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Anal fibrosis or stenosis
I underwent a laser haemorrhoidectomy in 2022 but the piles didn't shrink completely even after surgery. I reached out to the doctor in 2022, but he said it would shrink, but it didn't. Now for the last 6-7 months, I'm facing difficulties in passing the stools even after on laxatives which might be due to fibrosis or stenosis as I can feel my sphincters could get relaxed that's why I failed to clear my bowels.Please guide me what are possible treatment available for the including immediate and long-term term
Answers (5)
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Use smuth/cremagel ointment and using a finger glove, daily twice dilate try to dilate your sphincter. It might work. And do kegels exercise. It strengthens your pelvic floor muscles and helps yu to push out stools easily.
Next Steps
try this. dietary fibre and hydration. if it doesn't settle, see a surgeon.
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you can try this only if it's not bleeding now.
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Get direct per rectal examination and find out grading for haemarroids
It may be treated surgically
Check for Complete blood picture as this leads to anaemia
Use soft diet, more fluids, fibre rich food, avoid constipation
Next Steps
Use Anobliss ointment, Cremaffin syrup 30ml (Only if u are passing air or flatus on that particular day), Pain killers only when pain is intolerable
Health Tips
Take Sitz bath, fibre rich foods like green leafy vegetables, avoid high protein diet like non-vegetarian diet,Hot spicy foods
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Meet A General Surgeon for Per rectal examination with proctoscopy
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Use anal dilator ,syrup lactulose 30 ml hs
, ointment lignocaine with nifedipine local application ,and sitz bath for two time a day in lukewarm water,eat easily digestible food
Next Steps
do this for ten days
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Dr. Rajasekar Selvarajan
General Surgeon
15 yrs exp
Chennai
Dear all,
This is nothing but the "IATROGENIC FISSURE IN ANO"
Let us compare the Fissure I ano with Post Haemorrhoidectomy status
FISSURE IN ANO
Superficial Mucosal breach in the perianal region, itself is intolerable with agonizing burning pain
During Haemorrhoidectomy, we are cutting perianal mucosa along with severing of sphincters invariably, which may extend from minimal to severe depending upon the competency & experience of the surgeon.
However we are injuring anal sphincters, which is not avoidable, i.e we are creating deep fissures at 3 sites.
For proper healing of this wound, patients may require periodic and continuous follow up minimum on a weekly basis for the next 3 months. If it is not done, severed mucosa and sphincters goes for chronic inflammatory fibrosis and anal stenosis, which may cause severe symptoms
The follow up is tackled with proper PR examination, anal dilatation if needed along with CCB blockers for L/A
I used to follow "LATERAL SPHINCTEROTOMY ALONG WITH HAEMORRHOIDECTOMY" in advance to avoid future Anal stenosis/ IATROGENIC FISSURE induced complications
However this patient may need one more surgery to alleviate the symptoms . This will be confirmed only after proper PR, if needed Proctoscopy.
Next Steps
Kindly consult qualified and competent Surgeon
Thank you
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.