I had my LIS in July 2011 and still suffering with a tight, clinched butt when I need to #2. I take Miralax every morning and I take stool softener every night before I go to bed. I eat properly and I drink plenty of water. My body wants to #2 and tells me to go to the restroom, but my muscle down there doesn't chill out and allow for the process to take place. I sometimes get minor blood when I strain to get the poop out, but the discomfort only lasts for a few minutes. The pain is maybe 1/10 of the torture I had pre-LIS. I have nitro cream if necessary, but haven't used it since pre-LIS plus the headache ruins my day. My specialist seems quick to go back to surgery and doesn't have other options for me. My insurance stinks and I really don't want to shell out another $2000 for another surgery that might not correct the tightness. Any suggestions?

Maybe your doc thought it better to cut too little rather than too much? A few people do need another LIS to totally fix the tightness.
Could you ask to try diltiazem instead of the nitro, it doesn't seem to give the headaches to as many people as the nitro does.Or as I do myself, you could pop a pain pill half an hour before using the nitro, and/or use it just before you go to sleep.

Hi....it could be also a pelvic floor disorder....in this case the sphincter closes instead relaxing during having a BM.
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I'm not familiar with the pelvic floor dysfunction so can't really offer any insight there. I'm inclined to think perhaps your surgeon was a little too conservative out of caution. As Val said, some folks needs a little extra help. I hope you can get it resolved soon. Seems like at the very least your surgeon would be willing to go back in at a reduced rate given the circumstances.