(Sphincterectomy, Anal; Surgery for Anal Fissures; Lateral Internal Sphincterotomy; LIS)
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Reasons for Procedure
- Eating a High-fiber diets
- Drinking plenty of fluids
- Using stool softeners
- Taking warm baths
- Using topical medicines (applied to the skin)
- Leakage of gas or stool from the rectum
- Adverse reaction to anesthesia (eg, light-headedness, low blood pressure, 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.
The night before surgery:
- Do not eat or drink after midnight the night.
- 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 stimulate bowel movements.
- The day before the surgery:
- Aspirin and other nonsteroidal anti-inflammatory drugs (eg, ibuprofen , naproxen )
- Blood-thinning drugs, such as warfarin (Coumadin)
- Anti-platelet drugs, such as clopidogrel (Plavix)
- Local anesthesia—This 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 medicine, 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
- Unable to control bowel movements
- Difficulty urinating
American Society of Colon & Rectal Surgeons http://www.fascrs.org/
Family Doctor.org 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/Home/
Anal fissure. American Society of Colon & Rectal Surgeons website. Available at: http://www.fascrs.org/patients/conditions/anal%5Ffissure/ . Updated 2008. Accessed January 24, 2011.
Anal fissure. Mayo Clinic website. Available at: http://www.mayoclinic.org/anal-fissure/ . Accessed January 24, 2011.
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 October 2010. Accessed January 24, 2011.
Anal fissures. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/disorders/anal%5Ffissures/hic%5Fanal%5Ffissures.aspx . Accessed January 24, 2010.
Anal fissures. University of California San Francisco Medical Center website. Available at: http://www.ucsfhealth.org/education/anal%5Ffissures/ . Updated October 2010. Accessed January 24, 2011.
Sphincterotomy. Baylor College of Medicine website. Available at: http://www.debakeydepartmentofsurgery.org/home/content.cfm?proc%5Fname=sphincterotomy&content%5Fid=274 . Updated January 2011. Accessed January 24, 2011.
Wood D. Anal Fissure. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated September 2010. Accessed January 24, 2011.
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
- Review Date: 12/2011 -
- Update Date: 12/30/2011 -
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
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