BOTOX INJECTION IN MUSCLE FOR ANAL FISSURE OUTCOME

jennifer...my advice is to go for it, it will just take half a day at the hospital but once the area is relaxed it helps to heal the fissure and get out of that vicious circle of repeated tearing and stretching and excruciating pain. hopefully u only need that one day off work. i went for botox a third time 2 years ago and the surgeon decided i didnt need it again and instead she sorted other problems out such as the piles and fissures....this was my third surgery. but thankfully since nov 2010 im pain free...after 10 long years of suffering. the loss of control may vary from person to person but for me as a result i would say i cant keep it in 25% of the time but it depends on how loose the motions are. but overall after years of pain and painful procedures i have my life back....it was worth letting those doctors poke around down there.

jennifer, 9 months of AF is not so long compared to my personal experience, but u r lucky that your surgeon has suggested botox so soon...dont hold back!!

I am a 51 yr old male - just had second round of Botox - first was Oct 2012 - made pain of going to loo much better but it wore off and by March the pain from fissure had returned.

So 2 days after Botox injection and an anal skin tag removal and I am in a fair bit of pain.

Lying on side in bed writing this.

I think pain will lessen in a few days as Botox takes hold but have to say that yesterday's BM was just excruciating - during was like someone slicing with a knife and then rubbing lemon juice into a cut - then the afterburn!

I am taking Naprosyn and Paracetamol for the pain. Plus at night to help me sleep Tylenol PM - has a sleeping agent which can cause constipation so I also take lactulose and Senokot.

It really does take over your life and I have to plan around going to loo in morning first - as when I need to go - I gotta go - no questions!

I'll keep you all updated on how my post-op progress goes.

Stay strong if you are in pain and know that others like me know how bad this is - how painful and how wearing down it becomes.

Jeff

Hi,

I had botox and a fissurectomy 10 days ago. It was all going o.k. Until two days ago and now I am in severe pain after every bowel movement such that I hadn't experienced before the op. I wasn't advised to expect this and was only told that I might have some 'tenderness'. I had started to manage the fissure by keeping a high fibre diet and taking pain killers. But suddenly I am no longer sure that I am eating the right foods. I was going for fibre, nuts, seeds, whole meal bread etc. but should I be going for just veg and fruit for a while to avoid bulking up? I am in so much pain and starting to feel depressed and am in tears a lot. No-one else seems to. Understand the pain.

I have used fybogel for a while which normally helps keep me regular. I have just bought. Some dulcolease to soften up. I hope I can use the two together?!

I wasn't advised about diet or sits baths by the consultant, I was just told 'don't get constipated'.

Am really not sure what to do and can't see an end to this....

Hi JMC40

Is a fissurectomy where they cut the muscle a little (Lateral internal sphincterotomy - LIS) - or something different?

Anyway - to give you an update on what happened since my last post - 7 days after my Botox on May 3 - I had to go to hospital as the pain I was experiencing was off the chart - I like to think I can take pain but this was way beyond the normal 8/9 pain levels (out of 10) I had come to endure.

So after being assessed I was giving intravenous pain drugs and then eventually (as nothing was even touching the pain) I was giving morphine - than helped - I went in at around 1pm and was back in theatre at 10pm - the consultant wanted to check nothing had become damaged or infected following the botox.

I awoke around 1am back in a side room at the hospital ward and managed to speak to a registrar (UK version of consultant's assistant - kind of) who said they found nothing of a major concern.

I left hospital with a bag full of pain killing drugs and it has taken me nearly 2/3 weeks to get back to anything near how I was prior to going in for my Botox 2nd round.

I only eat salads and veg and fruit and rarely bread - never pizza or meat etc - no crisps - basically all the stuff I love. One positive is that I have shed almost a stone and need to badly.

I tale Lactulose each day and also Fibogel (2 x pkts if I remember) - I also take some Magnesium Hydroxide Mixture (BP) - couple of tablespoons each day - and finally 1 senokot before bed.

Each morning I hit the toilet and its super soft - sometimes too much but I am terrified of a solid/hard poo.

This way I can at least lead some sort of life.

So my advice is hang in - the pain will get less - just ensure you drink loads of water - dont worry about over doing the different looseness/softeners because it getting the poo to come out and not hard the will give you some time to repair up inside.

I have no idea what the future holds and if I will ever get this gone. In hindsight would I have gone for Botox twice - honest answer is no.

I know it works for some people - but after my experiences all I can say is a HUGE FAT no to Botox.

On an ionic note: they took of a skin tag as well when doing 2nd round of botox but as I had the worst poo of my life ever day 4 after botox (lots of blood dripping bath etc) - I have a new skin tag (bigger) on the other side!!!!

So I am going back to consultant in 10 days time to see if its poss to take that off without ANY invasive up the bum work - if it does I will just live with the skin tag.

I still get this burning each day which just comes and goes - so got to try and not sit down too much.

