What this experience covers
This experience focuses on one specific aspect of recovery after lateral internal sphincterotomy (LIS): scar tissue. It is a composite drawn from many anonymised accounts — not one person’s story, but the common patterns people describe when they discover a hard lump, a ridge, or a thickened area at or near the surgical site.
If you are looking for a general week-by-week recovery overview, see the related experience on LIS surgery recovery. If you are concerned about bowel control changes, see the experience on continence changes after LIS. This page focuses specifically on the scar tissue that forms, what it feels like, how it changes, and when it warrants attention.
Scar tissue after LIS is extremely common. Most people develop some degree of it. For the majority, it softens and becomes unremarkable over months. For a smaller number, it becomes a source of ongoing concern — either because it causes physical symptoms or because the uncertainty about whether it is normal creates anxiety.
The pattern
The discovery: weeks 2 to 6
Most people first notice scar tissue during the early weeks of recovery. They describe feeling a hard lump, a ridge, or a thickened area near the surgical site. The discovery often happens during cleaning, sitz baths, or simply becoming aware of something that was not there before.
The immediate reaction is almost always concern. People worry it is a new hemorrhoid, a sign of infection, or evidence that the surgery has failed. The anxiety can be significant — especially for people who had a long, difficult journey with their fissure before surgery.
What people typically describe at this stage:
- A firm, pea-sized or slightly larger lump near the incision site
- Tenderness when touched directly but not painful otherwise
- A ridge or raised area where the skin feels thicker
- Worry about whether this is normal
Months 2 to 6: the slow change
For most people, scar tissue gradually softens over several months. It does not disappear overnight. The progression people describe is a slow transition from hard and noticeable to softer and less prominent. Many people check it regularly and notice incremental changes over weeks rather than days.
During this period, people commonly describe:
- The lump becoming less firm to the touch
- Reduced tenderness as the tissue matures
- Gradual flattening of raised areas
- Periods where they forget about it entirely, followed by moments of checking and worrying again
Beyond 6 months: settling
By six months to a year, most people describe their scar tissue as either barely noticeable or something they have simply accepted as part of the landscape. It may still be palpable but does not cause symptoms.
A small number of people find that scar tissue remains more prominent or begins to cause functional issues. This is where the experience diverges.
When scar tissue becomes a problem
Anal stenosis
The most significant concern related to scar tissue after LIS is anal stenosis — narrowing of the anal canal. This is uncommon but not rare. People who develop it describe:
- Increasing difficulty passing stool, even when stools are soft
- A sense of the opening feeling tighter over time rather than more open
- Thin, ribbon-like stools
- Straining that does not resolve with dietary changes
- Pain during bowel movements that feels different from fissure pain — more of a stretching or pressure sensation
Anal stenosis typically requires medical attention. Treatments people describe include gentle dilation, dietary management to keep stools very soft, and in some cases further procedures.
Scar tissue and re-fissuring
Some people describe developing a new fissure at or near the scar tissue site. The scar tissue can be less flexible than the surrounding skin, making it more prone to tearing. People who experience this describe the frustration of having addressed the original fissure only to develop a new one in compromised tissue.
What people try
- Keeping stools consistently soft to minimise trauma to the scar tissue area
- Warm sitz baths, which some people feel help with tissue flexibility
- Gentle massage of the area — some people describe this helping, though it is not universally recommended
- Patience — the most consistent advice from people further along in recovery is that scar tissue continues to change for up to a year
- Raising concerns with their surgeon at follow-up appointments rather than waiting and worrying
The emotional side
The anxiety around scar tissue is a recurring theme. People describe a cycle: feeling something unusual, worrying it is a problem, researching online, finding alarming possibilities, and then either contacting their surgeon or spending days in anxious uncertainty.
What helps most, according to people who have been through it, is having a clinician confirm that what they are feeling is normal scar tissue. That single reassurance — even if the lump is still there — changes the emotional experience entirely.
If something about your recovery does not feel right, or you just want reassurance about what is normal, our chat can help you think it through.
When to contact your doctor
- A lump that is growing, very painful, or warm to the touch
- Increasing difficulty passing stool despite keeping stools soft
- Bowel movements that are becoming progressively more painful weeks or months after surgery
- Bleeding from the scar tissue area
- Any sign of infection — redness, swelling, discharge, fever
If you are unsure whether what you are experiencing is normal healing or something that needs attention, it is always reasonable to ask your surgical team. People consistently describe their clinicians as welcoming these questions.