What is a lateral internal sphincterotomy?

A lateral internal sphincterotomy is an operation used to treat chronic anal fissures. This procedure helps improve blood supply and heals fissures by lowering the resting pressure of the internal anal sphincter.

It is a minor operation performed under local or general anesthesia and does not require an extended hospital stay for recovery.

What to expect with a lateral internal sphincterotomy

A lateral internal sphincterotomy becomes an option after you've tried other treatments. If your symptoms remain severe, your doctor may recommend this procedure. 

This treatment happens while you're under either general or local anesthesia. This means you might be fully asleep or in a very calm, sleepy state. Plan to have someone drive you home afterward. While you're relaxed and possibly also asleep, your doctor makes a small cut into the group of muscles that control your bowel movements. This releases the tension in the muscles. When they're tight, that makes it difficult for your fissure to heal.

After the surgery, the strong pain you had before may disappear in a matter of days. It can take up to six weeks for you to heal completely. Be sure to get plenty of rest during this time and try to walk a little bit every day. Drink plenty of fluids and continue to eat a high-fiber diet. Sitz baths, which are shallow warm baths that you sit in, can help you stay comfortable. It's common to see some blood when you move your bowels. Some people have trouble controlling their bowels right after surgery. This can improve as your incisions heal.

Common conditions requiring a lateral internal sphincterotomy

Anal fissures can be extremely painful. They can produce bright red blood when you have a bowel movement. Simple procedures like Botox injections and over-the-counter stool softeners are usually the first treatments. That's because most doctors try to avoid surgery if it's not necessary. However, this procedure can bring relief if nothing else works.

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