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Colorectal Diseases

Post-surgery anal fissure problems

11/30/2006

Question:

I had surgery to repair an anal fissure in early September 2006. Specifically, I had a fissurectomy and a lateral internal sphincterotomy.

It`s late November 2006 now, and I`m still having pain, bleeding, and itching. The bleeding is rare, but I itch daily, and usually have pain with bowel movements.

Post-surgery, I did everything I was told to do (sitz baths, Colace, etc.). But, I never healed from my surgery.

I drink plenty of fluids, eat at least 30 grams of fiber daily, and I exercise for 1-2 hours per day. I am in my mid-20s and otherwise extremely healthy. I have had a full colonoscopy, and everything is normal, except for my anus.

The surgery did lessen my symptoms. For example, my itching no longer wakes me up while sleeping, and the pain isn`t as bad. But, I`m not better.

Is it time for another surgery? Why haven`t I healed? Do you have any suggestions?

Please help!

Answer:

Lateral internal sphincterotomy for the treatment of chronic anal fissure/ulcer is successful in relieving symptoms 98% of the time. Reasons for non- healing after fissure surgery- incomplete sphincterotomy; Crohn's disease; poor toileting habits (hard stools, prolonged sitting on the toilet, straining, chronic diarrhea). Ask your surgeon why you haven't healed, and if he or she cannot explain it, seek a second opinion. You may not get the answer- sometimes we just don't know- but a fresh perspective sometimes is very helpful

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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