on 4/10
Week 4: Pain came to 7/10. Developed a stupid infection on the skin tag removal site. Started antibiotics again. And fortunately it cleared off in 6 days. BMs were as per week 3.
Week 5 : Pain during BM was 2/10. Mild burning. Started emptying the colon using a enema douche. Was the best decision I made. Felt so good by cleaning the colon up. Skin tag site is still a bit sore but better. BM still doesn't feel normal. It still causes discomfort while pushing things out even if they are soft. I guess muscle is now too sensitive.
Week 6 (day 1) : Same as week 5.
My recommendation : Use sanitary pads for first 2 weeks. Wet farts and stool leakage is common. Keep using Sucral Ano cream as it contains metronidazole (antibacterial) and Lidocaine (anesthetic). It will keep infection away. Stop using pads as soon as you stop seeing the stool particles on the pad. Use enema douche for completing the BM.
This is a long journey. No matter what the doc says. It is not going to be okay in 6 weeks. It is going to take 12 weeks at least. It's an anus, you are disturbing it's healing Everytime you move. It's sensitive. So be patient. That's what I have accepted after lot of frustrating days and nights. Many of them even with tears cause I used to feel so disabled. But there is light at the end of tunnel. Just keep on moving ahead and take good sanitary care.
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