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Hi to all. I am looking for some advice regarding sphincteroromy.
I had a sphincterotomy 12 days ago for a cronic anal fissure. I had a haemorhoid operation many years ago and also a sphincterotomy about 10 years ago for a similar condition both of which I recovered fine from.

Anyway, on the day of the surgery, my surgeon said I had a lateral internal sphincterotomy. He suggested that it should take 6 weeks to heal.

My problem is that in the days following surgery, I did not feel too bad. Some pain from site of the sphincterotomy, as well as some from the site of the fissure. There was also some bleeding but not excessive. After a few days it stopped bleeding and I thiought I was on the road to recovery.

In the last two days however, the bleeding has started again in earnest. I have to wear a pad so prevent soiling. Also, I am in a lot of pain which is coming from the site of the fissure . My heart is in my mouth as now I am very worried that I am not healing and the bleeding is really worrying.

I did not get constipated at all so I am puzzled at this backward step. Please can anyone that may have had a similar problem let me know what you think... Also, any other advice or info would be greatly appreciated.

Rgds
Gerry
Hi to you and thanks for taking the time to reply. I did talk to the surgeon last week and he gave me a perscription for Scheriproct ointment. This has helped enormously with the pain as he said that it was most likely inflamation causing the upset.

Not a great day today, the fissure sure isnt gone, but he did tell me last week when I spoke to him that I was worrying prematurely and that he would expect some bleeding at this stage. He said I could have 3 or 4 more weeks ahead of me before I really am over the majority of the pain etc. He did also say that it can take even longer for a fissure to completely heal. He said that even though you may no longer have symptoms, the fissure may not be totally healed for several months.
Hello, and I'm glad you got my reply - and thank you for replying to my reply.

Well, I guess there's no easy, quick road to recovering from this type of ordeal - but at least you've been able to talk with your doc and get something to help with the pain. --- The bleeding is just such an unnerving thing, IMO.

I went in this past Monday and had a doctor (in my crs's building) talk to me about my bleeding - which has been absent for the past two days. Anyway, my crs is overseas, on military duty for three months - so I can't see him until July, which is why I had to see a different doctor. Anyhow, the guy on Monday didn't examine me internally, but he looked at the general exterior area and didn't see anything awry. He said that, because I had an LIS and a fissurectomy, the area had undergone a "trauma" (that must be surgeon talk for saying the area is delicate) and that it probably got irritated - abraded - because of my constipation. --- So, I am back on Miralax and two stool softeners, per day.

A friend of mine, who recently had an LIS, said that his crs told him that completely sphincter healing takes about a year. So, we need a lot more time to fully recover.

I just want to heal, and I know you do, too. I will continue to pray for all of us who are going through this type of recovery. It can be extremely trying and emotionally tough.

Take care, and keep me posted as to your recovery.
No problem , will stay in touch, I guess all the online forums about no pain or bleeding 3 or 4 days after LIS are some peoples experiences however I suspect that those of us who have different experiences to them are more reluctant to go online and voice our concerns for some reason. Its nice however to talk to someone who has been in the same boat as myself. As for me, I have woken to the fact that it will be a long drawn out process and that there will be ups and downs along the way...

I wish you all the very best too and its been very helpfull to talk with you. I will stay in touch.
I wish you the very best, too. I said an afternoon prayer for your (our) healing included.

ITA, this is a long, drawn-out process that will surely take a lot of time and patience, before we feel healed. I really have ups and downs - and I'm just trying not to lose my mind over this whole thing. I had months of horrendous fissure pain, and now I'm trying to cope with the post-op recovery, which has been more difficult that I anticipated or hoped it would be.

