Lateral Internal Sphincterotomy (LIS) | Anal fissure surgery

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DISCLAIMER: This video is purely educational and does not constitute medical advice. The content of this video is my personal opinion and not that of my employer(s). Use of this information is at your own risk. Albert Chung, M.D. will not assume any liability for any direct or indirect losses or damages that may result from the use of the information contained in this video including but not limited to economic loss, injury, illness, or death.

[@edwinnyakundi8267]

I had LIS surgery and thank to my doctor I am now getting better I was suffering with chronic fissure for 3years and the surgery did magic

[@Jotunn91]

Wow bro I feel for you! I dealt with it for 3 months and the pain was so bad I couldn't sleep so I couldn't work then I finally got my surgery today and the pain I feel now is less than what I was feeling. I can't imagine 3 years you are strong, brother!

[@pasqualedevita6146]

I appreciate your knowledge but I suffered for more than 20 years and tried everything you suggested and more. Once I had my sphincterotomy I had instant pain relief after the surgery. The recovery was less painful than the actual pain I was suffering. I'm 3 months post op. The best surgery I ever had. Would do it all again in a heart beat. Wish I had it done 20 years ago. It's a life changing surgery.

[@oussamadjabali9306]

i hope you are doing okey

[@johnfranklin5204]

Hi...are you able to hold ur gas n poop post surgery n recovery

[@pasqualedevita6146]

Hi John, yes I can. No issues.

[@johnfranklin5204]

I underwent this surgery yesterday..laser method...but the pain post surgery was unbearable...inspiite of pain killers the pain didn't subside... how was your experience...my spasm was +++ and had a big ulcer (cut)....after 8weeks of medications my condition didn't improve....hence opted for the surgery...is it a good move or should I waited for few more weeks of recovery....pain was severe while passing stool...infact was on liquid n semi liquid diet along with fibre powder n stool softners only...condition didn't improve....pls share ur experience to the road to LIS

[@pasqualedevita6146]

Had a good post op experience. Instant relief. Traditional LIS performed. Not familiar with laser procedure. Wish you a speedy recovery.

[@bojanbozovic9200]

I wish there is more doctors like you. Thank you ♡

[@zenobiabrown7383]

You give awesome, straight forward and easy to understand information. Thank you so much! Everyone should subscribe to your channel.

[@majorhelmet2101]

I'm in my 20's and this is really good current information, thank you

[@hipshot823]

Thanks again Doc for your informative video. I'm sure there's a lot more than 10,000 people that are watching your videos and getting help from them. Congratulations on your milestone!🤯👏👏😁

[@yourfriendlyproctologist]

I appreciate that!

[@trusteezy]

Thank you for your honesty

[@Ram44]

Very nice video Dr. Chung. I had my LIS after 6 years of dealing with my AF in the fall of 2020. I actually refused to fill the Rx for painkillers after the surgery because they can cause constipation and I felt confident the post-op pain would not be any worse than what I had endured for 6 years (and I was right - there was minimal pain). I was pretty much back to normal life within 10-12 days and when I saw my CRS three weeks post-surgery he said the fissure was completely healed. Now it's been over 2.5 years later and still no issues. Going to the bathroom is always normal like the good ol days. Glad I had my surgery done here in Chicago by a top colorectal surgeon. This is not one I would trust to just anyone. Be mindful of who you see. There is no way I would see a general surgeon for this. I should also mention to those that say have a high fiber diet to cure it. Not everyone can tolerate too much fiber or probiotics. I have issues with trapped gas pain and when I stopped fiber and probiotics, my gas pains were 90% cleared up. I tested positive for SIBO (Small Intestinal Bacterial Overgrowth) and anything that produces gas can aggravate it. So it is not one size fits all. In terms of treating any NEW fissures - yes, they can occasionally happen - that has been relatively easy for me. If I ever have one I immediately do 2-3 warm sitz baths that same day. That alone seems to relax the area and it heals up the same day. If I have a situation where I am straining to have a BM (very rare) and I realize it may tear me up really bad (not to mention it's dangerous to strain period) I will use my index finger and insert it gently to break up the large stool. But it always works. No blood, no pain, no problems. The threat of incontinence is always there but I got my life back - the pain was simply unbearable at times and 6 years of suffering was long enough. Everyone is different.

[@pinkychowdhury8235]

Name of the doctor

[@Lu-uk9jt]

Can you tell the name of the doctor ? I need to see him because I have a chronic fissure for many years.

