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Colorectal Diseases

Rectal surgery won`t heal

10/08/2007

Question:

I had a thrombose external hemorrhoid and an anal fissure. The surgeon removed the hemorrhoid and went through that opening to do a sphincterotomy. The operation was successful in curing the hemorrhoid and opening the sphincter but I still have intense pain for 6 to 12 hours after a BM, all at the site of the incision.

The surgery was six months ago and there has been no progress for the last four. Have tried Nifedipine, diltiazem and use a glycerin suppository before passing. What should this 59 year-old male do next?

Answer:

You should be examined for completeness of sphincterotomy and absence of Crohn's disease. Barring this, you need to aim for soft "fluffy" stools that are easy to pass, minimizing trauma to the anal canal. This is often possible with 30 grams of insoluble fiber each day, with 90 ounces of water intake.

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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