I understand your depression and tears and all I wanted to at times was to talk face to face with a fellow suffer - nobody but yourself or someone who is going through it can truly know the agony and relentless pain - it wears you down, makes you cranky and irritable and live is frankly shit.

BUT - think it will get better and to recap

1. DRINK LOTS OF WATER EACH DAY - min 2 ptrs

2. TAKE LACTULOSE or equivalent

3. TAKE FIBOGEL

4. EAT FRUIT

5. IF YOU ARE STRUGGLING TILL TAKE MAGNESIUM HYDROXIDE

6. TAKE 1 SENOKOT TABLET BEFORE BED

Don't eat bread too much and make sure its high fibre.

If you get that terrible burning and stinging after BM then used cotton wool pads soaked in Distilled Witch hazel to clean inside (go gentle) and do it till the pads are clean (nothing showing on it - it does help.

I always use wet-wipes and then shower the area thoroughly.

Lastly, getting relaxed helps and some people have found that Valium can relax you and your muscles - have to say I am taking some and find it does it - but then I think I like the sensation of being chilled just as much!!

I wish there was a support group in Wiltshire, UK - where I live. So if anyone who is a fellow suffer wants to chat or whatever then just reply or Private Message me (if site allows this). Because at end of day just talking sometimes to someone who really knows what this is lie can make a huge difference (IMO).

Stay strong - nothing bad (or good) lasts for ever - it will get better!!!

Jeff

I forgot to mention that when I went into theatre at night - the consultant injected a pain killing/deadening agent - directly into my nerves inside my anus (I was out cold by then thank god) - that was total relief - when I came to I could not feel a thing - sadly it wore off!!

If the sold this in easy to take form we would all be buying it!!!

Thanks Jeff,

Fissurectomy is where they cut out the fissure in the hope that a clean wound heals better. I have since learned that not all doctors agree it's a good way forward.

I haven't heard of magnesium hydroxide, I'll look it up.

It's just all such hard work, I thought I was getting better but it's going to be such a long process.

Thanks Jeff,

Fissurectomy is where they cut out the fissure in the hope that a clean wound heals better. I have since learned that not all doctors agree it's a good way forward.

I haven't heard of magnesium hydroxide, I'll look it up.

It's just all such hard work, I thought I was getting better but it's going to be such a long process.

Hi Jmc40

So sorry to hear you are still in a lot of pain after your treatment. I'm not exaggerating when I say the things I read on here and other forums about Botox actually saved my life.

I developed a fissure after giving birth to my daughter so not only was I dealing with the usual stresses of having a little one, I was in absolute agony.As others have said, unless you've experienced it, it is impossible for another to gauge this. I initially had the LAS surgery which worked in the short term, but then the agony returned. I was so bad at one point, I was actually scared to eat and my weight plummeted to about 6.5stone. What people don't realise is that you very quickly descend into a state of depression, I feel exacerbated by the fact the pain you're suffering is in a place you cannot openly discuss with others - give me a broken arm any day!!

I had a fissurectomy and Botox injections in 2009, and paid for it privately as it wasn't widely available on the NHS. I feel it saved my life. Following the surgery there was a lot of pain, I had 2 weeks off work, and needed to take Diclofenac painkillers for some time. However, after about 3-4 weeks, I was pain free, and have mostly remained so for over 3 years.

I still need to take care over what I eat....no white bread/rice etc, all wholemeal foods, but along with this, I HAVE to drink a lot of water. If I don't, I notice it straight away. I also steer clear of nuts and seeds, simply as I found they caused pain!! It's very difficult to get the stool consistency right....and it took a bit of trial and error, but listen to your body. I lived largely on brown rice and veg for a little while and then gradually introduced other foods. I steered clear of too much fruit as I found it made me go too often...looks so crude to type such things, but I know you'll all understand!!! I now go once a day at pretty much the same time. I also now find that if I haven't gone, a little exercise gets things moving in a more natural way than any lactulose etc I had been taking previously. (Although not in your current condition I appreciate!!)

Jeff, I'm sorry to hear your treatment wasn't as successful as my experience. I agree it would be lovely to have local support groups. I was so thankful to discover forums like this.

I thought it important to show there is hope out there for any of you who are still suffering.

All my best

I been suffering from anal Fissure for almost 3 months and it started to to get better about 3 weeks ago. My routine is, I drink 1 serving (11.2 oz not a bit more) of 100% coconut water and I increase fruits and vegetables everyday. I got off all my medication after I see myself feeling less pain. Also when you wipe make sure its either baby wipes or moisturizer wipes that don't have alcohol or acid in the ingredients. Use those wipes after every bowel movement. Avoid caffeine, spicy food, fruits with acid, tomatoes or anything with tomatoes, and don't eat too much starch or carb foods. It helped me so much. I been drinking coconut water for almost a month now its high in potassium, magnesium, and zinc.

If you don't mind can I ask how much time gap should be taken between two Botox injection.. ???