We gotta hang in there. Yes, please keep me posted. It helps to have the support of others - just to know that someone else out there is going through the same thing.
Hi again, its me, your suffering buddy in Europe. Hope your keeping well, I would love to hear how you are getting on. As for me, well unfortunately the news is not good. I really dont think the fissure has healed at all. I get some good days and some really awful ones with occasional bleeding (bear in mind that its seven weeks today). I am waiting for my CRS to get back to me as I want to meet him in his surgery with my wife in attendance. (Unfortunately, the stress that this is causing me is also affecting her and we need to make some decisions soon)

As I probably said before, I have had previous operations in the anal area so I really think that this latest fissure may be the final straw and the amount of internal scarring in my rectum will prevent any permenent healing. I did speek to my CRS two weeks ago and he suggested botox injections but as I have had these before I opted for sphincterotomy. I fail to see how they could possibly help me now.

Truth is, I am so desperate, depressed, stressed that I am even at the point of considering a colostomy, just so my wife and I can go back to leading a normal life again. (I know that for me, no pueing means no pain so thats my reasoning)

Sorry if this mail is a bit disjointd but given my state of mind right now, I guess its not too bad :)

Again, hope your well...

G
Just want to let people know of my experiences.

Very briefly suffered from anal itching for decades and discomfort in that area since about 2003.

In the months leading to June 2010 the discomfort turned to a lot of pain - mostly referred into hip, upper buttock and running down leg into knee. I was passing a lot of mucus after bowel movements. Also groin and right testicule pain - all pain on right hand side only and was constant which was not good.

After finally seeing a doctor at end of June 2010 I was referred to the hospital for investigation but with various cancellations by them it took 14 weeks to have this done by a qualified nurse - she looked at the first 12 inches of the back passage - she took biopsies etc but said everything looked perfect.

I waited until the end of January 2011 to see the consultant who was desperate to discharge me as nothing had been found apart from a cyst in my right testicule that was picked up in an ultrasound I also had. Insisting that he examine me he found an anal fissure for which he said would have been driving me up the wall - how true!

Over the following months tried the ointment then Botox injections but nothing helped - finally consultant agreed I needed the surgery and have the LIS - after saying I could go private this was done within 3 days!

Terrible pain for a few weeks after op but was willing to put up with that but now 6 weeks after I have just had a bad bowel movement and a bowl full of blood and whilst pain had been improving now it is back and worse - hoping this pain is temporary and seeing consultant in 6 days so at least good timing to get his take on this.

I still have right testicule pain but this was getting more tolerable until this happened - both areas of pain seem to magnify the overall pain I am dealing with.

I am presently off work as I mainly sit and it is all problem solving etc and having pain and taking tramadol is not good - tramadol does not take much pain away but helps mentally to cope albeit turns me into a virtual zombie.

I could go into a lot more detail but this is basically me at the moment - I will post back with progress to help others.
IMO, recovery from this type of surgery (of the anal sort) takes a lot of time for some people.

You're still early into your recovery - and I'm 2 1/2 months past my surgery and am still having some discomfort and soreness.

I'll pray for your healing andy speedy recovery. Are you taking anything - like a softener or laxative - to keep things moving easily?

BTW, when I've had my sorest moments down there, it's also been uncomfortable for me in the urinary area. I think that everything is so close together down there, that pain in one area might affect the other area.
[QUOTE=Tweetums;4963658]IMO, recovery from this type of surgery (of the anal sort) takes a lot of time for some people.

You're still early into your recovery - and I'm 2 1/2 months past my surgery and am still having some discomfort and soreness.

I'll pray for your healing andy speedy recovery. Are you taking anything - like a softener or laxative - to keep things moving easily?

BTW, when I've had my sorest moments down there, it's also been uncomfortable for me in the urinary area. I think that everything is so close together down there, that pain in one area might affect the other area.[/QUOTE]


I have started taking the laxative again but yesterday due to this my bowel movement felt like it might be my last - dramatic but the agony is that bad -been bad like that a few times now as its very difficult to judge the quantity of laxative needed as variety of diet each day and number of tramadol taken all play a part.

Bottom line for me is that most bowel movements seem ok as my pain is generally 24/7 anyway but that is probably down to the delay on going to the doctor and the lengthy delay in getting any diagnosis - I read on another forum that you have to push and not take no for an answer hence my consultant did find something and it only took him seconds to see just what was going iro the anal fissure.