[@erigelavani4162]

Thanks for your information dr Chung

[@grillguy3845]

Wow that was so helpful. Dr. Chung, I'm meeting with my colon & rectal surgeon at Beth Israel Deaconess Medical Center in Boston tomorrow. I felt as you gave me such a different perspective on the surgery. Sounds to me like it's a diet lifestyle change and make every attempt to stay away from the surgery. I've had a laparoscopic sigmoid colectomy due to diverticulitis about 10 months ago and now I have a fissure...unfortunately. Thank you so much and I wish you well.

[@kathcares]

10K better-educated people thanks to you!🎉 I can't even begin to tell how much you've improved my life, and certainly many of your subscribers. Multiply that 10K by even .1% and you have permanently changed the lives of 1,000 people for the better! Thank you for putting in the work to educate us. It's a tough topic, but you make it easier!🤓👍💖

[@yourfriendlyproctologist]

Thank you so much! I'm so glad you're better!

[@cathyduong5709]

Thanks for your information, it's very helpful,.

[@vijayalakshmip4339]

Always your speech gives me more clarity and confidence to come out of this painful thing. Congratulations for your 10k.

[@yourfriendlyproctologist]

Wow, thank you! Wish you the best.

[@dog24]

hi vijaylaxmi how are you now please reply 😢

[@namuliregina2156]

Very good doctor and teacher as well .I was about to do surgery but am reconsidering it

[@sudheerk82]

Thank you so much Dr

[@nawafaloufi6843]

I was looking for Dr to help me not to getting money for surgery.thank u

[@klenovicaklen657]

Thank you. Great content.

[@yourfriendlyproctologist]

Glad it was helpful!

[@praveenbandi4184]

I had gone through LIS recently, good to hear about surgery theoretically. Dr Chung, your videos are really helpful to so many people who are suffering with this silently as they can’t talk about it openly

[@christopherbeltran7697]

Does LIS surgery hurt a lot afterwards?

[@likhitha6038]

Hi how is your fissure now and what operation did u done?

[@user-ni1he8qv6u]

how r u now praveenbandi4184??

[@lillsjul]

I was pain free for about 4 years after LIS. Then recurrence. LIS gave me years of pain free life, and now I want to have it done again. It was worth it ! I think when doctors feel like failures, they start laying it on the patient - it's your diet, it's your stress, it's your depression, you, you, you. When I hear that, I know this doctor is not a good surgeon but a dietician. Because by the time I go to a SURGEON I've already googled and tried all things and know all that a patient can do better than the doctor because of personal experience while they just read a book. If I need diet advice, I would go to a DIETICIAN.

[@shhunya]

generally, it shouldn’t occur post sphincterotomy. if it has, it should go away with conservative methods, definitely

[@Ram44]

I have had the LIS. I have had a few minor fissures pop up but there were gone by the next day and no pain. If you ever have another fissure, you should be able to treat it immediately the same day because it's an acute tear and it hasn't become chronic yet. When I have a BM, I try to relax and not push or strain. I will do a few sitz baths the same day and that should do it. I treat it no different than a simple cut on my finger. I put a band-aid on the finger, I do sitz bath for my anus. Fortunately it is rare that I have any fissures anymore but I am confident they will not be a problem ever again.

[@likhitha6038]

Hi the now the fissure which has reoccured got healed?

[@likhitha6038]

​@@Ram44 Hi which operation did u have ?

[@user-ni1he8qv6u]

@@Ram44hi Ram44, did you have burning and pain before LIS??

[@shravanyalala]

Thank you Doc!! Can you help us understand with a video management of mild incontinence post LIS. I have had it a few years ago and have mild incontinence now. Thank you!!

[@roccocamarillo]

Can't a fissure be repaired with external suture to help secure from opening during the healing process. Sorry if this is a dumb question. I just have always wondered.

[@coolsid04]

Thankyou for the information Doc. Are the cuts (from where blade is inserted to cut the internal spincter) stiched ?

[@norcell1001]

Thank you so much Doc..

[@yourfriendlyproctologist]

Most welcome!

[@tunisientun]

hello Dr, is it possible that a chronic fissure is less painful than an acute fissure? I no longer have the pains of the fissure but simply discomfort with constipation and narrow stools.

