My Anal Fissure and Sphincterotomy Surgery

 


What is an Anal Fissure?

An anal fissure is a tear in the skin of the anal muscle.  When this happens, I may have pain during bowel movement and pass stool with blood.

 


What is a Sphincterotomy?

Sphincterotomy is a surgical operation to allows a fissure or piles to heal.  A small part of the anal sphincter muscle is cut to open the anal canal.  This relieves pressure when I move my bowels and allows a fissure to heal.

 


Preparation Before Surgery:

An important part of preparing for surgery is emptying my stomach. I need to buy 1 bottle - Magnesium Citrate 10 oz. and 2 Fleets Phosphate enemas.  You can buy these at a pharmacy.  You do not need a prescription.


Eat lightly for breakfast and lunch.


Drink only clear liquids after lunch until midnight (I may drink as much as I want). Examples of clear liquids :

  • Soup
  • Juice without pulp: grape, apple or cranberry
  • Water
  • Carbonated beverages, clear sodas
  • Weak coffee or tea, no milk or creamer, sugar or substitute okay

At 2 pm, drink Magnesium Citrate 5 oz. (1 bottle).

I showered after every bowel movement.

I continued to drink only clear liquids until midnight.


The morning of surgery, before I come to the hospital, give myself the first enema 1? hours before I leave home.

I gave myself the second enema 1 hour before I leave home.  Shower after results of the second enema.


Food to Avoid

 

  • No alcoholic beverages of any kind
  • Chips
  • Peanuts
  • No dairy products of any kind

After SurgeryRectal Care

  •     Abstain hard wiping of the anal area for the first few days.  Do not use toilet paper, instead, use alcohol-free baby wipes.
  •     Take a sitz bath at least 3-4 times a day and after each bowel movement.  This will help reduce the pain of rectal spasms and aid healing. Sit in a bathtub of warm water for 10-20 minutes.
  •     I need to take a stool softener and laxative such as Metamucil to prevent constipation, while on pain medicine.
  •     I will have reddish-yellow drainage from the rectum for at least 7-14 days.  I will need mini-pads or sanitary pads for my undergarments during this time.  The drainage will reduce in amount and become lighter in color.
  •    With bowel movements and increased activity I may notice an increase of bloody drainage.


Activities

  •     For the first 6 weeks, do not lift more than 10 pounds.  Lifting puts extra strain on the surgical area and increases the chances of bleeding.
  •     Abstain sitting or standing for longer than 1 hour at a time.
  •     Do not drive while on narcotic pain medicine.
  •     Sexual activity may be resumed when I am comfortable.
  •     Check with my doctor before returning to work.
  •     I will return to see my surgeon 1 - 3 weeks after surgery.


Pain Medicine

Do not drink alcoholic beverages, drive a car or operate machinery while I am on the prescribed pain medicine.

My doctor ordered pain medicine for me. 


Constipation

Both a fiber supplement and a stool softener will be ordered for me.

I should prevent constipation while I am taking pain medicine. 

These will help the stool pass more easily.


Diet

Eat a well-balanced, high fiber diet each day:

  •     At least 4 portions of fruits and vegetables.
  •     At least 4 portions of breads and cereals (2 of these should be whole grain).
  •     8-10 (8 oz) glasses of non-caffeinated fluid.


When to Call the Doctor

 

  •     Incontinence (unable to control bowel movements).
  •     Foul-smelling discharge.
  •     Trouble passing urine.
  •     Excessive swelling in the rectal area.
  •     Breaking open of suture line.
  •     Big amounts of blood from the rectum that does not stop with pressure to the rectum for 10 minutes.
  •     Temperature over 100.4º F for 2 readings taken 4 hours apart.
  •   Take my temperature once a day for a week.