Lateral sphincterotomy op today!!

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: Lateral sphincterotomy op today!!

Postby Danalope » 23 Nov 2022, 12:08

patience_and_healing wrote:Hi Danalope, have you talked to your doctor about the spasms? Maybe he can prescribe something to help you get past this stage. Don't lose hope, your body may be going through an adjustment phase after the surgery, and will settle down with time.

Take lots of probiotics to lessen the number of BMs. I think they're making the area hard to heal. Take care, and try to stay hopeful.


Hi Patience,

Yes spoke to senior nurse at hospital I had surgery at today. She says the cause of the spasms is almost certainly post operative swelling of the sphincter, not due to normal fissure driven spasms. That makes complete sense & her recommendation was to use ice & ibuprofen to bring down the swelling. Done this & pleased to say things have been better today since doing this, so feeling more positive now.

Still getting the sharp burning soreness after bowel motions (another 3 today), but not quite as sharp as yesterday.
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Re: Lateral sphincterotomy op today!!

Postby Danalope » 23 Nov 2022, 12:15

curious350 wrote:Hi Danalope!

Thanks for your follow-up posts! Any tips on keeping the area clean? I want to do everything to prevent an infection/abscess and planned to use a bidet, wet wipes, sitz baths, shower head and blow dryer in that order after a BM. Then, will place a sterile gauze to catch any discharge. What have you been doing?


Hi Curious,

Current tactic which seems to work quite well is bowel motion, followed by very quick pat/gentle wipe with water based baby wipes, then sitz bath for 15 minutes, then I nip in the shower & give a quick 1 minute spray of the area to make sure it’s all properly clean. Next I pat dry & use a cool hairdryer to dry inside bits. Finally new sanitary pad & since today some antiseptic/nappy rash cream (recommended by nurse at hospital), using this to try & reduce post BM soreness a bit.

Hope that helps!
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Re: Lateral sphincterotomy op today!!

Postby Danalope » 24 Nov 2022, 04:37

Day 7 update - 1 week since op!

Currently sitting in sitz bath after 2nd BM of the day, currently still having x3 per day, seems to have become a habit now as timings similar each day, so not sure how I can break it.

Still getting the searing pain after each BM from incision area (I think). Really not sure what to make of it to be honest, best guess is stitched have popped out or dissolved and it’s thus behaving a bit like an acute fissure now in that area, hence agony as poo passes over it & afterwards. Really hope this eases soon though as it’s becoming a bit much. I now have a sitz bath ready to literally jump into once poo is completed. That brings the agony almost instantly back to a more manageable 4/5 out of 10.

Yesterday once 1st 2 BMs were done pain during day generally low 1-2/10, and good news went for a walk & was able to walk at normal pace for 1st time with only very minimal discomfort!! Swelling has eased also so no real spasms at all yesterday or so far today, the frequent ice packs have done the trick there. Overnight minimal blood also just a bit of light brown weeping but best so far in terms of discharge.

So mixed news I guess. I do feel I’m slowly healing, the real problem now is the after poop agony, very keen to see that reduce asap.

Any ideas what this could be? I may phone Surgeons medical secretary to see if she can ask him for a view. I think my guess is probably right though as don’t think it’s an infection or anything (no other symptoms).
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Re: Lateral sphincterotomy op today!!

Postby Rich44 » 25 Nov 2022, 13:53

A word of caution on probiotics and antibiotics. If you have SIBO (Small Intestinal Bacterial Overgrowth) probiotics can make things worse. Antibiotics can also wreak havoc on your gut biome as well. I stopped taking probiotics this past June after taking them daily for over two years (with my gastroenterologist in agreement) and many of my gut/gas/pain issues resolved!

Definitely stay in contact with your surgeon's office about the incision pain. My incision pain was moderate and did fade around 10 days. I was never on any prescription painkillers or antibiotics. I think this should start improving daily for you. Keep up the sitz baths.
Fissure June 2014 - Oct 2020
Botox, skin tag removed - Feb 2015
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LIS, skin tags removed - Oct 2020
Fissure 100% healed - Nov 2020
Still healed as of March 2024
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Re: Lateral sphincterotomy op today!!

Postby Danalope » 25 Nov 2022, 16:33

Day 8 - a good day!

Feel I’ve made a big step forwards today. After 3 x BMs yesterday again took a calculated risk last night, took a codeine tablet before bed to try & slow down food passed through intestines. Had a Movelac to reduce risk of a hard stool, and it worked. Broke the poo on waking cycle & back to pre op poo after breakfast, with just 1 other this afternoon after further codeine tablet this morning.

No further codeine now as hopefully habit broken & don’t want to push my luck - PM poo was harder though just about ok still.

Now to the other good news:

No blood on sanitary pad since last night, first time that’s happened, just a very small amount of brown weeping only.

Sharp/burning incision pain immediately following BM was less agonising this morning 7/10, but this afternoon fell further to maybe 3/10, burning gone more uncomfortable.

Spasms/feeling of needing to go has disappeared last 48 hours, the ice has done the trick so it was just swelling in the sphincter.