[@thurgrime5037]

After pushing myself hard, i had to go through 2 fissures and few internal hemorroids this year. First doc suggested immediate surgery, second one suggested disciplined life for 4-5 months. i took the second one. Processing high fiber diet is a bit more difficult for digestion system. When you increase your diet with fiber(prebiotics), you need alot more water and probiotics(yoghurt/kefir/vinegar,pickle) to process those fibers well in your intestines. Don't lighten your stomach acid by drinking water right before or during or righ after your meals, its important for digestion quality and killing harmfull microbes in your stomach come by your food. Eating less didnt help me, eating enough but correct helped me(i visit a dietician). When i had pain after a bowel movement in the morning once or twice a week bcuz of hard stool, i take half a laxative pill before i sleep to make sure stool is softer next morning. Took 1 whole pill if its really hard and had bleeding, but whole pill caused to go to bathroom more than once and late ones are almost liquid, so half pill was ok. Creams, oils and pelvic floor exercises are nice, gives you temporary comfort. But only steady soft stool everyday heals it. its been few months im ok, i started going to gym again, weight lifting and running. I still have no courage to try eating snacks or whatever i want though. I can't have that pain back, it already paused my life for months. Dr. Chung and good other few good channels help a lot.

[@KINGAamir]

Hello … how often did you take stool softener during fissure…

[@thurgrime5037]

@@KINGAamir Once a day. Around 8 hours before i go to bathroom.

[@sreelathavk4450]

Can you suggest diet please

[@hardeoganness9505]

@@thurgrime5037hi am from Trinidad 🇹🇹 and having this problem it’s very painful I wanted to go do the surgery but not sure yet I order the pranicura and I does drink miralax and paraffin oil my stool does be soft and after I done in the toilet about one hour after is a lot of pain for the entire day could you share some information with me please

[@iszla2369]

​@@hardeoganness9505 iam having anal fissure and my stool is hard and same thing when i go to toilet my poop are hard dry and next 1 hour my struggle starts with the pain for the next day ..! I dont know what to do

[@precarious9707]

hey Doc, thanks for these videos, I am 30 years old. I had fissure few years back and it became chronic and that place has a sentinel pile, recently I got fissure again on a new place but it got healed by ointments, I wanted to ask should I go for sentinel pile removing surgery because sometimes its quite painful but my surgeon may recommend both LIS and sentinel pile remove surgery and i dont want to go for LIS, do you think going for sentinel pile surgery may cause anal stenosis type situation and it may create new fissures ?

[@subhrojitcoomar6321]

Hello doctor I want to know about laser surgery for piles & fissure. How safe is laser surgery?

[@magamedaliyev8133]

Hello Doctor any problem with incontinence of gas and stool after this surgery ? If yes for how long ? Can you pls answer i really need your help

[@ScottAyersStuff]

The reason I needed to have this surgery is because I have a problem pushing the stool out(constipation). So I was told to up my fiber intake by my doctor. Which caused a horrendous bowl blockage incident of super dry stool that I ended up pushing so hard to get out that I damaged my rectum. FIBER CAN BE VERY DANGEROUS!....It can really dry out your stool like concrete....Always have an enema bottle ready to insert some water & mineral oil in there to make the dry stools slip out without damaging the walls or the rectum! If I had known about enemas I would have used one and the damage would not have happened requiring surgery. Even now with the muscle cut. I still have a very hard time getting the stool to come out without pushing too hard. It just gets hung up in the rectum for some reason so I need to insert water in there every so often before expelling it. Maybe I don't produce enough bile to make the stool slippery enough? Maybe I have an abnormally dry rectum or something? I would hazard a guess that people that still have fissures even after surgery are having a similar type of problem. And they're still pushing too hard. The rectum is very delicate and it takes very little pushing to damage it. I would tell every patient that if the stool does not slide out effortlessly then they should insert a small amount of enema water in there to lubricate the lining of the rectum. The rectum needs to be made as slippery as possible if you have fissure problems.

[@amoebicdysentery5846]

Regularly doing enema is bad too. Take stool softeners and drink sufficient amount of water, try to take fiber from fruit source, add ghee in your diet (you can find it in indian supermarket), your colon might be absorbing too much water.

[@ScottAyersStuff]

@@amoebicdysentery5846 "More water, more fiber, use stool softeners". That's the stereotypical recommendation you'll get everywhere. That is a good place to start. Technically getting stools out faster makes them softer and thus "should be" easier to expel. I do take metamucile fiber daily to keep things moving as fast as possible. And it does help...But only a tiny little bit. But here's the glaring failure in that stereotypical recommendation: Water, fiber & stool softeners helps the stool transit through the colon. But once it gets to the rectum. Some people like me still suffer with problems getting the stool to exit. Even if it's soft. For some people like me (I often wonder how many others?) it isn't enough to just soften the stool. The rectum still won't let it out once it reaches it. Imagine being on a water slide and when you hit the last section the water got turned off. OUCH! There are ZERO doctor's that can tell me why this is happening. But I can't be the only person with this problem. ******** Enema's are only "bad" if you do them a certain way. The devil is in the details. A "standard enema" consists of a bag filled with roughly 2 cups of water (sometimes more) gravity feed using a hose. The thing that makes these "bad" is the volume of liquid being used is too high. What I'm doing is using a small squeeze bottle kit with a long tip on it. The bottle only holds about 4.5oz. But I only insert half of that amount. Sometimes even less. Just enough to lubricate the walls of the rectum and that's all. This has been a huge game changer for me. And due to the extremely low volume of liquid, it's completely safe to use on a regular basis if needed. I would never have recovered without doing this trick. And I still use it once or twice a week when I find myself pushing. IMHO. EVERY SINGLE PERSON with constipation, and/or having surgery should use this trick to help them recover. If you are like me and totally frustrated because the only reply you're getting is: More Water, More fiber, More stool softeners and it's not working. At least give this a try and see if it helps. ********

