Problems with my LIS

Desperately need advice from people who have had LIS

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: Problems with my LIS

Postby Jbl22424 » 13 Dec 2014, 00:25

So sorry you are suffering. Can you not get a second opinion from another CRS?
Developed fissure from constipation due to breastfeeding 7 weeks after delivery (Jan 2014)
Nifedepine
Colace
Magnesium
Miralax - godsend
Nitro - some improvement
LIS (May 2014) - cured for 3 months then setback
Diltiazem
Feeling better for now
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Re: Problems with my LIS

Postby Worrier12345 » 13 Dec 2014, 06:28

Hi Jbl,

I don't think a second opinion will help at this point. I need to wait to see the surgeon who did the op, I need to find out what went wrong. Specifically I need to know why a simple LIS operation has left me with what looks to me like a deformed anal opening - and whether I'm now facing a lifetime of faecal incontinence. If I find his answers unsatisfactory (which I expect to be the case) then I will seek a second opinion. Or more likely just give up.
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Re: Problems with my LIS

Postby owmybum » 14 Dec 2014, 08:40

So sorry to hear of your new problems. I have pm'd you.

OMB x
fissure after hem banding and tag removal feb 11
Pelvic floor therapy
Diltiazem
Botox June 13
Nitro
Internal flap July 14
EUA and polyps removed Nov 14
Diagnosed with neuropathy Jan 15
Diagnosed with HS EDS type 3 (causes poor wound healing )
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Re: Problems with my LIS

Postby Worrier12345 » 14 Dec 2014, 12:04

Hi owmybum,

Thanks for your reply - I haven't received any messages though. I'm not sure if that function is working correctly. Could you try again?
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Re: Problems with my LIS

Postby owmybum » 14 Dec 2014, 13:42

So sorry worrier.... I can't find the message I sent you.... I've no idea where it's gone! It must be lost in cyber space!
How are you doing?? I'm sorry you're not coping so well with it all.

OMB x
fissure after hem banding and tag removal feb 11
Pelvic floor therapy
Diltiazem
Botox June 13
Nitro
Internal flap July 14
EUA and polyps removed Nov 14
Diagnosed with neuropathy Jan 15
Diagnosed with HS EDS type 3 (causes poor wound healing )
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Re: Problems with my LIS

Postby Worrier12345 » 14 Dec 2014, 14:34

Hi owmybum,

Thanks for trying anyway.

I'm feeling lower than I've ever felt to be honest with you. Unfortunately I suffer from anxiety problems and this along with the surgery complications is more than I can handle.

I just feel like I have made a mess of my life by pushing for surgery. I should have lived with the fissure, which was not painful like most people's on here, rather than risk lifelong incontinence problems. But I pushed for it anyway, pinning all my hopes that surgery would allow me to live without having to worry about my arse any more. The decision backfired, in the worst possible way for me.

Along with this regret and anger with myself, I also feel pathetic from for not being able to deal with this. Other people have much worse problems than a leaking arsehole - but it's already beaten me. Perhaps I'll snap out of this soon, and learn to live with it. But at the moment I'm finding day to day life a struggle.

Does anyone have any advice for dealing with stool leakage? I'm having a hard time with itching and constantly feeling unclean. Since the fissure hasn't healed either I'm not sure whether I should use barrier cream or not. The hardest thing is cleaning after a bowel movement. It seems I could clean forever - stool gets stuck just inside and around the anus, but as soon as I clean it with wet wipes or shower or whatever, more stool just seeps out. I find the whole process quite distressing.
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Re: Problems with my LIS

Postby Worrier12345 » 14 Dec 2014, 21:13

I'm sorry to keep going on but I'm unable to sleep thinking about all of this. I've been trying to figure out what went wrong, how I've ended up with a misshapen anus from LIS - which is something that I've never come across in the entirety of this board. But I just found a passage in this book which sounds exactly like what has happened. Regarding incontinence due to sphincter damage it state that there are 3 kinds:

"1. If the anal muscular framework is completely divided, then total fecal incontinence is caused.

2. If the muscles of the lower two thirds of the anal canal are cut, and the edges of the sphincter retract, a grooved or "gutter" deformation occurs which can allow fluid or faeces to filter onto the perianal skin.