General pain between BMs now down to 1/2 out of 10, not much at all just a bit of pulling, pinching around incision area, but much much better.

So feeling much happier tonight, think I’m past the worst now & hoping by next weekend I’ll be in an even better place, perhaps starting running again, but will see.
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Re: Lateral sphincterotomy op today!!

Postby Danalope » 25 Nov 2022, 16:40

Rich44 wrote:A word of caution on probiotics and antibiotics. If you have SIBO (Small Intestinal Bacterial Overgrowth) probiotics can make things worse. Antibiotics can also wreak havoc on your gut biome as well. I stopped taking probiotics this past June after taking them daily for over two years (with my gastroenterologist in agreement) and many of my gut/gas/pain issues resolved!

Definitely stay in contact with your surgeon's office about the incision pain. My incision pain was moderate and did fade around 10 days. I was never on any prescription painkillers or antibiotics. I think this should start improving daily for you. Keep up the sitz baths.
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Re: Lateral sphincterotomy op today!!

Postby Danalope » 25 Nov 2022, 16:40

Rich44 wrote:A word of caution on probiotics and antibiotics. If you have SIBO (Small Intestinal Bacterial Overgrowth) probiotics can make things worse. Antibiotics can also wreak havoc on your gut biome as well. I stopped taking probiotics this past June after taking them daily for over two years (with my gastroenterologist in agreement) and many of my gut/gas/pain issues resolved!

Definitely stay in contact with your surgeon's office about the incision pain. My incision pain was moderate and did fade around 10 days. I was never on any prescription painkillers or antibiotics. I think this should start improving daily for you. Keep up the sitz baths.



Great to hear from you Rich, enjoyed reading your story pre op & how well you did, was just the positive boost needed. The probiotics are just a short term fix to build back my good bacteria levels as think my bowels were struggling with my high fibre diet post antibiotics (lots of wind/painful gas). The latter has now cleared completely but will finish probiotics end of this weekend, no plans to buy any more.

Sitz baths have been a godsend last few days after the searing post bowel movement pain (you did well to avoid that!!), I was literally getting on it as quick as possible to quell the burning pain, it was quite something to endure!
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Re: Lateral sphincterotomy op today!!

Postby Danalope » 27 Nov 2022, 04:01

Day 9/10 update:

Not much change to report, still no further blood in sanitary pad during day or overnight which is good news, some very mild light brown discharge still but much less than in week1 & improving each day.

Off painkillers for 1st day yesterday so slightly more discomfort during day, say 2/3 out of 10 but really not much & less than the gripe I used to get from the fissure.

Post poo torture pain still holding steady around a 7/10, though quickly quelled by the sitz bath I get into straight after. Still have a slightly brutalised feeling for an hour or so post poo, more discomfort than anything around a 4/10, slightly better morning day10 possibly. Had a bit of fresh blood in sitz bath this morning after poo, not too fussed about it though.
Bowel motions still soft & back down to 2 a day now as per before the op. No sign of any spasms.

So overall still moving forwards, big milestone for me will be no more post BM pain or brutalised feeling, hoping that will come over next 7 days, but accept it might end up taking a bit longer. Got some GTN ointment now and also some wound healing cream from Doctor to try & speed things up a bit. Mixing up cold & heat packs now also, emphasis more on heat packs now as swelling much less of an issue, trying to get the blood flowing through the area!!
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Re: Lateral sphincterotomy op today!!

Postby Danalope » 28 Nov 2022, 11:25

Day 11:

A step forwards today, woke in little/no discomfort, minimal overnight discharge, pretty much nothing overnight for last couple of days, still some during day though after bowel movements but this is getting less & less each day and no blood for last 2 days.

Had usual post breakfast poo, much less soreness following it this morning though, immediate sharp soreness now down to 5/10 (was 7 yesterday), this afternoons 2nd down to a 3/10. So seeing real improvements now & think I’m past the worst now when it comes to pain/soreness.

Off work officially till Friday though doing bits & pieces from home now, still can’t sit down comfortably on normal office chair for too long as incision still a bit sore.

Working on rehab now so 3 x sitz baths a day, shower area after each BM also. Then several heat packs to promote blood flow. Using GTN ointment to help with this also. Feeling hopeful now I’ll be largely pain/discomfort free by next weekend, hoping to restart proper exercise (running/gym) at that stage also.
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Re: Lateral sphincterotomy op today!!

Postby Danalope » 30 Nov 2022, 14:01

Day 13:

Not much to say, just slow but steady improvements over the last 2 days.

Bleeding/discharge stopped now since Day11, likely to ditch sanitary pads from tomorrow assuming nothing changes between now & then.

Pain continues to reduce, the acute soreness/burning immediately following bowel movements has reduced from a 7/8 out of 10 a few days ago down to a 3 today. Between BM’s pain around 1/2 so more a slight discomfort now & that reduces as the day goes on.

So really now waiting for pain to completely go so I can restart running, hopefully by this weekend. Sitting down for long periods still a bit uncomfortable, hoping that improves over next few days also.

All in all looking good though.
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