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What Causes Spasms After Bowel Movement Post Lateral Sphincterotomy?

Posted on Mon, 20 Jul 2015

Question: Hi Doctor
I hv done surgery lateral spincherectomy in April this year . I took lactulose for 2 weeks post surgery n ws advised to eat normal food.
After one month post surgery there ws no pain passing stools but occassional spasms after sitting long periods. After 2 months post surgery i began experiencing mild pain during bowels. My surgeon advise lactulose 30ml every night and cream Nifedipine (0.3% w/w lidocaine 1.5%w/w) once daily. Now Stools are soft and easy to pass. But after passing stool i get spasms which come n go throughout the day. I hv travelled abroad to join work and wont b meeting my surgeon very soon. I m applying the cream since 10days now. once daily. Doctor why is it the healing getting delayed. I thot surgery will completely heal the fissue. How can i ensure completely recoverly as i m getting very stressed. :(

Answered by Dr. Ajit Naniksingh Kukreja (27 minutes later)

Brief Answer:
May be it has gone chronic

Detailed Answer:
Hi

Thanks for writing in

It seems your fissure has gone chronic

I would suggest you manage your stress first

Add a local ointment with sucralfate

A good bulk forming laxative at bed time and a probiotic twice a day

Take sitz bath twice a day

In case the symptoms persist, it would be better to see a surgeon

Hope this helps
Do write back in case of concern

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Ajit Naniksingh Kukreja (39 minutes later)

Doctor..
I mentioned i hv done surgery lateral spinchterotomy in April this year.
I m taking 30ml laxative and applying annobliss cream since last 10 days.
The stools r soft and hardly feel any pain. But after passing stools the spasms last almost the whole day.
I eat on green veg/fruits n lots of water. No red meat.
Shouldnt the fissure hv completely healed after 2 months or shud i be more patient n wait for positive results of the cream. Anobliss.

Answered by Dr. Ajit Naniksingh Kukreja (5 minutes later)

Brief Answer:
As I Said it has probably gone chronic

Detailed Answer:
Hi

Thanks for your followup

I clearly understand the state of affairs that you have mentioned

Once the fissure goes chronic, it keeps on nagging you day in and out

I had a feeling if you go for a probiotic it will help you in maintaining the intestinal flora which will prevent collitis and there by the sense of inadequate defecation

A sucralfate ointment and sitz bath will give you soothing effect and help relieve spasm

Continue with green vegetables and wait for symptoms to go off for another
week or so else see a surgeon

Hope this clears your doubts
Wishing you a healthy life ahead

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Ajit Naniksingh Kukreja (1 hour later)

Thnx Dr for yr prompt reply.
Pls recommend good probiotic available over the counter. Does it come in powder or tablets?
Should the sucralfate ointment applied twice daily in rectal area?
Yes will continue green diet. Hav lost lot of weight. Wish i can start eating normal foods soon.

Thanks & rgds

Answered by Dr. Ajit Naniksingh Kukreja (4 hours later)

Brief Answer:
Yes twice a day

Detailed Answer:
Hi

Thanks for your followup

Where are you located ? I can recommend a brand in XXXXXXX - you may go for Actigut, Magnipro or VSL#3

Yes apply the ointment twice after passing stool and before retiring to bed

If you have lost weight in short span of time get your self evaluated
Am sure things will be normal in due course
Hope this clears your doubts

Get well soon
Regards

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Above answer was peer-reviewed by : Dr. Neel Kudchadkar