What does this mean?

Post-LIS muscle tightening?

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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What does this mean?

Postby msimon » 30 Aug 2014, 16:25

For those of you who have had the LIS surgery, what does it mean when you say your muscle tightens up again? How is this possible if the muscle is severed? Is it maybe that other muscles tighten up in response (like maybe the external sphincter)? Just wondering as I find the botox into the internal sphincter for me causes my external sphincter to tighten up. Weird. And it makes BMs more difficult as a result...
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: What does this mean?

Postby Jbl22424 » 30 Aug 2014, 16:58

The LIS cut loosens the muscle right away and then it starts to regain strength again over time. For example, right after LIS gas escapes you without sound and you cannot control it. Within a few days you have control of gas again. I think the muscle continues to gain tone for several months up to a year after LIS.
Developed fissure from constipation due to breastfeeding 7 weeks after delivery (Jan 2014)
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Miralax - godsend
Nitro - some improvement
LIS (May 2014) - cured for 3 months then setback
Diltiazem
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Re: What does this mean?

Postby msimon » 30 Aug 2014, 18:15

You mean the part of the muscle above the cut gains tone? Because my understanding is that the severed part is permanently severed and the muscle can no longer contract in that section. Maybe the increase is an overall increase in tone attributed to other muscles compensating?
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: What does this mean?

Postby Jbl22424 » 31 Aug 2014, 12:26

Hm... I just assumed the severed piece reattaches when it heals (they stitch it back together during surgery) and regains strength over time. That is an assumption, though.
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
User avatar
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Re: What does this mean?

Postby Roidsfizzman » 31 Aug 2014, 13:29

The internal sphincter muscle is an involuntary muscle that is closed in the resting position and the muscle prevents gas leakage and a water stool to pass until it is BM time. Many of us with a fissure have to push to activate/open the internal sphincter muscle at BM time because this muscle has a high resting pressure and this muscle often prevents the fissure from healing. The internal sphincter muscle is not severed with LIS surgery a nick is cut into the muscle and it weakens the muscle to relax spasms, allow more blood flow to the anal area, and passing of stools without pushing. After LIS, over the course of the first year some of the cut muscle re-heals and the muscle gains strength, but not to the original strength as the entire muscle does not re-attach. With LIS there are two cuts a conservative cut the length of the fissure and a more aggressive longer cut to the Dentate line.
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Re: What does this mean?

Postby Savaici » 31 Aug 2014, 13:41

Like any other muscle in our bodies, it recovers; likewise in a LIS. It just reduces the pressure giving the fissure time to recover. To sever the muscle would not be good for continance. Thanks for that great description, Rhoidsfizzman
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Re: What does this mean?

Postby msimon » 31 Aug 2014, 23:32

Thanks guys. What I actually meant to say is the the muscle is severed ONLY AT A CERTAIN LEVEL. My CRS says he usually cuts the bottom third. SO you are saying that making a cut at the bottom will weaken the whole length of the muscle? How would it reattach after being cut, this is really possible?
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
msimon
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