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Colorectal Diseases

Recovery from sphincterotomy/fissurectomy

12/21/2009

Question:

Hello. I am 23 years old and I suffered from an anal fissure for 10 months. I tried many forms of treatment and finally decided on surgery to relieve the intense pain (the pain was a 10 on a scale from 1-10). I had my surgery 5 days ago. I have had 4 bowel movements since the surgery and I am still in a lot of pain. My Doctor told me that the pain caused by the fissure would be relieved immediately, but it doesn`t feel like that is the case. I also have had pain from the incision constantly throughout the day since the surgery; it is hard to walk, sit, sleep, etc. I took Vikodin for the first two days but decided to stop do to very hard stools, I have been taking Advil to try to control the pain but it doesn’t really help that much. The first three bowel movements after surgery were very painful because they were quite hard and I had to strain to get it out (even though I have been taking fiber supplements, drinking a lot of water and taking stool softeners since the surgery). The fourth bowel movement was softer but there was still a lot of pain. There is hardly any blood. I am not sure if the pain is from the fissure or from the incision. My Doctor made me believe that the pain would be gone almost immediately from the fissure so I expected recovery to be a breeze, but so far that has not been the case. I opted for the surgery to get rid of the intense pain during bowel movements, but the pain is still persisting. Is it normal to be in this much pain still? How long will it take for the pain from the incision to go away? Once that pain is gone, will I still have pain from the fissure? Or will I be pain free? I’m in a lot of pain and I need help.

Answer:

I tell patients they will be in pain from the surgery for about 2 weeks, and the fissure will take several weeks to heal as well. In my experience pain relief is not immediate. Best to keep your bowel movements VERY soft at this time- use an over the counter laxative like polyethylene glycol, and powdered fiber- to help (as long as you have no other medical contraindications for their use).

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Response by:

Janice Frederick Rafferty, MD Janice Frederick Rafferty, MD
Professor of Surgery
Chief of Colorectal Surgery Division
College of Medicine
University of Cincinnati