Hi everyone,

Im in desperate need of some advice! I too am an anal fissure sufferer! I have gotten a fissure from recent child birth and i feel at a complete loss what to do. I have exhausted all options out there in terms of creams and laxatives. Has the rectogesics worked for anyone?? Although it has only been 3 months it feels like a life time. I thought child birth was bad and then came along this killer pain i found out was a fissure. I dont think i can handle the pain anymore, i spend 8 hours in agony pacing around my house and with a newborn baby i feel im slowly sinking into depression. Can anyone recommend the quickest and most effective solution for this before it gets anymore out of control? Im willing to pay private or fly abroad for the da vinci robotic surgery! help anyone please?!

My advice, having suffered for a long time, is to use vitamin e oil directly on the fissure. I found that is has really helped and I am in the best shape in a very long time (after a failed fissurectamy and now two lots of Botox). I think hat the oil helps in two ways, firstly to lubricate the whole area pre and post bowel movement, secondly, vitamin e will help the skin heal. I also take two vitamin e tablets a day together with a whole host of other vitamins including zinc, vit c, garlic, magnesium and linseed/flaxseed oil.

My Consultant also said not to worry about taking more than the recommended dose of stool softeners as they won't do any damage. You need to find a combination that works for you. I take dulcolease in the morning and lactulose and night as well as two lots of fybogel a day. lactulose is great and really works but is too strong for me during the day. Also, the fear of the pain of going to the toilet stops you from going so you need to try and heal the fissure as well as keep things moving so definitely invest in some vitamin e oil. Sits baths after a BM also help, although not always practicable.

Hang in there, eat well, look after yourself and drink lots of water, eat oats rather than bran as its too harsh and limit nuts for the same reason. Lots of fruit and veg and food that's easy to digest.

That's the bestbimcan offer in advice after a year of trying to heal myself!

I have had an anal fissure for what seems like forever (at least 5 years), as a result of banding to some piles in 2008 at the age of 28. I am going to be very graphic and open about my experience, firstly to get things of my chest and secondly to hopefully help others with my treatment, condition management suggestions as it helping me to read your suggestions.

I have to say this is the first time I have reviewed a forum and it is helping to read all of your postings, it makes me feel less isolated regarding the curse that has been inflicted on us and can totally empathise with all of you.

I am a 33 year old man with what can only be described as a chronic anal fissure/spasm. Every day is a horrific ordeal of blood, pain, misery and I am becoming increasingly depressed.

I have been under the care of St Thomas' Hospital in London since April this year and have had various appointments, the most recent was last Thursday and I had some tests that involved various devices being inserted into my rectum (which only lasted about 10 mins and wasn't actually that bad. I have been using Diltiazem Hydrochloride 2% Cream which relaxes the anal muscles making it easier to go to the toilet and promotes healing. I was told that this has a 70-80% success rate, unfortunately I fall into the 20-30% failure bracket. They will be sending me a letter with the test results and a treatment plan that could involve Botox injections but I will wait and see what the plan is. The consultant said that the Botox may cause wind and skids marks (lovely!) and again has a 70-80% success rate, I just hope I'm in that percentage and not failure, I need the torture to end and to return to normality!

I have also had appointments with a physiotherapist who taught me a technique to avoid straining, you rest your feet on something akin to the width of 2 yellow pages, elbows on your knees, back straight and puff out your stomach, this is the optimum position to empty your bowels reducing the need to push or strain.

I have been taking Movicol and Fybogel both twice daily to keep me regular and soften my stools, also glycerine suppositories make me go quicker and limit straining, I use them twice in the morning to get my self empty so I can get on with my day, the only drawback is needing to go a third time which can cause a bleed if i'm not careful. I eat a high fibre diet with porridge and fruit using alpro almond milk with honey every morning. Fish, potatoes and high fibre vegetables such as cauliflower, courgettes etc and plenty of non acidic fruits. Nothing unnatural or processed. I am going to really make an effort now including no bread, which I will now be cutting out of my diet completely. Also starting using coconut oil after my final bowel movement and taking daily baths to soak the area. I've also started jogging as regular exercise is supposed to be helpful, so hopefully all these extra steps will be beneficial.

I think the fissure would of healed by now if it wasn't for the spasm, more often than not now there is no blood dripping into the toilet but (I apologise that this next part is graphic but it's best to be open) I have to push the spasm back into my rectum using toilet tissue, this is unavoidable as it won't go back on it's own which causes the fissure to bleed, I'm certain it would heal using Diltiazem if it wasn't for that! I think there is a severe internal fissure.

If I had the time I would take a bath after every bowel movement but that's impossible with a busy life and living in shared accommodation, I could possibly afford a place with my own bathroom but I am only in a temp job, even though my contract has been extended twice I can't risk leaving my myself stranded in a place I can't afford if I become unemployed.

I have to stay positive and hope that all of this will be a distant nightmare, as I'm sure you are all aware until you have experienced this do you realise how it can ruin your life!

I hope you all have positive outcome also.