Sphincterotomy

WHAT YOU SHOULD KNOW:

• An anal sphincterotomy is a surgery to relax your anal sphincter (the ring of muscles that forms your anus). Your anus is the opening where stool leaves your body during a bowel movement (BM). Your anal sphincter controls the passage of your stools by opening or closing the anus. You may need a sphincterotomy if you have anal stenosis or an anal fissure. 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 also may 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 also may help relieve pain and bleeding around your anus.

INSTRUCTIONS:

Take your medicine as directed:

Call your primary healthcare provider if you think your medicine is not working as expected. Tell him if you are allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs you take. Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists.

• Pain medicine: You may need medicine to take away or decrease pain.
  
  
  • Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.
    
    
  • Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.
    
    
  • Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.
  
  
• Stool softeners: This medicine makes it easier for you to have a bowel movement. You may need this medicine to treat or prevent constipation.
  
  
• Steroids: Steroids may help your anal muscles relax and increase blood flow to your anus. This medicine also may decrease your pain. Steroid cream may be put just inside your anus. Your caregiver will teach you the right way to use this medicine.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

• 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 also may help your caregiver know if the sphincterotomy relaxed 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 your stool 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 of food with high fiber include certain cereals, beans, vegetables, and whole grain breads. Prune juice may help soften your stool.

Drinking liquids:

Adults should drink about 9 to 13 cups of liquid each day. One cup is 8 ounces. Good choices of liquids for most people include water, juice, and milk. Coffee, soup, and fruit may be counted in your daily liquid amount. Ask your caregiver how much liquid you should drink 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 have trouble controlling your bowel movements.
  
  
• You are unable to have a BM.
  
  
• You pass gas more often than before your sphincterotomy.
  
  
• You have a fever (high body temperature).
  
  
• You still have pain after taking pain medicine.
  
  
• You see blood in your stool or on the toilet paper after you use it.
  
  
• 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.

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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.

Learn more about Sphincterotomy (Aftercare Instructions)