Glad my consultant visit is only next week as I am starting to worry about work - I have good sick leave entitlement but you never know what Human Resources are thinking etc.
[QUOTE=andmaz777;4963680]I have started taking the laxative again but yesterday due to this my bowel movement felt like it might be my last - dramatic but the agony is that bad -been bad like that a few times now as its very difficult to judge the quantity of laxative needed as variety of diet each day and number of tramadol taken all play a part.

Bottom line for me is that most bowel movements seem ok as my pain is generally 24/7 anyway but that is probably down to the delay on going to the doctor and the lengthy delay in getting any diagnosis - I read on another forum that you have to push and not take no for an answer hence my consultant did find something and it only took him seconds to see just what was going iro the anal fissure.

Glad my consultant visit is only next week as I am starting to worry about work - I have good sick leave entitlement but you never know what Human Resources are thinking etc.[/QUOTE]

I don't know what country you're in, but I'm in the western part of the U.S. - and I always get in to see any crs, very quickly - usually within a week. One time, I was in pain and called for an appt., and I was seen within the hour.

So, yes, push for your best interests!

The thing about the pain is that, like in my case, it has gone on forever -- however, in stages. I feel discomfort right now, but it's actually more in the surrounding muscle - perhaps bone area down there, somewhere - and my anal area isn't bad at all. HOWEVER, it's taken me nearly three months to get to this point - and I'm still not pain free.

It just takes a long time -- and that's the general consensus out there, especially if you had more than a LIS done. I had both a LIS and a fissurectomy, which has made for a challenging recovery.

As to balancing the diet/fiber/softener . . . I know exactly what you mean. I've been doing that dance here, too, trying to find the right "formula." So, what works best for me is fiber cereal in the morning, fiber supplement (mixed in water) at noon, and Miralax at night. For now, that's my program, because it's working. At some point, I do hope to cut back on the Miralax, but my crs said I'd probably need the fiber supplement for the rest of my life.

Whatever works. Whatever makes me heal and keeps my bottom okay, that's what I'll do. --- Anyhow, you're in my prayers!
I live in England and have relied on the NHS upto having the LIS.

The NHS is frantastic but the great British tradition of queing is not good when you are poorly.

Luckily for me my employer changed private health provider giving me the chance to join covering existing conditions - this I have to pay for but its cheaper than paying privately on my own and worth dramatically speeding up the whole process.

Today I have my bowel movements under control and all I did was increase my bran intake. Also most of my pain today is in my upper buttock and hip both on the right hand side.

I have just spoken to my boss and he was very understanding so that has put my mind at ease for now concerning work.

I will report back on Tuesday when the consultant has seen me.

Heres hoping we all are pain free very soon!
I saw my crs yesterday - and I also have pain in the right upper buttock and hip. My crs said that, even though I'm female, I have no padding on my bottom - which he says most females have. He advised me to sit on a pillow -- but he did ask if the pain is in my rectum, and I said it was not . . . and I don't think it is, but it's sometimes hard to tell. When the pain kicks in, it's really a "pain soup" down there.

He didn't see anything else . . . so, I really don't know how I'm doing. It just seems like it's taking an awfully long time to heal.

Yes, please report back. I wish us, all, pain-free and healthy bottoms and futures.
I saw my crs yesterday - and I also have pain in the right upper buttock and hip. My crs said that, even though I'm female, I have no padding on my bottom - which he says most females have. He advised me to sit on a pillow -- but he did ask if the pain is in my rectum, and I said it was not . . . and I don't think it is, but it's sometimes hard to tell. When the pain kicks in, it's really a "pain soup" down there.

He didn't see anything else . . . so, I really don't know how I'm doing. It just seems like it's taking an awfully long time to heal.

Yes, please report back. I wish us, all, pain-free and healthy bottoms and futures.
Saw consultant yesterday - he did an examination and said that part of the fissure had healed but the bit that had not had discharge.

He said that the upper buttock and hip pain is not caused by the fissure - before I had the set back with the bleeding this pain was significantly reduced so I personally think it must be linked.

