To get LIS or no?

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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To get LIS or no?

Postby layla18 » 07 Nov 2018, 16:37

Hello all,

I've been reading through this forum for a while, and now feel it's time I've made a post of my own. My fissure has been around for a year now, and the past few months were going great. My stools are consistently soft (I'm on Miralax and stool softeners) and my diet is the best it's ever been. I've also been on Nitro since my fissure was professionally diagnosed (about 6 months ago), and do at least 2 sitz baths a day. I hadn't seen any bleeding or felt any sharp pain since July (3 months ago), but today out of nowhere, there was blood in my stool (although my diet has not changed at all) and the familiar pain returned. This has been an ongoing cycle for the past year- things go well, then I have a setback that pulls me into depression. I'm now seriously considering LIS, but the only thing that holds me back is that I'm a very young female (21 years old), and the incontinence risk scares me to death. At the same time though, I'm realizing that if this thing hasn't healed up for a year, my odds are slim to none without surgery. Do you guys think I should wait it out a little longer with hopes that things will get better, or go forth with getting surgery? I just want my life back. I'm actually holding back tears as I write this. Any advice is appreciated, thank you all so much!!!
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Re: To get LIS or no?

Postby chachacha » 07 Nov 2018, 17:28

Where are you located? If you're in the UK, I might hesitate, because the surgeons there don't perform a lot of LIS procedures. Many good surgeons in the U.S. and Canada though, do a lot of them and have very, very low rates of incontinence. My own surgeon, for example, has never had one in his 30-odd years of having become accredited. He also only has heard of one case in his hospital (again over a very long time-span), and that was only gas incontinence.

Wherever you are though, you need to seek out a surgeon whose specialty is colo-rectal issues and one who has a great track record.
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: To get LIS or no?

Postby layla18 » 07 Nov 2018, 17:41

I am located in the US, and my CRS is board certified in Colorectal Surgery, as well as General Surgery. He hasn't pushed the surgery on me, which I was thankful for, and pretty much left it up to me to decide. Now that decision is completely consuming me! Constant back and forth :(
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Re: To get LIS or no?

Postby chachacha » 07 Nov 2018, 18:07

It will be a hard decision to make, but at least you'll be in good hands if you go ahead with it. For me, even though I was terrified of even the remotest of possibly bad outcomes, my fissure finally got to the point that I simply had no quality of life at all. Basically, the decision was made for me.
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: To get LIS or no?

Postby Thorgrim » 08 Nov 2018, 21:28

Hey layla, I am a 30 year old male in the US, I got LIS done 28 days ago tomorrow. My fissures sounds a lot like yours- had it for about a year off and on (that I know of), I was never in a lot of pain but it was always in the back of mind. When I made the decision to get surgery I was in zero pain, but I actually saw it for the first time and had been trying all kinds of creams and baths. Its possible that I have had a fissure off and on since I was around your age, I have felt the broken glass feeling every now and then for years. I am very healthy otherwise, and believe I was just given a small butthole, which lead to a fissure.

I really would recommend the surgery, now that I am getting better, its becoming very apparent that I was compensating for a lot of things when I had my fissure. A few tips on surgery- I would find a surgeon that you really trust, my surgeon is a rockstar, he is totally confident in his abilities. Second, find out the kind of cut they will be performing, they will either cut you from the outside of your anus or the inside of your anus. The outside cut is less invasive, heals faster, and has lower complication rates, it is the preferred method of a doctor that knows what they are doing. I would also opt for a closed over open LIS. My surgeon performed the surgery I described on me, and I felt okay after a week, I was able to walk around for about an hour and go back to work on limited duty. Incontinence is very low, personally this did not scare me at all, I was much more worried about an infection, which also has pretty low occurrence, unless you have an IBD. You might have some leakage after the surgery but that is a maybe, the surgery was a walk in the park for the most part, I think having wisdom teeth removed is worse, and I survived without any painkillers.

There is a lot of other info I could share with you on things I felt made my surgery and healing more successful, but this should help you with your decision. I wish I had gotten it done earlier. Best of luck!
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Re: To get LIS or no?

Postby layla18 » 09 Nov 2018, 19:58

Thank you so much for your amazing advice. It truly means a lot, and has really opened my mind up to the possibility that maybe surgery really is the best way to go for me. I’m so happy to hear that it’s all worked out for you!
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