What this experience covers
A composite diary of what people experience in the weeks leading up to lateral internal sphincterotomy (LIS) and the early recovery that follows. This covers the waiting period — the anxiety, the preparation, the second-guessing — as well as the first few weeks of healing. It draws from many anonymised accounts and represents common patterns, not any single person’s story.
The waiting period before LIS surgery is often overlooked. People have been dealing with a chronic fissure for months, sometimes years. They have tried topical treatments, dietary changes, and possibly Botox. Surgery is the next step. And then comes the wait — weeks or months between the decision and the operating room.
The pattern
The decision: relief and dread
People describe the moment they agree to surgery as a mix of competing emotions:
- Relief — that something definitive is going to happen after months of trying things that did not work
- Fear of incontinence — this is the most commonly described anxiety. The idea that the sphincter will be cut generates intense worry, even after the surgeon has explained the risks
- Frustration — at having to wait weeks for the surgical date while continuing to live with daily pain
- Doubt — wondering if they should try one more thing before committing to surgery
The incontinence fear dominates the waiting period. People describe reading every account they can find, calculating percentages, and asking their surgeon the same question multiple times in different ways.
The waiting weeks: living in limbo
Between the decision and the surgery date, life continues — but with a fissure that is still causing daily pain. People describe:
- Counting down to the date while trying to manage symptoms with their existing routine
- Anxiety that builds as the date approaches, especially in the final week
- Researching obsessively — reading every LIS experience they can find, which both reassures and terrifies
- Preparing practically — stocking up on stool softeners, fibre, sitz bath supplies, and arranging time off work
- Telling very few people, because the location and nature of the surgery feel too private to explain
The final few days before surgery are consistently described as the worst for anxiety. Sleep suffers. Appetite drops. People describe rehearsing worst-case scenarios.
Surgery day: shorter than expected
LIS is a short procedure — typically 15 to 30 minutes under general or regional anaesthesia. People describe:
- The build-up being worse than the event itself
- Waking up and being surprised that it is already done
- Immediate post-operative pain that is different from fissure pain — a broader soreness rather than the familiar sharp cut
- Going home the same day in most cases
- The first few hours at home spent resting, groggy, and cautiously hopeful
Week 1: the recalibration
The first week after LIS is a period of adjustment. The fissure pain may reduce immediately, but surgical pain takes its place:
- Pain that is different — people describe the pain as less sharp than a fissure but more of a deep ache. Many say it is easier to bear because it feels like healing pain, not injury pain.
- The first bowel movement — dreaded by everyone, and usually less terrible than feared when stool softeners have been started in advance
- Noticing changes — some people describe noticing reduced spasm almost immediately. Others take longer.
- Rest and routine — sitz baths, stool softeners, light walking. The first week is quiet and focused on recovery.
Weeks 2 to 4: cautious optimism
By week two, most people describe a turning point:
- Bowel movements are becoming less painful — and for many, significantly less painful than before surgery
- The surgical soreness is fading
- Activity levels are increasing — walking, light daily tasks, some people returning to desk work
- A growing sense that the surgery was the right decision
- Still checking every sensation anxiously, but the checks are becoming more routine and less panicked
Looking back
People who are weeks or months past LIS consistently describe the waiting period as the hardest part. The surgery itself and the recovery, while not easy, were more manageable than the anticipation. The most common reflection: “I wish I had done it sooner.”
When to contact your doctor
- Bleeding that is heavy or not settling
- Pain that is getting worse rather than gradually improving after the first few days
- Fever or signs of infection
- Any changes in bowel control — even minor ones — that concern you
- Difficulty urinating after the procedure
- Symptoms that are not improving at all by the two-week mark