(Sphincterectomy, Anal; Surgery for Anal Fissures; Lateral Internal Sphincterotomy; LIS)
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Reasons for Procedure
- Eating a high-fiber diet
- Drinking plenty of fluids
- Using stool softeners
- Taking warm baths
- Using medications applied to the skin
- Inability to control the leakage of gas or stool from the rectum
- Adverse reaction to anesthesia such as lightheadedness, low blood pressure, and wheezing
- Abscess or fistula formation
What to Expect
Prior to Procedure
- Physical exam and health history
- Digital rectal exam—The doctor inserts a lubricated finger into the anus and feels for lumps or abnormalities.
- Anoscopy—A tool is inserted in the anus to allow the doctor to examine the anal canal.
Ask you to take steps to clean out your bowels.
The day before the surgery:
- Eat a light breakfast and lunch.
- Drink clear liquids only after lunch. Clear liquids include items such as water, broth, juices without pulp, popsicles, and clear Jell-O. Talk to your doctor about which liquids are allowed.
- Do not eat or drink after midnight the night before surgery:
- You may also be asked to give yourself an enema to help clean out your bowel. This is a fluid that is introduced into the rectum to encourage bowel movements.
- The day before the surgery:
- Ibuprofen and other non-steroidal anti-inflammatory drugs
- Blood-thinning medications
- Anti-platelet drugs
- Local anesthesia that will only numb the rectal area
- General anesthesia —You will be asleep during the surgery
Description of Procedure
How Long Will It Take?
How Much Will It Hurt?
Keep your rectal area clean:
- Remove your dressing before having a bowel movement.
- Take a sitz bath 3-4 times a day and after each bowel movement. Sitz baths will help relieve discomfort and clean the area. For a sitz bath, sit in warm water for 10-15 minutes. Pat the area dry. Do not wipe or rub. Devices are available to place on top of the toilet to make this process easier.
- For a few days, use alcohol-free baby wipes rather than toilet paper to wipe after bowel movements.
- You will have reddish-yellow drainage from your rectum for a week or more. Use sanitary pads to absorb the drainage. You may have increased bloody discharge after activity or bowel movements.
- If you are taking pain medication, you may need to take a stool softener to prevent constipation . Eating a high-fiber diet can also prevent you from becoming constipated.
- Avoid sitting or standing for more than one hour at a time.
- For the first six weeks, do not lift anything heavier than 10 pounds (4.5 kilograms).
- Resume sexual activity when you feel comfortable.
- Check with your doctor to see when you can return to work
Call Your Doctor
- Large amounts of bleeding from the rectum
- Foul-smelling drainage from the rectum
- Excessive swelling in the rectal area
- Inability to control bowel movements
- Difficulty urinating
American Society of Colon & Rectal Surgeons http://www.fascrs.org
American Academy of Family Physicians http://familydoctor.org/
Canadian Society of Colon and Rectal Surgeons http://www.cscrs.ca
The College of Family Physicians of Canada http://www.cfpc.ca
Anal fissure. American Society of Colon & Rectal Surgeons website. Available at: http://www.fascrs.org/patients/conditions/anal%5Ffissure/ . Updated October 2012. Accessed May 28, 2013.
Anal fissure. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated November 20, 2012. Accessed May 28, 2013.
Anal fissure/fistulotomy/sphincterotomy surgery. University of Wisconsin School of Medicine and Public Health, UW Health website. Available at: http://www.uwhealth.org/healthfacts/B%5FEXTRANET%5FHEALTH%5FINFORMATION-FlexMember-Show%5FPublic%5FHFFY%5F1105646271830.html . Updated April 24, 2013. Accessed May 28, 2013.
Anal fissures. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/disorders/anal%5Ffissures/hic%5Fanal%5Ffissures.aspx . Updated April 19, 2010. Accessed May 28, 2013.
Anal fissures. University of California San Francisco Medical Center website. Available at: http://www.ucsfhealth.org/education/anal%5Ffissures/ . Accessed May 28, 2013.
6/6/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
- Reviewer: Marcin Chwistek, MD; Michael Woods, MD
- Review Date: 05/2013 -
- Update Date: 03/18/2013 -