Anal Fissure

What is surgery for anal fissure?

The most common operation to treat anal fissure is Lateral Internal Sphincterotomy (LIS). This involves making a small cut in the ring of muscle around your anal canal. The muscle is known as your anal sphincter. This surgery works by reducing tension in your anal canal, thereby promoting healing of your anal fissure.

It is a generally a short and straightforward procedure and most patients may be discharged on the day of the procedure. You will likely heal fully within two to four weeks.

Why surgery for anal fissure?

If you have a chronic anal fissure that is resistant to other treatments, or if your symptoms are severe, your doctor may recommend surgery. Studies have found that for chronic fissure, surgery is much more effective than any medical treatment, and have a good track record of success. Surgery not only allows the anal fissure to heal, but also decreases your chances of developing any fissures in the long run.

What to expect?

Before the procedure

  • Limit or cut out smoking or alcohol.
  • Stop all current medications one week prior to the procedure or as instructed by your doctor.
  • You may be given bowel preparation to help you clear your bowels before the surgery.
  • You will be asked to fast accordingly.

On the day of the procedure

  • You will be given anaesthesia to help you fall asleep prior to the procedure.
  • A small incision is made in your skin at the left lateral side of your anus.
  • The bottom of the internal sphincter muscle is incised and the spasm is released.
  • The wound is closed with a single suture.
  • Skin tags associated with the fissure at the back is also excised.
  • The surgery will last for around 30 minutes.
  • The nurse will check on you when you wake up in the room to make sure you are stable and comfortable.

After the procedure

  • Consume a diet high in fibre and drink plenty of fluids. It will help you have soft and regular bowel movements. This is especially important for patients who are recovering from anal fissure to prevent anal fissure from returning.
  • You may be prescribed laxatives to soften your stools.
  • Keep your wound clean and dry.
  • Wear dressing over the affected area to cushion it and prevent the small amount of discharge from staining clothes.
  • You will need to change the dressing daily.
  • Wash the affected area gently with soap and bathwater after each bowel movement.
  • You may experience mild to moderate pain, though it is less than before the surgery. Pain medications may be prescribed to relieve the pain.
  • You will be able to resume daily activities within 1 to 2 weeks post-surgery.
  • Schedule a follow-up appointment with your doctor within 1 to 2 weeks.