[@amoebicdysentery5846]

@@ScottAyersStuff I'm just assuming here, I think you might have multiple anal fissures which healed later on and developed a scar tissue and as you mention that you face hardship in getting your stool evacuated, I think you're into a cycle of getting fissures and healing it with a scar tissue later on. Problem with scar tissue is it doesn't have same peristaltic property like the native mucosa in there, maybe that's the reason you find lack of any movement or push in the dentate region of rectum. I'm assuming only. You should definitely visit a specialist and ask this thing i mentioned here

[@carlaarias2185]

@scott ayers I feel your pain finally doctor had to take me in for urgent surgery it literally felt like labor pain spasms every hour on the hour. I’ve only been dealing with this fissure for 6 months I don’t know how people go longer than this. The doctor told my brother the pain your sister was trying to handle no man would be able to take. He said my one little fissure got deeper and longer.

[@princessloca2623]

That's terrible...you need to see a specialist and get a correct diagnosis and treatment...

[@anthonycarrozza8152]

I had my first anal fissure 2 years ago. After every bowel movement, that pain would remain unbearable for 12 hours straight. It healed completely after 6 weeks. In November I suffered another anal fissure and it's been killing me for 4 months. I wouldn't wish this pain and discomfort on my worst enemy. The pain was so bad I would have tears in my eyes., while gnashing my teeth. I ordered the Pranicura cream and it's arriving tomorrow. I can't wait to use this product. It's the only hope I have left.

[@hardeoganness9505]

Hello am going through the same problem you are having and I ordered the pranicura only start using it 2 days now but it does burn when I put it inside did it help you

[@pasqualedevita6146]

Forget the creams and just go get the sphincterotomy done. Trust me.

[@user-ni1he8qv6u]

how r u now anthony? sorry to hear about ur condition

[@mazharirfan9943]

No need of any kind of surgery just change urs eating habbits by avoiding meat especially beef, mutton and all kind of fish, cheese ,spicy and oil fried foods. Use 5-6 figs soaked overnight in covered glass of water and eat 30 min before urs breakfast. Very important is to drink water in which figs were soaked. I got complete relief from my chronic fissure which was atleast 13 year old. Wash anal region with muslin shower 3-4 time and maintain vood hygiene. After 5-7 days, clear results and pain relieve will be achieved.

[@pksingh3227]

Thanks Doctor for your informative video. The last part of the video isn’t going the throat well. You mentioned that the Internal Sphincter is stronger than the external sphincter and is more responsible for holding the stool (continence). Isn’t it the other way round, that is the external sphincter plays a larger role in holding the poop from passing down? please clarify.

[@forlandoc]

I had the lis surgery a year ago and the extreme pain is gone, but I just saw my surgeon a few weeks ago and was put on antibiotics as I’ve been having a discharge (pus) for about 6 months and bleeding after bm …again nothing like the pain was before the surgery. 2 weeks on the antibiotics and not as much discharge and seems to be improving.

[@GirlyStories-gd5lk]

hows u feeling now?

[@tonycharles2345]

Doctor I am suffering from fissure I a. Talking midicine cos I have no money for sugery..I have been suffering almost 2months sometime it's closed after toilet its reopen.sir can fissure full healed without surgery

[@pasqualedevita6146]

So far I am symptom free. Fingers crossed.

