BOTOX INJECTION IN MUSCLE FOR ANAL FISSURE OUTCOME

I have had a fissure for 18 months. It comes and goes a little but I can't remember the last time I had a pain free BM with normal action. I have to use my hand and the pain and spasm is pretty bad sometimes. I did try , duculose and the gtn cream, but gtn gave me dreadful headaches and turned my face red.

So I am having Botox later today.

I suspect the menopause is to blame but no physician listens to me.

I'm scared of General anaesthetic and becoming incontinent- but also that it won't work!

Hi All,

I had been suffering for 3 months after the birth of my baby with an acute anal fissure. All the GPs advice was completely useless, they even misdiagnosed my fissure for haemorrhoids. After seeing 4 different GPs and pleading with them that i was in agony and could not look after my baby because of the 8 hours of pain after bowel movements, they prescribed me the rectogesic ointment which is NOT licensed for breastfeeding so I didnt use it. I ended up being referred privately to see a superb colorectal specialist. The key is to been seen as soon as possible otherwise it only gets worse!! I was told that BOTOX was the best option for me as recotgesic is not suitable for breast feeding. BOTOX has no horrible side effects eccept for slight wind the first week. I have to say I was terrified of going under general and the after pain. However It was the most simplest of procedures. NO pain after and immediate relief!! I was told i had a very deep fissure and the botox definitely stopped any pain for 4 weeks afterwards and gave the fissure a good chance to heal. Howafter the botox wore off it had not fully healed but almost and by that time i decided to stop breast feeding and use the rectogesic. The side effects were quite unpleasant; racing heart beat, faintness, headache and red face. I had a 6 week follow up after the botox and the rectogesic and im pleased to say my fissure is fully healed. My personal recommendation to all suffering with anal fissures is:

1. TAKE LACTULOSE 4 TBL SPOONS TWICE DAILY

2. TAKE 2 FIBOGELS TWO TIMES A DAY

3. DRINK PLENTY OF WATER

4. SEE A COLORECTAL SPECIALIST ASAP

5. USE BOTOX WITH RECTOGESIC (If you can handle side effects)

6. HIGH FIBRE DIET

BREAKFAST: ALPEN, YOGURT, RASPBERRIES

LUNCH: LENTIL SOUP

DINNER: STUFFED PEPPERS WITH BROWN RICE

GOOD LUCK EVERYONE!

My doctor won't give me the Botox as he said it would cause anal leakage. Anyone agree?

I have since had anoheal cream and also Macrogol (2 per day) and I am finally (fingers crossed) in no pain and long may it last.

All on NHS - worked for me and I can pretty much eat what I want :-)

Sorry to answer your question: I had two rounds of botox (did not do much at all for me - but everyone is different) - it certainly did not cause anal leakage - then again consultant said me anus was like a vice :-( (tight - not the other kind ;-)

BOTOX does not cause leakage. It can only cause passing uncontrollable wind for up to one week when the effects are most potent. Botox does not cause any lasting effects. It works best up to 3 or 4 weeks and then the effect where off and you hope that the fissure has had the chance to heal. It stops the muscle spasming (tightening) which causes painful bowel movements as each time the fissure is torn open. You MUST make sure you drink plenty of water all of the time and use stool softeners to aid the recovery process. It is about getting the right consistency. IT can take a long time to fully heal but the Botox definitely relieves the pain greatly. Rectogesic helps after the botox wears off after 4 weeks. I had a very deep fissure which i never believed would go but after the Botox and 1 week of using the rectogesic I am pleased to say i am fully healed! Botox works for around 70% of patients so its quite a good first port of call. The other procedure which is cutting into the muscle to relieve the spasm causes permanent damage and soiling in 20% of BM times. So best to avoid if possible! Botox sounds scary but really was very simple and saved me from turning into a mad person!

I had Botox on Monday, no leakage or uk controllable wind. I have been able to pass stool normally rather than dig out with my hand for first time in a year. Pain better, hope fissure now heals.

