Tag or Pile after LIS Surgery?

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Tag or Pile after LIS Surgery?

Postby fissures_can_suck_it » 30 May 2015, 11:19

Hello All, I had an anal sphincterotomy for my fissure and removal of two sentinel piles over a week ago. Recovery has been very rough (some good/some bad days). I am also 19 weeks pregnant, so I cannot take pain killers or use any topical ointment.

The pain now happens when I have a BM. The 3rd thru 7th day of recovery I had horrible constipation, even though I take fiber, stool softener, drink plenty of water and eat fruits/veggies. The spasms after the BM last for several hours.

Then, yesterday I started to feel something "down there". It felt like something was forming, and when i tried to get a better look it resembles a small pile or tag (kinda like a tiny flesh pebble). This morning when I had my BM, I could feel the pain stemming from the stool passing that area where the tag is. Has anyone had a similar experience? I have been religious with my sitz baths and they help after each BM. But now I am worried I have another pile, when I just went through surgery to remove two! Sorry for babbling, just stressed and feeling very hopeless. I honestly wish I never did the surgery.
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Re: Tag or Pile after LIS Surgery?

Postby msimon » 30 May 2015, 12:59

What colour is it? Where is it located (ie., near the incision site)?
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: Tag or Pile after LIS Surgery?

Postby fissures_can_suck_it » 30 May 2015, 13:44

Hi Msimon, its hard to get a good look since im pregnant and cant bend over all the way. Yesterday when i looked i thought it had a white head but when i looked today i think its flesh colored. I am not sure if its on the incision site or not, but def in that general area.
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Re: Tag or Pile after LIS Surgery?

Postby msimon » 30 May 2015, 17:42

Not to alarm you but I had an abscess form at the incision site. If it does happen is usually happens in the first week or so. Does the area feel hot at all? Do you have a fever? It could of course just be a tag. Tags can grow down there in response to trauma. They usually settle down on their own after the area heals.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: Tag or Pile after LIS Surgery?

Postby msimon » 30 May 2015, 17:44

I know you said you can't take ibuprofen but what about a topical anesthetic like lidocaine...can you use that when pregnant?
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: Tag or Pile after LIS Surgery?

Postby fissures_can_suck_it » 30 May 2015, 21:01

No fever and its only painful during BM. I don't think I can take lidocaine while pregnant. If it is a tag, do they normally go away? I had two sentinel piles that were removed during surgery, and those two were quite large. This one is very tiny.
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Re: Tag or Pile after LIS Surgery?

Postby msimon » 30 May 2015, 22:14

They can go away, especially if they are small. Sometimes they become permanent but asymptomatic after you heal from surgery. One thing I found soothing is witch hazel. You put it on a cotton ball and dab it on the area. It's good at reducing swelling and skin irritation. Should be available at any health food store.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: Tag or Pile after LIS Surgery?

Postby chachacha » 31 May 2015, 10:05

I had one sentinel pile before LIS and my doctor said it was better to leave it be, rather than remove it. Immediately after the surgery however, I developed 3 more tags, one of which was extremely tender, and would become very sore even if a corner of the toilet tissue touched it. That one, according to my husband, looked a bit white, was smaller, and almost looked like a pimple. Over a few weeks time, it gradually became less and less painful, and now only hurts if I wipe right on it and without being careful. That pain is very minor, and can be completely avoided as long as I'm careful while wiping, so I am not at all unhappy with the outcome. I had years and years of completely debilitating pain with my fissure, so am now over the moon that I can poop like a normal person and not have 15 hours of screaming pain afterward. I go to the toilet now, have a poop, and then go on with my day! It is so totally amazing to me still and I had the surgery back in January. My doctor told me that the old tag, and the new ones are permanent though, and while I'm not thrilled to have them, the trade-off was WAY more than worth it.
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
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Re: Tag or Pile after LIS Surgery?

Postby fissures_can_suck_it » 31 May 2015, 13:09

Thanks for the feedback. My BMs are just awful. I still have to strain because it still feels very "tight" down there. The stool itself is soft which is what is frustrating. I thought surgery was supposed to loosen it, no?
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Re: Tag or Pile after LIS Surgery?

Postby chachacha » 31 May 2015, 15:29

One of the difficulties of this surgery is cutting the right amount of tissue out of the sphincter. If the surgeon cuts too little, the procedure won't work, but if he/she cuts too much, there's a risk of incontinence. My stools still require a bit of a push from me, but I'm definitely looser with flatulence. Not that it will escape unbidden, but I do seem to pass gas more easily and almost always when I sit down on the toilet, even for a pee.

You are so freshly out of surgery though, so I wouldn't judge things yet, or worry about them. Let your body take more time to heal (especially since you can't take painkillers or anti-inflammatories), and keep up the good diet and sitz baths (I was doing 4 a day for the first couple of weeks).

Fingers crossed that you'll be back in completely good health very soon.
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
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