[@magamedaliyev8133]

Hello doctor Can you pls answer I did use nifedipine ointment for one year but its not helping me for my spasm and i just got Botox injection and hemoroid bend like shrink they told me and now i have fistula but after all my bowel movement i have problem with muscles squeezing and i have fissure problem too …i m a truck driver i need help from you can you pls answer do you think Lateral internal sphincterotomy is good idea for me or no ? And if its risk for gas incontinence and stool if yes so for how many weeks or month ?? Pls help me

[@jakelesnake4927]

Thanks for the explanation, much more clear then the doctor that recommended this surgery for me. From his examination - or the inability to perform even a partial digital examination due to the tightness of my sphincter - he said I have severe stenosis, and so the relaxation of the sphincter should basically get me to a normal situation. Since then my fissure feels to have healed substantially - fingers, arms, legs and eyes crossed - but the sentinel pile is still there, hurts a bit less but doesn’t feel like it’s reducing much at all, and I don’t think the stenosis is improving. I also have a pain right at the top of my crack, like it’s splitting open when I poop. I don’t even know what this could be, if it’s somehow related to stenosis, I’m very nervous about more bottom end problems, but for the moment at least nothing is stopping me living a normal life so I’m just enjoying the relative normality and hoping it will continue to improve until one day I just realise I haven’t felt anything for a few weeks and I can relax about the whole thing. Thanks again for your consultation and these clear and calming videos, they;ve been a great help in a very difficult time..

[@yourfriendlyproctologist]

WOOOHOOOOO!!!!! congratulations!! keep going! things will get better.

[@coolsid04]

You are not alone. I too suffer from same issue. We will win over this

[@RahulKumar-sp8cu]

Hi Dr You state that internal sphincter is responsible for incontinence. However, at several place, the docs state the external is responsible. Pls clarify

[@hanshawks5088]

I just had my surgery today ! Butt no pun i have some pian the Doc said it could take 6 weeks to complete heal

[@nrtnrt6676]

What about fasting or liquid diets?

[@theresak6688]

I did some experimenting and found out that mine came from allergies.. I had an underlying gluten/yeast sensitivity which was causing my issues. Whenever I'd eat bread they'd re-appear. When I didn't for a week or so it would heal/stop. Also making sure I'm drinking water, taking vitamins, and stretching after lifting.

[@princessloca2623]

Do you think lack of physical contact and intimacy had a factor in me not being able to relax my sphincter?

[@rituraj303]

Problem with Europe and USA is that they don't use lasers for fissure LIS hence they suffer a lot here in Asia Laser in fissure doing wonders.

[@Sofia-qb9hp]

Thank you so much, were is your work place please?

[@yourfriendlyproctologist]

Orange County, CA. Check out the description box for the address.

[@benhassenmohamed393]

great vid as always dr chung ! im a 20 years old athlete height : 6ft 4 , weight 190 , dont smoke dont drink , no prior health problems dealing with a 5 week anal fissure , the pain comes and goes from time to time , i just started using meds and creams 2 days ago after seeing my local proctologist , i was wondering if exercice such as going to the gym could affect the healing process. willing to hear from you : ) much love

[@yourfriendlyproctologist]

Check out my new vid as I address this issue!

[@zeeshanshaikh4508]

Lifting weights makes it worse. Fix this problem first

[@learningenglish0]

Dr I have been using GTN for the past 3 months, my fissures keep coming, a doctor told me to use a cream for dilating anal muscles, are such creams available as my doctor has not recommended any other cream besides GTN.

[@ferencferenc6849]

Thank you dr. Chung! Very informative! Could make a video about Botox injections as well? I would try it but affraid of it...

[@yayamix3540]

I tried Botox injections couple times but didn’t help at all . I have had chronic fissure for over a year n nothing has helped sadly .

[@ferencferenc6849]

@@yayamix3540 have you tried Miralax or LIS?

[@TNTechy]

I am suffering from anal fissure last 6 year My surgeon advise me open LIS. Can we go for surgery. I tried every medicine. Sir please tell. Is that LIS good

[@kennyhussein3435]

Hello, doctor Does playing football could bring back a healed pile after surgery being done

[@rituraj303]

3 of my friends undergone LIS none had recurrence of incontinence till date all 5 yrs ago One had LIS 10 yrs ago

[@dog24]

rituraj bro... where are you from

[@rituraj303]

@@dog24 Jodhpur Rajasthan Mee to underwent laser LIS 10 months ago life is rocking again without fissure pain. Don't suffer with creams . I have no incontinence at all

[@RahulKumar-sp8cu]

Hi Rituraj Wanted to seek your advice. Plc could you ping your number or email

[@amirdastgah5780]

I have had an anal fissure for 3 year, because of a new colorectal surgeon operated on my hemorrhoids. I have tried Metamucil, fibers pills, more fruits. What helps the most is the mineral oil . 2 tablespoons a day. The anal fissure is chronic and not getting better. However, stool softens up and becomes much narrower. It takes a day or 2. Need to fix the chronic fissure.