Anyway I have another appointment in 6 weeks fingers crossed it is healed and then that problem can be crossed off the list of possible causes of pain - I am praying that most of the pain is gone but realistically very much doubt it.
I'm still having pain and some discomfort. At this point, I don't know when I'll heal.

I have to take my mother on a long trip next week . . . I'm very concerned about how I'll manage myself. Hopefully, I'll do okay. I'll try my best. I really feel that I need another 2-3 months, before I make this kind of trip . . . but it can't wait. My mother is now 85.

ITA with you about pain/fissure being connected with the hip and bottom pain. What else could it be? --- So, you wait for six weeks and then go back . . . I hope you do okay and get better. Keep us informed.
[QUOTE=andmaz777;4963513]
I am presently off work as I mainly sit and it is all problem solving etc and having pain and taking tramadol is not good - tramadol does not take much pain away but helps mentally to cope albeit turns me into a virtual zombie.
[/QUOTE]

Hi, did your Dr. discuss the dangers of Tramadol with you?


kat
[QUOTE=katlin09;4969006]It's not safe. Tramadol is extremely addictive, it causes grand mal seizures, its easy to overdose on. It is one of the hardest drugs to detox off of. It also has Anti-depressant qualities, so if your taking any other psych meds you run the risk of Serotonin Syndrome. It's really not a safe med.[/QUOTE]

I take no other meds other than ibuprofen and paracetomol.

Current daily dosage is 100mg 2 to 3 times a day - what are the overdose fresh holds?

Completely agree with the addictive qualities - when reducing the dosage I not only have an increase in pain but terrible headaches and a general feeling of what could be described as depression!
The max recommended daily dosage is between 300 - 400mg, depending on age and type of pain. I've seen many chronic pain patients that are being prescribed way over that. I was prescribed way over that when I took it years ago, I OD'd on it, had Grand Mal Seizures from it, now have a lovely seizure disorder from it....it's a drug that never should have made it on the market. When you get into fullblown withdrawals the RLS and generally restlessness/anxiety/tremors almost make you insane, you feel like your going to climb right out your own skin.

kat
I had LIS and Fissurectomy 2 years ago and still suffer with occasional pain and discomfort, according to my CRS this is to be expected in some patients while the majority completely recover and heal there is a minority that can suffer for life with bouts of pain from the fissure site and/or where the sphincter was cut, I shouldn't really complain since I'm about 95% pain free most of the time, before the op I was in constant pain so LIS has actually helped me a lot though I'm still disappointed that I wasn't one of the "majority" ..

Anyone that has had fissure or hemmorhoid surgery should expect a long slow recovery with multiple set backs along the way, this is because of the sheer amount of nerve endings in the anus making it such a delicate area to perform surgery on, for those of you that are only in the first 6 months post-op, you may still have a long road in front of you, don't expect too much too soon, one day at a time...
Went to see Colorectal consultant about 2 weeks go - he can see no sign of the fissure now so all healed and I am now discharged.

Great but to be honest if there is any reduction in pain it's no more than 10% but really it's probably exactly the same - it could be that the effects of the fissure may take a lot longer to go heal but the consultant again said that the pain I have is not related to the fissure.

As my lumbar spine scan came back indicating that it is perfect I am struggling to know where to turn next - do not want to keep taking tramadol and codeine forever especially as they have minimal impact on the actual pain but at the moment they are all I have to keep me sane!

Requested an Occupational Health consultation to see if they can help as they will hopefully look at getting me cured rather than treat the symptoms - however I am not pinning all my hopes on this and expect that seeing a pain management specialist may come next - I could go to see a chiropractor now but that could be a bad thing to do!
[QUOTE=andmaz777;5082662]Went to see Colorectal consultant about 2 weeks go - he can see no sign of the fissure now so all healed and I am now discharged.

Great but to be honest if there is any reduction in pain it's no more than 10% but really it's probably exactly the same - it could be that the effects of the fissure may take a lot longer to go heal but the consultant again said that the pain I have is not related to the fissure.

