why cant they just stitch the tear in the spincter .. and give a liquid soup and ensure diet until it heals like any other muscles or any other laceration.. whats with all the dumb muscle cutting and sphinter removing or stretching solutions that will only lead to flatulance and fecal incontinence.. 1 the fissure to creat a mending point 2. sew together 3. liquid diet 3 months on all soup and ensure.. ??

I am assuming that you are suffering from an anal fissure given some of your questions? Given that you are questioning the LIS surgery (Lateral Internal Sphincterotomy) or Anal Dilation procedure I would guess that your fissure is a chronic one and not acute since these procedures are not usually recommended unless you are chronic. You can't simply sew the sphincter or fissure back together and live on liquids for 3 months. Your fissure is chronic because it will not heal due to constantly retearing every time you have a bowel movement. Now, imagine that you were lucky enough to find a doctor who would just sew your sphincter shut for you, you don't think that's going to hurt when you have a bm? Your fissure is chronic because it will not heal and since you are mentioning these procedures I am guessing that you have seen a colon rectal surgeon for your problem and these were given to you as your options to heal. A chronic fissure will not heal because as time has gone by and you have torn that fissure open probably time after time it has caused the internal muscle (sphincter muscle located inside that you have no control over) to tense up because of the pain and lack of blood supply to the area. Once this muscle is in a spasm it cannot relax when you have a bowel movement, therefore, you tear open the fissure again. Your anus has two muscles that are used when you have a bowel movement. The one on the outside that you can feel is the external sphincter muscle. You can control this muscle. Ever had to go and have to hold it for a few? You held it in by contracting that muscle. The second muscle is the internal sphincter muscle. You have no control over this bad boy. Once it tightens and spasms your fissure is chronic. This second muscle is the one they make a small incision into to relax the muscle so that it is relaxed when you have a bowel movement allowing the fissure to begin healing because there is no longer a tight sphincter, it is loosened. I had a chronic fissure not too long ago and I had it for 8 long, miserable months of hell before I decided to have the LIS surgery. Yes, I spent months agonizing over having the surgery because I was afraid that I might spend the rest of my life passing gas or defecating on myself. You know what? After I lost 62 pounds, had no life left to speak of, began missing lots of time from work because I couldn't stand the pain after a bowel movement unless I was sitting in a tub of water. I wanted my life back so I did my homework and found a surgeon with an impeccable record at performing this procedure and had it done. Best decision I ever made. I don't pass gas in public and certainly have not lost control of my bowels and went on myself. Only thing I got from the surgery was relief and my life back. You can't live on a liquid diet for 3 months without compromising your health, to begin with, not to mention the fact that your rectum would shrink up from not being used to have a full formed bowel movement, its called stenosis. You'd be right back where you are first time you ate a solid meal and have to have a bm. You would tear your anus open because its not used to being stretched.

Avoid a sphincterotomy @ all costs! I had it done 10 years ago and still have fecal leakage. The surgeon was Dr. James Wielgolewski. He practices in the west suburbs of Chicago, IL. He performed this surgery on me w/o even mentioning the possibility of incontinence! If you developed your fissure because of chronic constipation, attempt changing your diet to correct it. My fissure developed because of over wiping from chronic diarrhia that went on for about a week. I've never been constipated a day in my life! If I had it to do over again, I'd attempt a liquid-only diet to heal the fissure. You can drink something nutritional like Ensure for health purposes. Nearly every study I've read concluded there's a significant chance that a permanent alteration in continence will result. Just search the web and you'll find some of those studies. The muscle that's cut during this procedure works involuntarily to maintain a "seal" to keep "stuff" from coming out w/o your knowledge. When that muscle is cut, that seal is compromised - leaving the flood gates wide open. Drill a small hole in the bottom of a boat and see what happens. Good luck!