Lateral Internal Sphincterotomy (LIS)

What is Lateral Internal Sphincterotomy (LIS)?

Lateral Internal Sphincterotomy (LIS) is a surgical procedure commonly performed to treat chronic anal fissures that have not responded to non-surgical treatments. An anal fissure is a small tear in the lining of the anus that can cause severe pain, discomfort, and bleeding during bowel movements. LIS involves making a small incision in the internal anal sphincter muscle to reduce tension and promote healing of the fissure.

Symptoms of Anal Fissures

Anal fissures can cause several uncomfortable symptoms, including:

Severe Pain: Intense pain during and after bowel movements is the hallmark symptom of an anal fissure.

Rectal Bleeding: Bright red blood may be noticed on toilet paper or in the toilet bowl.

Itching and Irritation: Persistent discomfort, itching, and irritation around the anus.

Visible Tear: In some cases, the fissure may be visible around the anus.

If you experience these symptoms and they persist despite treatment, LIS may be necessary to relieve pain and promote healing.

Causes and Risk Factors

Anal fissures are often caused by trauma or excessive pressure on the anal canal. Some common causes and risk factors include:

Chronic Constipation: Straining to pass hard stools can tear the lining of the anus.

Diarrhea: Frequent bowel movements with loose stools can also irritate the anal tissue.

Childbirth: The pressure during childbirth can lead to fissures in some women.

Inflammatory Bowel Disease (IBD): Conditions such as Crohn’s disease increase the risk of developing fissures.

Procedure Overview

During an LIS procedure, the surgeon will cut a small portion of the internal anal sphincter muscle to reduce muscle tension, which helps the fissure heal and alleviates pain. The procedure is typically performed on an outpatient basis and usually takes less than an hour. The patient is placed under general anesthesia or local anesthesia with sedation to ensure comfort. A small incision is then made in the internal anal sphincter muscle to reduce pressure in the anal canal. The fissure is allowed to heal naturally as the muscle tension decreases. Finally, the incision is closed with sutures, and the patient is moved to recovery.

When is LIS Needed?

LIS is typically recommended for patients with chronic anal fissures that have not responded to conservative treatments such as medications, dietary changes, or Botox injections.

Chronic Anal Fissures: Fissures that have persisted for more than six weeks despite other treatments.

Severe Pain: Intense pain during bowel movements that interferes with daily life.

Failed Non-Surgical Treatments: Fissures that do not respond to conservative measures, such as fiber supplements, topical ointments, or sitz baths.

Recovery After LIS

Most patients experience significant relief from pain within a few days after surgery, with recovery being generally quick. Most people return to normal activities within a week. Pain management typically involves over-the-counter or prescription medications to relieve post-operative discomfort. Additionally, dietary adjustments, such as a high-fiber diet and plenty of water, can help prevent constipation and strain during bowel movements, promoting healing. It’s important to avoid heavy lifting or strenuous activities until your surgeon gives you clearance to ensure proper recovery.

Schedule a Consultation

If you’re suffering from chronic anal fissures, LIS may be the solution to relieve pain and promote healing. Schedule a consultation with Texas Advanced Surgical & Bariatrics to discuss your symptoms and determine the best treatment option.

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