Why there are different opinion regarding anal fissures when some colorectal surgeons say after LIS surgery anal fissures do not come if occasionally stool becomes hard where other say it can come if stool get hard? But the fact is fissures occurs due to high resting pressure of internal sphincter muscle and during LIS surgery this high resting pressure reduce to normal pressure so why after surgery still fissure comes if stool get hard? But generally all people do not get fissures or ulcers if stool becomes hard, some people are habitually constipated still no anal fissures face.

Dr. Adnan MattooGeneral Surgeonyrs exp

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Hello user. Good to see you have researched quite a bit about your disease. Basically high pressure of the int. Sphinc. Is not the cause. It propagates the condition and doesn't allow the fissure to heal. Anal fissure fails to heal because of a cycle between constipation=pain=spasm. By doing LIS (lateral internal sphincterotomy) we break the cycle by targeting spasm and allow nature to heal the fissure. But still you can have hard stool sometimes causing injury to the delicate anal mucosa leading to fissure. But the difference is it will heal quickly as compared to in a patient whose internal sphincter is intact. So even if you have undergone an LIS, You should always avoid constipation by taking lots of fruits and fluids. You can add stool softners to diet. Besides make doing sitz bath bedtime a habit. It Dsnt cost anything. Does it? Hope it clears your doubts. Feel free to enquire more. Regards.  

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