[@rituraj303]

There is this Ayurvedic oil by name of Jatyadi Oil having excellent fissure healing properties use it through a pipe inserted through injection/syringe Even when GTN failed healing it helped.

[@madangupta4930]

Sir I have severe and rare Paradoxical Puborectalis Contraction that is only occured on left side of internal anal sphincter muscle. That's why I cannot even pass gas and not able to eat. Please suggest a surgery for that.

[@tunisientun]

DR PLEASE. I have suffered from anal fissures for several years. My last fissure was over a year ago with very strong pain. However, over the past few months the pain has greatly diminished. In fact, I only have discomfort. I don't really have any “pains”. My doctor wants to perform LIS, but he's not sure it's just that. Do chronic Fissure became mildly painful over time or could my problem be as trivial as constipation. I specify that I am a little constipated even with the laxative but that it is especially irritation after the stools and not a pain. I'm afraid to be operated LIS while the problem may be something else. (I did all the possible exams

[@akashameer2271]

How was the colonocopy procedure? Was it painful while having fissure pain

[@tunisientun]

@@akashameer2271 yes reopened fissure with huge pain but I was lucky ( only 1 week )

[@SandraLeadley]

Dr Chung can a fissure stilled be healed after having it for 20months? Its a small fissure, no bleeding, just pain and spasms. Had Botox 3 months ago, got incontinence with the procedure so will not ever get the LIS surgery! I still have hope to heal naturally. Thank you for doing these videos.

[@vaneziahamilton]

Did the incontinence go away?

[@user-ni1he8qv6u]

how r u doing now sandra?

[@marymcwatters7606]

Had it done 20 years ago, but now having trouble again, don't know what to do, I don't want another surgery, it hurt so bad when I had this surgery, I just don't think I can do it again.

[@vaneziahamilton]

Hopefully the surgery procedure has advanced enough to reduce your pain!

[@nant5434]

Is it possible to have a fissure that the dr can’t or did t see with the anoscope?

[@yourfriendlyproctologist]

I don't need an anoscope to see a fissure.

[@captainwheeler1753]

Thank you. Can you live with the fissure without surgery? Or is it important to do it. I’ve had mine for many years now. I’m just wit might get worse.

[@oggamer2244]

Lazer next please doc

[@NP-zg3hq]

I have been in touch with 3 of my relatives who had surgery, no one had a successful recovery even after multiple surgeries. So, I really scared to consult with a surgeon even my gastro doctor advised for it

[@yourfriendlyproctologist]

Awful. Sorry to hear that.

[@billydelrosario5197]

Y don’t u put a incision on the fissure or staple or glue on it so that it healed and it won’t reopen when u poop and would heal properly than do LIS it’s that posible

[@SaikrishnaGameplays]

Have been suffering with anal fissure for past 3 months. I did everything. Took lots of fibre, stopped processed food, took 3-4 litres of water every day, did sitz baths, taking stool softeners. The bleeding has stopped, I don't have fissure pain but I feel discomfort while pooping and a pulsating pain after 1-2 hours of pooping. The pulsating pain's severity is dependent on how solid my poop was. Sometimes the pain stays for 16 hrs and some other times it stays for 2-3 hrs. When I went for a checkup, a surgeon said that I have anal spasm and he asked me to get laser internal sphincterotomy done. I am confused, in pain, without mental peace and very low on confidence. I used to be a foodie and now I just eat to survive. I feel helpless. I need suggestions and help, doctor. Please help me! Sometimes I feel I have no will to live and cry for no reason. I am depressed.

[@amirdastgah5780]

Try 2 table spoons of mineral oil everyday.

[@zdheat]

Will muscle relaxers help relax the internal sphincter?

[@yourfriendlyproctologist]

possibly! Some of my patients did benefit.

[@UgurTerem]

I'm curious about this. After a LIS (Lateral Internal Sphincterotomy) surgery, is there a visible shape change in a healed anus? It seems to me that there might be a symmetry disruption since a muscle is cut from one side of the anus.

[@MarkAnthony-wo9fr]

Can this procedure be performed without general anaesthetic?? I heard something about a nerve/pain block?? Thank you ❤️

[@yourfriendlyproctologist]

General anesthesia is my preferred method.

[@MarkAnthony-wo9fr]

@@yourfriendlyproctologist In my case general anaesthetic is not option due to respiratory issues associated with muscular dystrophy. So can be performed alternatively? Thank you

[@kelvinarias8466]

Can this surgery help with erectile dysfunction does anyone know?

[@hanshawks5088]

No😂😂😂

[@arielelaine615]

Hi Dr! I had this surgery when I was 17. I'm now 32 and have a baby on the way. Will this affect a natural birth?

