Category Archives: Introduction

What is Sphincterotomy?


Sphincterotomy is a surgical procedure to cut or stretch sphincter. Sphincter is the circular muscles around the anus that control bowel movement (BM).

Sphincterotomy is a treatment for patients that suffers from anal fissures, piles or sometimes described as passing of glass. The purpose of sphincterotomy is to loosen the sphincter muscles and facilitate healing.

The procedure or operation is not to be confused with fistulotomy. Fistulotomy is a surgical operation on fistula, an abnormal growth in various tracts in the body organ. However, it is common to have both sphincterotomy and fistulotomy performed in the same operation.

There are 2 types of sphincterotomy :

  1. Lateral Internal Sphincterotomy (LIS) – This the only type of sphincterotomy used to treat anal fissure.
  2. Endoscopy Sphincterotomy (EST) – This is a type of surgery using endoscope to remove gallstones from bile (not a treatment for anal fissure)

Sphincterotomy is not the only treatment available for anal fissures. Below are some other common treatments, usually for less serious cases of anal fissure :

  • High fibre diet
  • Stool softneners
  • Botox

Botox (botulinum toxin) treatment is also known as chemical sphincterotomy. It is performed by injecting Botox into the internal sphincter. It involves no surgical procedure.

In many anal fissure cases, sphincterotomy usually is the final solution suggested when all other treatments failed.

Do you really need to go for Sphincterotomy?

Chances are, you are here because your doctor suggested sphincterotomy procedure to treat your piles or anal fissures problem. You barely can pronounce the name correctly, let alone hear or know what it is.

Some questions ran quickly through your mind. How is it performed? Is it painful? What are the risks? What are the chances of recovery? What are the side effects?

I know. It is scary. But this article will explain based on real experiences of sphincterotomy treatment and recovery.

By the way, sphincterotomy is pronounced as sfink-ter-ro-te-mi. A surgical incision of a sphincter (muscles that control the anus). See What is Sphincterotomy?

Sphincterotomy is usually suggested to patients with the following conditions:

  • Anal muscle is abnormally tight.
  • Frequent spams during passing motion or BM (What is BM? See Glossary).
  • Scar tissue has formed from previous wounds and it takes long time to heal.

That being said, a sphincterotomy is a viable choice if you have been suffering from piles or anal fissures for a long time. You should also consider this procedure if the wound or tear is becoming bigger and taking longer to heal.

The sphincterotomy procedure is performed by cutting the sphincter to weaken the muscle, thereby reducing pressure and promote healing of the wounded area. It may also involve cleaning of scar tissues to prevent further tearing.

It may sound painful, but sphincterotomy can be performed with only local anesthesia. Many who went through the operation claims that the pain is much less compared to the pain of anal fissures itself.

You may feel continuing pain a few days after sphincterotomy (some reported up to a week). This could be quite depressing for some, especially those who think of sphincterotomy as the last resort.

However, the situation usually improves starting from the second week after the operation. Full recovery may take up to 2 months. See Sphincterotomy Recovery – A Guide. BM is painless and normal for most people after that.

Post-sphincterotomy care is necessary to ensure quick recovery and to help you deal with the temporary side-effects. Side-effects may include mucous around the scar, itching to inability to control BM and gas movement. It varies from person to person, so it is best to consult your doctor or surgeon.

During sphincterotomy recovery, you can take medications and supplements to soften stools (best taken at night for BM the morning after). A diet containing generous fiber and water intake is recommended.

Nowadays, sphincterotomy has almost 100% of success rate!