Sphincterotomy

WHAT YOU SHOULD KNOW:

• An anal sphincterotomy is surgery to relax your anal sphincter (the ring of muscles that forms your anus). Your anus is the opening where the stool from your bowel movements (BM) leaves your body. Your anal sphincter controls the passage of your stools by opening or closing the anus. You may need a sphincterotomy if you have an anal fissure or anal stenosis. Anal stenosis is when your anal opening becomes very tight and stiff. An anal fissure is a cut or tear in the skin tissue just inside your anus. It may be caused by constipation (hard, dry stools), certain diseases, injury, and cancer or its treatment. With an anal fissure, you will usually have pain and bleeding around your anus after a BM.
  
  
• Your caregiver may want you to have a sphincterotomy if other treatments do not work for you. You may also need surgery if your anal fissure is very painful. With an anal sphincterotomy, your caregiver will cut your sphincter just enough to allow it to relax. This helps decrease the pressure around your sphincter. It may then increase the blood flow to your anal tissue. Having a sphincterotomy may heal your anal fissures and may help stop them from occurring again. A sphincterotomy may also help relieve your pain and bleeding around your anus.

INSTRUCTIONS:

Medicines:

• Keep a written list of the medicines you take, the amounts, and when and why you take them. Bring the list of your medicines or the pill bottles when you see your caregivers. Learn why you take each medicine. Ask your caregiver for information about your medicine. Do not use any medicines, over-the-counter drugs, vitamins, herbs, or food supplements without first talking to caregivers.
  
  
• Always take your medicine as directed by caregivers. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. Do not quit taking your medicines until you discuss it with your caregiver. If you are taking medicine that makes you drowsy, do not drive or use heavy equipment.

• Pain medicine: You may be given medicine to take at home to take away or decrease pain. Your caregiver will tell you how much to take and how often to take it. Take the medicine exactly as directed by your caregiver. Do not wait until the pain is too bad before taking your medicine. The medicine may not work as well at controlling your pain if you wait too long to take it. Tell caregivers if the pain medicine does not help, or if your pain comes back too soon.
  
  
• Stool softeners: You may be given stool softeners to soften your bowel movements, making them easier to pass.
  
  
• Topical medicine: Topical medicine may help your anal muscle relax and increase blood flow to your anus. This medicine may contain anesthesia to help decrease your pain. Topical medicine may be put just inside your anus. Your caregiver will teach you the right way to use topical medicine.

Ask your caregiver when to return for a follow-up visit. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

After your surgery, you may need to return to your caregiver for tests. Your caregiver may do an anal ultrasound if your anal fissures keep coming back. An ultrasound may also help your caregiver know if the sphincterotomy was enough to relax your anus.

Constipation: If you are constipated, you may have a hard time having a bowel movement (BM) Do not try to push the BM out if it is too hard. Walking is the best way to get your bowels moving. Eat foods high in fiber to make it easier to have a BM. Good examples are high fiber cereals, beans, vegetables, and whole grain breads. Prune juice may help make the BM softer. Caregivers may give you fiber medicine or a stool softener to help make your BMs softer and more regular. You can also buy these medicines at a grocery or drug store.

Drinking liquids: Men 19 years old and older should drink about 3.0 Liters of liquid each day (close to 13 eight-ounce cups). Women 19 years old and older should drink about 2.2 Liters of liquid each day (close to 9 eight-ounce cups). Good choices for most people to drink include water, juice, and milk. If you are used to drinking liquids that contain caffeine, such as coffee, these can also be counted in your daily liquid amount. Some food items such as soup and fruit also add liquid to your diet. Ask your caregiver how much liquid you should have each day.

Sitz bath: Your caregiver may ask you to take a sitz bath. A sitz bath is a pan filled with warm water that fits on the toilet bowl. This may help decrease pain and swelling. You may need to do this more than once a day. Ask your caregiver how to use a sitz bath.

CONTACT A CAREGIVER IF:

• You feel the need to pass stools right away or have trouble holding your bowel movements.
  
  
• You are unable to have a BM.
  
  
• You pass gas more often than usual.
  
  
• You have a fever (high body temperature).
  
  
• You still have pain after taking pain medicine.
  
  
• You have blood on your stool or toilet paper.
  
  
• You have spasms in your anus that do not stop.

SEEK CARE IMMEDIATELY IF:

• You have very bad pain in or around your anus.
  
  
• You have bleeding from your anus that does not stop.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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