[@saikrishna3062]

After surgery how many days bed rest??

[@andrijanastojanovic7466]

Labor can cause some micro traumas(1/4 of women) on your sphincter muscle, that you won't feel after giving birth, and along with surgery you've had before, it can cause (there is only possibility) gas incontinence. Don't worry...

[@mba1887]

How long does the bleeding last after hemorrhoid surgery? I had surgery a month ago and the bleeding still persists. Please recommend anything. Thanks!!

[@yourfriendlyproctologist]

It varies. Please see your surgeon as I do not know what was done.

[@MB-xq3ol]

Dr Chung some doctors have the fancy chairs and tables to work on your but some use tape on each cheek to pull apart but cheeks and some work is standard table and you lie on your side. please comment on this topic.

[@yayamix3540]

I been told I have a fissure , I been suffering from unbearable fissure pain for 2 years . Had over 10 exams tried all sort of medications and diets nothing helped . Now my doctor is telling me he thinks it might not be a fissure since he can’t see it or feel it even tho I have pain ! Im lost at this point idk what to do, can’t handle this pain n not sure what to do 🤦‍♂️

[@praveenbandi4184]

You can try colonoscopy, it clearly examines large intestine and find out all problems

[@kellielesher5623]

Did it get figured out

[@Rookslife]

Is this procedure ever performed without a fissure? Or when there’s a fissure that’s healed but the internal sphincter still spasms?

[@yourfriendlyproctologist]

Yes, it has been done for other conditions like anal spasm. I don't agree with it.

[@Rookslife]

@@yourfriendlyproctologist thanks for the fast reply Dr Chung. You mean you don’t agree with LIS for anal spasm? Could you please elaborate as to why? Would you prefer conservative treatment, say the ointments anphysio forever rather than the LIS? I’ve have been checked to death and they say fissure is healed. I still have spasms. I use GTN every day for nearly a year CRS here say that is ok. Pelvic physio internally did not help with releasing the pelvic floor and sphincters. It often made pain worse and then it would all tighten again. Basically run out of options in the UK. No one wants to do Botox or LIS. Got little quality of life even with GTN (it does help). My pudendal nerve is affected and it’s like an electric pain in contact with the anus and that pain sets the spasm off and I don’t understand why. They just keep passing me to different surgeons and proctologist here. I’m on 50mg amitriptyline. Considering trying pregabalin again. No one wants to prescribe oral relaxers here either. Same for Valium suppository etc. None of those are options here. Have tried hypnotherapy and EMDR trauma theory and anxiety medication. Nothings working and I’m running out of money. Is it worth a consultation with you despite me being in the UK? I wouldn’t manage to fly out to you though for treatment.

[@kapilruchi5440]

​@@RookslifeI m same situation as yours. Please do let me know what is helping for spsams? In my area even GTN is not available

[@Rookslife]

@@kapilruchi5440Botox

[@carlosmendoza8753]

Can you bleed after a week of surgery? Is it normal? Why does it sting when you have bowel movement?

[@andrijanastojanovic7466]

Because you have 2 open wounds that are constantly irritated by stools so takes longer to heal and stop bleeding

[@faizhashmi7487]

The illustration was the hardest thing to understand in the world. 😂

[@shilahselinah]

I have suffered with Anal fissure since 2011,I had surgery on Saturday ...hoping this will be permanent solution

[@user-ni1he8qv6u]

hello, did surgery cure your problem? please update thanks

[@dog24]

how are you now please reply

[@georgesandu3581]

Hello, are you ok now?

[@codyosborne9307]

How soon after surgery can I take a sitz bath?

[@pksingh3227]

I restarted sitz bath after 3 days of the surgery. No problems encountered. As such I was on painkillers so wouldn’t have realised any pain

[@sudhakarthi6166]

I have done my surgery today one month complete.. still im feeling pain wen it will recover

[@shortsvesdiomaker]

Whats about now pain and situation

[@RanaVlogs04]

I had a LIS surgery 70 days ago...but still wound is not healed yet...is it normal..? Or should i take this seriously.. I am worried..

[@user-ni1he8qv6u]

how r u now shoaib? did it ever heal?

[@RanaVlogs04]

@@user-ni1he8qv6u its been now 5th month running....thanks to allah.. 95 percent healed

[@RanaVlogs04]

@@user-ni1he8qv6u yes....be patient..look after what u eat...the healing process is very slow

[@RanaVlogs04]

Its my 5th month of heaking process and thanks to allah its now 95 percent healed

[@user-ni1he8qv6u]

@@RanaVlogs04 wow gr8 congrats

[@srishtinagpal2809]

Great videos ❤️❤️ doc where exactly is the inner rim of anus, as pranicura treatment says to put the cream there? With 2 anal skin tags it's difficult to find the rim while applying the cream

[@yourfriendlyproctologist]

open your buttcheeks and apply in the middle. That will suffice.