3. If the internal sphincter is only divided at its lowest part (as in LIS) the anus retains both its shape and length and there should be no loss of control. "

https://books.google.co.uk/books?id=TdH ... =html_text

In all my obsessive, endless research into LIS both before and after the surgery I had not come across anything that mentioned the "retraction" of the sphincter and how it creates a gutter deformity. But this is exactly how my anus looks now. If you look at my previous posts in this thread it matches up with what I was trying to describe.

So if I am understanding what that book says correctly, the surgeon quite simply cut too much and has created a gutter deformity out of which I am now leaking shit.

I am veering between abject misery and anger now. He told me about how simple the procedure was, how it was a small surgery. Yet here I am with an arse that leaks crap because he did it wrong.

I don't know how to feel now. I will see him in 3 weeks for my NHS follow up. He won't be able to deny that something went wrong, will he admit he made a mistake? Does it even matter if he does? My life is now forever changed. He will tell me that I was aware of the risks, and send me on my way. And he will be right, I did know the risks, but I tried to be positive like everyone told me to be. Now I feel like a fool. I chose the surgeon, I chose the surgery, I chose to dismiss the risks.

Sorry for all this negativity. For those reading this who are yet to have surgery - please don't let this affect your decision. The chances are tiny - especially with a good surgeon. Just make sure you really trust your surgeon. And make sure they are up to date on the latest techniques and research on LIS. I wish I could go back and quiz my surgeon on all the things I know now. Perhaps I wouldn't be in such a sorry state now if had.
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Re: Problems with my LIS

Postby hopefulbutt » 16 Dec 2014, 15:09

Worrier, in so sorry about all this. Those of us in pain always think- if rather be too loose than have the pain, but no one wants that either!!do not give up!!! I know there are things they can help people with a sphincter that's been cut or damaged. Try a pelvic floor center, or search for a crs who specialiZes in sphincter repair. It may never be your perfect butt again, but I believe it can get better! I know it sucks and why do some of us have trouble, while others do not- no one will ever know. But keep going! Keep us updated. If science can put a man on the moon, someone can fix your butt! Even if you have to go to the mayo clinic. Also, I've heard the muscle gets tighter and tighter again- I'm a testament to that- even 6 months after I was just as tight if not tighter than ever. Some of it will get stronger!
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Re: Problems with my LIS

Postby hopefulbutt » 16 Dec 2014, 15:12

Also for some ideas from leaking- Amazon sells little butterfly pads for the bum hole that may help. Have you tried a small water enema after you go to really clean out the canal? Maybe if you do, then there will be no more risidual poo coming out. Or a barrier cream for the irritation- calmoseptine?
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Re: Problems with my LIS

Postby Worrier12345 » 19 Dec 2014, 09:44

Hi hopefulbutt,

Thanks for the replies.

I'm going insane here. Quite literally. I'm trapped in a cycle of overcleaning and checking for soiling throughout the whole day. It's taken over my life.

The whole muscle getting tighter thing doesn't fill me with hope. I have no trouble holding in stool or gas - so I don't think the problem has much to do with the muscle. The problem seems to be located at the anal opening, where the incision site has deformed the shape of my anus, making it lopsided with a deep groove that wasn't there before LIS, through which any faeces left in the rectum after a BM slowly leaks out over the course of the day. I'm not sure that the muscle regaining strength will have an effect on this.

I realise that my obsessions have taken over, but it's impossible to keep clean. Small bits of solid stool just hang around the opening, getting stuck in skin folds. It's not like I can even go and just wipe every now and then because it just doesn't clean it well enough. I have to use a mirror and rolled up pieces of toilet paper to remove the bits of stool. I realise that this is excessive, but I don't know what else to do - if I leave it it just becomes itchy and uncomfortable.

The fissure has clearly not healed either. Therefore I am worried about using creams in the area. Does anyone know Calmoseptine is ok to use if you have a fissure. I know that my overcleaning is not helping the fissure heal either - but surely it's better to make sure the area is as clean as possible, rather than having bits of stool around an open fissure? I really don't have a clue as to what is the best way to help things. And I have clearly lost track of what is normal anymore.

My anxieties around this have gone through the roof, and I am struggling to manage. I am feeling quite pathetic and rather lost. I should have expected that surgery wouldn't be the easy solution I was hoping for - and that my fragile mental state would exacerbate any complications that it might cause.

Again, apologies for my pathetic ramblings, I just feel like each day is getting worse and I don't know how to help myself any more.
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