As my lumbar spine scan came back indicating that it is perfect I am struggling to know where to turn next - do not want to keep taking tramadol and codeine forever especially as they have minimal impact on the actual pain but at the moment they are all I have to keep me sane!

Requested an Occupational Health consultation to see if they can help as they will hopefully look at getting me cured rather than treat the symptoms - however I am not pinning all my hopes on this and expect that seeing a pain management specialist may come next - I could go to see a chiropractor now but that could be a bad thing to do![/QUOTE]

When did you have your bottom surgery, andmaz? I had mine at the first of February (this year), and it's taken me a long time to feel significantly better down below. I'm finally at the point where it doesn't bother me much at all, anymore - but boy, I had months of post-surgery discomfort!

Maybe you need more time to heal . . .
[QUOTE=Tweetums;5083766]When did you have your bottom surgery, andmaz? I had mine at the first of February (this year), and it's taken me a long time to feel significantly better down below. I'm finally at the point where it doesn't bother me much at all, anymore - but boy, I had months of post-surgery discomfort!

Maybe you need more time to heal . . .[/QUOTE]


Had mine done on 1 March this year but overall pain about the same.

Just to the right of the anus feels very itchy and possibily describe it as sore - not sure if pain is coming from here or not it is so difficult to tell for sure.
[QUOTE=andmaz777;5083873]Had mine done on 1 March this year but overall pain about the same.

Just to the right of the anus feels very itchy and possibily describe it as sore - not sure if pain is coming from here or not it is so difficult to tell for sure.[/QUOTE]

And have you gotten any CRS opinions about what this lingering discomfort could possibly be?

I tell ya, these CRS guys are all different! My first two weren't any good at all, with regard to my fissure. The third CRS did the surgery - but I needed a fourth CRS to treat me while #3 was overseas - and as a result, I discovered that #4 was probably better (certainly more understanding and sympathetic) than #3!

I'm seeing CRS #4 now, for any problems I might have. But it's been a very long journey to get to this point, and I've had to go through alot of doctors, too, to get to this point.

Don't give up! Get as many opinions as you possibly can, because maybe one of those doctors can help you out, more than the others have. That's what happened in my case. The first CRS didn't even see the fissure - and the second CRS told me to live with it!
[QUOTE=Tweetums;5083948]And have you gotten any CRS opinions about what this lingering discomfort could possibly be?

I tell ya, these CRS guys are all different! My first two weren't any good at all, with regard to my fissure. The third CRS did the surgery - but I needed a fourth CRS to treat me while #3 was overseas - and as a result, I discovered that #4 was probably better (certainly more understanding and sympathetic) than #3!

I'm seeing CRS #4 now, for any problems I might have. But it's been a very long journey to get to this point, and I've had to go through alot of doctors, too, to get to this point.

Don't give up! Get as many opinions as you possibly can, because maybe one of those doctors can help you out, more than the others have. That's what happened in my case. The first CRS didn't even see the fissure - and the second CRS told me to live with it![/QUOTE]


Well Occupational Health consultation is next on my list - if that is mostly unhelpful then pain management then will regather my thoughts and try second opinions. Everything the Urologist suggested I had already tried so definitely want a second opinion in that area but this time will not go in doped up on 100mg of Tramadol - thought he was going to order a battery of tests but nothing in the end as I got the impression he thought I was making everything up - why would I do that when I am not claiming any benefits and working best I can?

It could be by the time pain management has been given sufficient time my pain may reduce but unlikely. If the anal fissure is not the cause of my pain as the consultant says then there will be not improvement as that is the only thing that has been treated.

I keep thinking that I may feel better mentally if I stop slowly the prescription painkillers but every time I try there are really bad days when the dose has to increase and its all back to square one!

One things for sure working full time means zero life during the week - at the weekend it's ok as we do things then in the afternoon have a lazy few hours - not going to do anything drastic yet but eventually may need to change priorities albeit it is good mentally getting into work.

I worked 7 days a week for years on not great money so it is difficult now to think I may have to only work a few days - I may have some tough decisions to make eventually.
Well I have been goin gback and forth with what exactly my issues are.