[@Lonniepsangel]

❤❤❤

[@pasqualedevita6146]

No fissurectomy. Just L.I.S. pain free now. All good

[@andrijanastojanovic7466]

But did the surgeon clean the fissure, or just cut the muscle? I am having Lis on 23March and I am afraid of post op pain, not of the incontinence.

[@motolordz6974]

@@andrijanastojanovic7466hi can you please share your experience after surgery?

[@alfredoestepa7468]

Doc , they did this to me 2 years ago and now i cannot sit for long periods of time :( huhuhu

[@alfredoestepa7468]

I dont know what to do right now :(

[@saimahaque4615]

What happens when you sit for long periods?

[@sudheerk82]

@@alfredoestepa7468 whats the problem for sitting long period of times?

[@mathewswandera7597]

Went through these procedure last year and now have developed an anal tag, that is painful especially during bowel movements, though there's no blood. Is these common doc?

[@drewcrawford447]

That’s the same as me and it hurts for longer than fissure I think the only option is to get it removed

[@mathewswandera7597]

@@drewcrawford447 been thinking about the same too, pain too much

[@drewcrawford447]

@@mathewswandera7597 you go first and then let me know 😂

[@vaneziahamilton]

@@drewcrawford447did you get the surgery?

[@vaneziahamilton]

@@mathewswandera7597did you get the surgery? I have the skin tag too

[@joellanderson5137]

Been suffering for 2-3 years now. Im running out of hope and really considering this surgery. But im worried about incontinence. 😞

[@LBelieveinJesus]

Get the surgery mate. You need some peace of mind and there are systems for coping with incontinence. I was thinking today I'd actually prefer a colostomy bag than this pain I'm in... If you feel the same even a little maybe just go ahead and get the surgery.

[@joellanderson5137]

@@LBelieveinJesus Right on. Is surgery an option for you?

[@LBelieveinJesus]

@@joellanderson5137 not sure if it is as I haven't finished growing my family and over here they won't do it unless you're done and no more future pregnancies. I'm considering a Botox procedure which might help, it's expensive and not sure if it's effective enough.

[@bilalabbasi5490]

Just had this surgery 10 days ago. Doing great so far. The recovery is fast. I carried the chronic fissure for about an year. Didn't feel incontinence. Post surgery pain is way less than the everyday suffering. I think you should opt for it.

[@joellanderson5137]

@bilalabbasi5490 I'm glad you are doing well. My surgery is Sep 11th and im nervous but ready. Thanks for commenting. I'll keep you posted about mine as well.

[@user-ud2te9bs5o]

I need help .i have anal fissure for long years going and coming i used all type of medicine for no thing .i am so sad sorry for my kids they need me but i can not do anything i feel so tried 😢😢😢😢😢😢😢😢😢

[@coolsid04]

Go for the surgery. Even I had a history of piles for almost 25 years and fissures for almost 10 years. Tried all types of medication including Homeopathy, ayurvedic, etc. But atlast went to surgery last week. I hope this is end of my ordeal. Go for it, if you have tried all conservative methods. All the best to you

[@motolordz6974]

@@coolsid04how are you now? Do you still have pain

[@coolsid04]

@@motolordz6974 hello friend, hope you are better now. I'm much better after surgery which happened about two months back. Although I still feel some pain when I pass stools however, it is much less than before. On a scale of 10, pain is around 2 or 3 now. My main issue is that my stools are naturally hard, hence the pain. how are you ? any relief from pain brother?

[@abdulraziq4370]

2 surgery chornic anal fissure but not successful 😢

[@asocksr]

doctor Chan i had fissure surgery eight years ago and I still have a pain in my rectum specially after pop also when I eat spicy food or tomatos salsa. I have a new doctor and she said that I have spasm. She checked me out inside of my anus and she felt a whole in the right side of my anus. Please if you have any experience of my case I will appreciate your video. thank you so much.

[@kellielesher5623]

Fistula?

[@rockandblues3635]

OMG so scared

[@Inmate533]

I think I'd rather starve myself than have that surgery.

[@rosemaryandrews1001]

My but on fire and stinging ❤

[@shadeenhamilton8362]

I had this procedure 7 months ago I'm noticing a difference in appearance with my anus

[@rituraj303]

This guy trying to sell his cream Otherwise laser LIS is best without need to irritate anus with creams again and again.