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Sphincterotomy, Anal Fissure, Spasms, Vicodin

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Posted on Fri, 25 May 2012
Question: Spasms after Sphincterotomy :
=========================

Hi,
I had a sphincterotomy today to treat a stubborn anal fissure (I had attempted non-surgical treatments for over one year prior with no success). It has now been several hours after my surgery, and I have been experiencing constant involuntary spasms in my sphincter. I am also experiencing these spams whenever I take XXXXXXX breaths. The spasms are not painful, as I am taking Vicodin for pain due to the surgery. However, I am concerned because I thought that the whole point of the sphincterotomy was to relax the sphincter muscle so as to prevent these spasms from occurring. My question is simple: Is it normal to be experiencing these symptoms shortly after a sphincterotomy (i.e. could this be a short-term side-effect of having the sphincter muscle cut), or is there cause for concern here? I am a 27 year old male, otherwise healthy. Please advise if you require any more information. Thank you.
Recovering
doctor
Answered by Dr. Poorna Chandra K.S (31 hours later)
Hello and thanks for posting your query.

Fissure in ano could be secondary to a colonic disease or a primary problem secondary to straining or constipation.

It's true that the aim of sphincterotomy is to relieve muscle spasm and hence aid in healing. However a complete sphincterotomy will lead to incontinence and hence some sphicter preserving may have been done.

Further the area of surgery involves the perianal skin which is highly sensitive as it is supplied by somatic nerves. Some amount of discomfort (which may be perceived as spasm) is normal upto a week after surgery.

A well done sphicterotomy usually heals the fissure and a soft stool during this period will help. Hence use some laxatives, take high fiber diet and have sitz bath once your surgeon allows it.

Regards,
Dr Poorna XXXXXXX
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Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
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Dr. Poorna Chandra K.S

Gastroenterologist

Practicing since :2000

Answered : 339 Questions

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Sphincterotomy, Anal Fissure, Spasms, Vicodin

Hello and thanks for posting your query.

Fissure in ano could be secondary to a colonic disease or a primary problem secondary to straining or constipation.

It's true that the aim of sphincterotomy is to relieve muscle spasm and hence aid in healing. However a complete sphincterotomy will lead to incontinence and hence some sphicter preserving may have been done.

Further the area of surgery involves the perianal skin which is highly sensitive as it is supplied by somatic nerves. Some amount of discomfort (which may be perceived as spasm) is normal upto a week after surgery.

A well done sphicterotomy usually heals the fissure and a soft stool during this period will help. Hence use some laxatives, take high fiber diet and have sitz bath once your surgeon allows it.

Regards,
Dr Poorna XXXXXXX