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Anal Discomfort After LIS
I have been experiencing anal discomfort, soreness, and a dull ache for the past 3 years without any bleeding. I underwent LIS surgery for a chronic fissure 1 year ago, and my surgeon later confirmed that the fissure had healed and the sphincter was relaxed.
However, I still experience daily discomfort, especially after bowel movements. The symptoms are usually worse during the day and improve overnight. Applying Lox 2% gel provides some relief.
It's exhausting because one day I'm feeling little to no symptoms, and the next day I'm throbbing and feel sore.
I recently had an anoscopy from a local clinic and attached the images. Can anyone help identify what is visible in these photos? Does this look like a fissure? What issue do I have?
Any insights would be greatly appreciated.
In the photo, anal valve is seen and some degree of local inflammation is seen. Possibly this is the reason you have relief with lignocain gel application and sometimes there is pain. Please consult a general or GI surgeon for examination, required investigations including colonoscopy, culture sensitivity tests, after which the diagnosis would be determined.
Next Steps
consult a general or GI surgeon for investigations.
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Are you still passing hard stool or straining much ? If yes then that might be the cause of pain .
Picture shows redness and ulceration but not fissure (need physical confirmation) . Also need to check anal tone , even if its relaxed ,hard stool may cause pain and discomfort,as per your history of Lignocain reliving pain , anal tone ,might be high .
Next Steps
Consult general
Surgeon to rule out cause of pain
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It appears to be an anal fissure. An anal fissure is a small tear or cut in the skin around the anus, commonly caused by passing hard stools or straining during bowel movements.
So everytime you strain to pass hard stools, you can have a fissure!
Next Steps
Treatment:
* Take a stool softener/laxative as advised to keep the stools soft.
* Apply local lignocaine ointment before passing stools to reduce pain.
* Take a sitz bath 2–3 times a day: sit in a basin or tub containing warm water for about 10–15 minutes each time.
* Most fissures heal within 1–2 weeks with these measures.
To prevent recurrence:
* Follow a high-fibre diet, including plenty of fruits, vegetables, and green leafy vegetables.
* Drink 3–3.5 litres of water daily (unless you have been advised to restrict fluids for another medical condition).
* Include curd/yogurt in your daily diet, as it may help maintain healthy bowel habits.
* Avoid straining during bowel movements and try not to delay the urge to pass stools.
Health Tips
If the pain, bleeding, or constipation persists despite treatment, please consult a surgeon for further evaluation.
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