At a glance
The first few days after lateral internal sphincterotomy (LIS) are a unique period. After months or years of chronic fissure pain, the surgery has addressed the underlying sphincter spasm — but the body is also recovering from a surgical procedure. People describe this period as a mixture of relief, discomfort, anxiety, and cautious hope.
This guide covers what people commonly describe in those early days: the pain patterns, the first bowel movement, the emotional landscape, and what to expect as the initial recovery unfolds.
The day of surgery
LIS is typically a short procedure performed under general or spinal anaesthesia. People describe waking up with a range of sensations:
- Mild to moderate soreness at the surgical site — different from fissure pain
- A sense of looseness in the sphincter area that some find immediately noticeable
- Grogginess from anaesthesia that clears over hours
- Relief that the procedure is done, mixed with anxiety about what comes next
Most people go home the same day. The immediate instructions are usually straightforward: sitz baths, stool softeners, pain relief as needed, and rest.
Day one
The first full day after surgery is dominated by managing the surgical soreness and beginning the waiting game for the first bowel movement.
People describe:
- Surgical pain that is dull and aching, centred on the incision site rather than the fissure
- The absence of spasm — for many, this is the most noticeable change. The background clenching that had become their normal is gone or significantly reduced
- Anxiety about the first bowel movement that is intense and often disproportionate to the actual experience
- Resting — most people spend day one doing very little, and those who push themselves tend to regret it
Days two and three
By days two and three, the surgical soreness has typically settled into a predictable pattern, and for most people, the first bowel movement has happened.
The first bowel movement
This is the event people dread most. The fear is understandable — months or years of painful bowel movements have created a powerful association. But the accounts are remarkably consistent: the first post-LIS bowel movement is, for the majority of people, noticeably different from what they experienced with the fissure.
People commonly describe:
- Less burning and tearing than expected — the sphincter is no longer in spasm
- Some surgical soreness during and after, but a different kind of pain
- A shorter recovery period after the bowel movement — minutes rather than hours
- A wave of emotional relief, sometimes unexpectedly strong, when they realise the spasm is gone
For some people, the first bowel movement is still painful — surgical wounds are tender, and the area is healing. But the character of the pain is different, and that difference gives people information about whether the sphincterotomy has done what it was intended to do.
What else people notice
- Mild bleeding — light spotting or blood-tinged discharge is common and expected
- Swelling around the surgical area that may take a week or more to settle
- Gas — some people describe increased difficulty controlling gas in the first few days, which usually improves
- Emotional processing — after years of pain, the shift can be disorienting. People describe not quite believing it. Waiting for the spasm to return. Feeling cautiously optimistic but unwilling to trust it.
The routine in the first days
People who navigate the first few days best describe a simple, consistent routine:
- Sitz baths after every bowel movement and one or two additional times per day
- Stool softeners and fibre continued consistently — the priority is avoiding hard stools
- Adequate fluid — two to three litres per day
- Rest — not bed rest necessarily, but gentle activity with frequent lying down
- Pain relief as prescribed — staying ahead of the pain rather than waiting for it to build
- Gentle walking — short walks to promote circulation, avoiding prolonged sitting
The emotional dimension
People who have had a chronic fissure for years describe the early days after LIS with a distinctive emotional quality. There is relief, but it is guarded. Hope, but cautious. The experience of chronic pain has taught them not to trust improvement — every good day before was followed by a setback.
The most commonly expressed feeling in those first three days is not pain, or relief, or joy. It is disbelief. The idea that the spasm might actually be gone — that the cycle might actually be broken — takes time to absorb.
This is normal. Give yourself time to adjust. The body is healing. The mind is catching up.