The Consultant back in October 2012 confirmed that the anal fissure was fully healed but I was still experiencing anal itching - that symptom is just been treated using ointment and it does work but hardly the permenant solution.

I have seen a Chiropractor as alot of my pain which is 24/7 is in my lower back/upper buttock on the right hand side - he advised that my right leg was 15mm shorter than my left mainly due to right pelvis being out - after adjustments that discepancy is down to 5mm but it does keep coming back out - regardless there is little differerence in percieved pain albeit whilst adjustment are being made there is improvement.

I came to the conclusion that I will continue with the Chiropractor once I had seen an Orphopedic Spinal consultant - problem with Chriropractor is that I would need this everyday to get the relief I want and at £34 a time its expensive long term!

So Orphopedic Consultant is being seen in 10 days time - hoping he will be able to explain my back pain and right testicular pain and possibly anal pain - now and again I do have external anal pain as well as itching which is worrying as after 3 years they are still none the wiser.

Bad news is that my GP has warned I may come out of the Orphopedic consultation with merely a "label"!!! worrying stuff - it amazes me that experts do not understand pain and how to control it.
[QUOTE=andmaz777;5173981]Well I have been goin gback and forth with what exactly my issues are.

The Consultant back in October 2012 confirmed that the anal fissure was fully healed but I was still experiencing anal itching - that symptom is just been treated using ointment and it does work but hardly the permenant solution.

I have seen a Chiropractor as alot of my pain which is 24/7 is in my lower back/upper buttock on the right hand side - he advised that my right leg was 15mm shorter than my left mainly due to right pelvis being out - after adjustments that discepancy is down to 5mm but it does keep coming back out - regardless there is little differerence in percieved pain albeit whilst adjustment are being made there is improvement.

I came to the conclusion that I will continue with the Chiropractor once I had seen an Orphopedic Spinal consultant - problem with Chriropractor is that I would need this everyday to get the relief I want and at £34 a time its expensive long term!

So Orphopedic Consultant is being seen in 10 days time - hoping he will be able to explain my back pain and right testicular pain and possibly anal pain - now and again I do have external anal pain as well as itching which is worrying as after 3 years they are still none the wiser.

Bad news is that my GP has warned I may come out of the Orphopedic consultation with merely a "label"!!! worrying stuff - it amazes me that experts do not understand pain and how to control it.[/QUOTE]

I hope you get some answers - and solutions! - andmaz. It seems that these "doctors" don't always have answers or solutions, and half the time they don't know what's going on, to begin with.

Bodily pains and itching, etc., can be maddening - and seemingly, without obvious cause. I have an itchy spot to the side of my right foot - and there's nothing there. Nothing. Sometimes I'll go months and that spot won't itch - then, other times it drives me crazy with the itching. Nothing has been found there.

Let us know about your progress. For me, the fissure/surgery seemed to open a floodgate of various symptoms, problems, etc. Maybe it's just that time is catching up to me.

Good luck and take care! Keep us posted.
[QUOTE=andmaz777;4964895]I live in England and have relied on the NHS upto having the LIS.

The NHS is frantastic but the great British tradition of queing is not good when you are poorly.

Luckily for me my employer changed private health provider giving me the chance to join covering existing conditions - this I have to pay for but its cheaper than paying privately on my own and worth dramatically speeding up the whole process.

Today I have my bowel movements under control and all I did was increase my bran intake. Also most of my pain today is in my upper buttock and hip both on the right hand side.

I have just spoken to my boss and he was very understanding so that has put my mind at ease for now concerning work.

I will report back on Tuesday when the consultant has seen me.

Heres hoping we all are pain free very soon![/QUOTE]
What was the operation for? Isn't your sphincter numb do you have an urge to go? I have a non relaxing anal shincter been through bio feedback and things got worse now my rectum is numb, I go by using miralax but I still leave a lot in the rectum and I'm backed up to the assending colon.and I also have problems urinating. I too have butt pain that runs down my leg when sitting on stool. It seems to tense me up. Did this procedure give your urge back? Wonder if this could help me? Please explain what lead to this. Thank Terlin





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