Had botox and operation on ky fissure on Thursday,didnt have any bowel movements on Friday and now its Saturday morning and its like trying to part with a brick already had 3 goes and thats after taking my lactulose and just now a senekot tablet and have drunk lots of water.Had no pain since operation but iam back in pain now and stinging very badly.

Hi Damon

This sounds familiar to my Botox experience afterwards.

I would seriously recommend getting onto Macrogol (are you in UK) - until I used Macrogol my BMs were not great - either I was overdosing on Senokot and Lactulose etc and it was either far to runny/water or the other way. Since being on Macrogol (2 sachets a day) I have not had a sore trip to loo.

Keep us posted on your progress.

BTW - Macrogol acts differently to lactulose in so much as it draws more fluid into the bowel area - I know everyone is different but for me it was nothing short of a bloody miracle - that was after almost 2 yrs of bloody hellish pain going to loo and for hours after,

Damon, don't strain, it's the worst thing you can do because it will re-open any healing that has take place. Don't bulk up too much on food. I have found that light easily digestible food is best with lots of warm water And lemon. I still take two fybogel a day. Lactulose at night 45ml and if I need it dulcolease in the morning. (I might also try macrogol as an alternative). Senacot was awful for me as it was too harsh.

I also now use a product called Dr Wheatgrass superbalm applied to the fissure after every BM. It's worth reading the Dr Wheatgrass website and the comments there about fissures. I know my fissure hasn't healed as confirmed by my consultant. I have been offered further surgery but have declined at present because my symptoms are manageable and I am hoping it will heal soon.

I hope you get you life back soon. Xx

Hi Jeff and Jmc,Thankyou for your advice I had to go somehow so I ended up either having to make q 40mile round trip back to York hospital or I was advised by a local doctor to maybe try glycerol deposits to make me go which helped a little as the lactulose and senokot were not loosening anything and eventually I was able to go for a BM without too much straining.I was a little sore after but my prescription for diltiazem hydrochloride ointment arrived and this seems to have helped ease the pain.Just dreading today and any BMS again,going to drink water and small amounts of fruit and veg and no big meals and see how I get on.Thankyou for getting back to me both of you.I was 35 years old and fit then I was diagnosed with coeliac disease and 2 years later I now have a mild form of psoriasis also I have had colonoscopies and endoscopies with the camera down both ends but the constant pain a fissure can cause I would not wish on anyone.

Hi Leland,I had a team of six waiting for me in theatre and was looked after really well,i was even fully awake half an hour later and in no pain,of course that wears off in time.Iam still tender after my op on Friday and get some pain if i sit on my bum,iam currently looking into stopping using the diltiazem hydrochloride ointment also which iam ment to put on around the entry of my back passage as it is causing a stinging sensation of 9 out of 10 pain for 4 hours after applying and that tells me something isnt right.My BMs are getting better though after continuing the lactulose and buying some dried apricots and prune juice.Iam okay at the moment when i sit on my side letting my hips take the pressure and weight or lying down on my front when i sleep is bliss as there is no pressure on your bum at all.

Hi all,new on here.I would recommend organic coconut oil,cut into chunks and used as a suppositary and general rectal lubricant to aid periostalsis,A pint of filtered water per day and a wonderful cream(all natural) called Analcare.This system works.Go easy on the high sugar stuff and you will improve.

Im on my 4th day in hospital after taking myself to the A&E department for the 2nd time in three weeks. Dr's tried to assist with pain management but even being groggy on 10ml IV morphine didnt stop me feeling the spasm pains off the scale. Im having a camera procedure tomorrow under general anaesthetic and the nurse let slip that they plan to do a surgical anal stretch whilst im there. After reading the unwanted after effects of this there is NO WAY the surgeon will be conducting that procedure on me (40% chance of permanent incontinence of gas, 20% fecal incontinence and 50% people have a relapse of symptoms!) I am praying that they are equipped to offer botox treatment so that I can get my life back. Ive been off work for a couple of months and my two young children are at home with my husband. Fingers crossed its sorted VERY soon, I won't be leaving hospital until it is because nobody can be expected to live like this. My heart goes out to everyone in their struggle to get better.