Lateral Internal Sphincterotomy: What to Expect at Home

Your Recovery

Lateral internal sphincterotomy is surgery to help heal an anal fissure that has not improved with medicine or other treatments. Most people notice that the pain from an anal fissure goes away within a few days after the surgery.

You may be worried about having a bowel movement after your surgery. You will likely have some pain with bowel movements at first, but it should be less than what you had before the surgery. You may notice some blood on your toilet paper after you have a bowel movement for the first few weeks after surgery. You can make your bowel movements less painful by getting enough fiber and fluids. And you can use stool softeners or laxatives. Sitting in warm water (sitz bath) after bowel movements will also help.

Most people can go back to work and their normal routine 1 to 2 weeks after surgery. It will probably take about 6 weeks for your anus to completely heal. Most people get better without any problems. But a small number of people have problems controlling stools when they pass gas. This usually gets better with time.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

How can you care for yourself at home?

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Be as active as you can. It can help prevent problems and help you recover. Walking is a good option for many.
• Ask your doctor when you can drive again.
• Most people are able to return to work 1 to 2 weeks after surgery.
• Shower as usual. Pat your anal area dry with a towel when you are done.
• Ask your doctor when it is okay for you to have sex.

Diet

• You can eat your normal diet.
• Drink plenty of fluids (unless your doctor has told you not to).
• Include high-fiber foods, such as fruits, vegetables, beans, and whole grains, in your diet each day.
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. Your doctor may suggest a fiber supplement, a stool softener, or a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. The doctor will also give you instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Be safe with medicines. Read and follow all instructions on the label.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • Store your prescription pain medicines where no one else can get to them. When you are done using them, dispose of them quickly and safely. Your local pharmacy or hospital may have a drop-off site.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.

Other instructions

• After a bowel movement, use a baby wipe, take a shower, or sit in a few inches of warm water (sitz bath) to gently clean the anal area.
• Sit in a sitz bath for 15 to 20 minutes 3 times a day. Then pat the area dry. Do this as long as you have pain in your anal area.
• Support your feet with a small step stool when you sit on the toilet. This helps flex your hips and places your pelvis in a squatting position. This can make bowel movements easier after surgery.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

• You passed out (lost consciousness).
• You are short of breath.

Contact your doctor now or seek immediate medical care if:

• You have nausea or vomiting and cannot keep down fluids.
• You have signs of a blood clot in your leg (called a deep vein thrombosis), such as:
  • Pain in your calf, back of the knee, thigh, or groin.
  • Swelling in the leg or groin.
  • A color change on the leg or groin. The skin may be reddish or purplish.
• You have signs of infection, such as:
  • Increased pain, swelling, warmth, or redness.
  • Red streaks leading from the area.
  • Pus draining from the area.
  • A fever.
• You cannot pass stools or gas.
• You have pain that does not get better after you take your pain medicine.

Watch closely for any changes in your health and be sure to contact your doctor if you have any problems.