BOTOX INJECTION IN MUSCLE FOR ANAL FISSURE OUTCOME

I have been following the discussion with interest. My condition also has been made worse after botox injection once for anal fissure and then again during the excision of of skin tag. After the latter I also developed blood and sepsis. 

The pain before and after the botox injection was quite different. I asked for a second opinion and there were is enough medical evidenc that  that the pain following the botox  is caused by nerve damage in the sphincter musle from the injections.

The doctor leading this investigation, has tried to do his level best to conceal this evidence from me, but usingFreedom of Information Act, I got hold of my medical records.

My GP has been prescribing low doses of an anti-depressant (Amitryptiline) the side effect of which is relief from neurapathic pain.  I have once again become human being.

I wonder whether the complaints which you describe could also be the result of the needle in the wrong place. Nerve damage from facial botox injections is well documented. So, it is more than likely that the same mistakes can be made in the anus.

your information is extremely interesting. I am in the process of collecting evidence to start  a medical negligence case against the surgeon who ruined my life with his injections. When this horrible pain occurred after the first botox injection and I made link between the treatment and the new complaints, I was told that this could not be.None of my descriptions were recorded by the colorectal surgeon  but b

When I went to have second opinion at another hospital the first doctor  there wondered, after he had given me an manual examination and identified 2 very pain sensitive spots in the  inner sphincter muscle, whether this showed nerve damage from the injections. I had a number of anorectal physiology tests . Again the physiologist believed that some of my pain reactions could be due to nerve damag and I might respond well to taking either Amitryptiline or Gabopentin. 

However when I had a discussion with the doctor in the clinic that had instructed those tests, no reference to the tests and or the physiologists recommendation were made. I was told that I suffered from something that would remain unexplained and my GP received a letter that she should refer me to a pain clinic.

However, she had already - at my request - started to prescribe Amitryptiline, which made my life worth living again. 

I still have fissures - they come and go and are painful - but they are nothing compared to the pain I had after the botox injection.

If I had not been already suspicious, I would have become so when the test results were not mentioned to me.

Following that extremely disappointing discussion about my unexplainde "chronic anal pain syndrome" I requested a copy of the anorectal physiology report from the consultant and senior registrar by secure delivery. They did not bother to reply but instead deferred my next appointment by 2 months!

One wonders why.

Jamie, if you get this comment (I don't know what happens now that I presssed the wrong button) could you get in touch with me again.

I have a legal insurance for personal injuries and I am considering using it.

I really think I am not the only person who has suffered accidental damage from a treatment that was supposed to help me. And I do not like the kind of cover up I seem to be up against.

2-3 years of this and still fighting it - I had 4 months of pain-free trips to loo and essentially a normal life - BUT a dietary slip up can mean muscle spasms (as per this week) and it feels like you are back to square one - blood in poo and hurting going to loo.

My regime is:

PAIN MEDS

- Naproxen

- Traumadol

- Paracetamol

- Diclofenac

RELAX AND SOFTENERS

- Diazepam

- Macrogol (movicol)

- Anoheal (much better than the other one that gives headaches)

If you are in muscle spasm, which for me makes my arse like a ducks-tight) then

Gently press the heat pack directly up against your anus and keep it there, the heat forces the muscle to relax and stops the spasms, which stops the pain caused by the fissure. You can use a hot water bottle too as long as you can mold it to place up against your anus. Seriously. This saved me from so much endless fissure pain, it's like a concentrated hot bath focused directly where you need it, but without the inconvenience of running a bath and being stuck in a bath just to get relief. (I know baths are nice and all but not really always practical or accessible)

Best position is to lie on your back in bed, put your knees up like you’re going to do a sit up and then place the heat pack between your legs right up against your bum hole. Sorry for the graphic image but I can't really think of another way to describe it. Just be careful not to burn yourself, you want the heat pack/heat bag or hot water bottle to be hot but not so hot you burn your skin. It helps to wrap it in a pillow case that's soft and then if your heat pack is too hot, wrap it in more layers of the pillow case, which will protect you a bit more if it's too hot at first.

Before the heat packs I was taking dangerous amounts of pain meds to deal with the fissure pain which for me was all the time, including during the nights which were really hard... until I discovered the heat pack. Which thank God I did because they really work. Please try them, I understand this might seem silly and I haven't read it anywhere else but I know the suffering from fissures and this will help keep the pain at bay. Seriously, heat packs, heat bags or a hot water bottle pressed lightly up against your anus and held there, keep it held there and it will work. I sometimes keep it there for 15 minutes or more and then I take it off. Then when the pain starts up again I'll put it back and the muscle relaxes and the pain go's.

Try it. I had tried everything from which hazel oil in my bum to manuka honey in my bum (my wife called me sweet cheeks because of the honey), but the best thing to stop the pain has been the heat packs. Heat relaxes the muscle, stopping the spasm and the pain.

Ultimately though you want to find a solution to heal the fissure once and for all so I suggest the surgery. I've had Botox and that did not work, in fact I was in a lot of pain afterwards, then I got the fissurectomy/sphincterectomy combo surgery and I am finally free from it all. I know it sounds nuts to get a surgical cut to fix a fissure but it’s the sure way to fix it. Conservative methods like Botox and Rectogesic Ointment but in the end only surgery worked. I wish I had done the surgery first cause I went through months of pain and hopelessness until I decided to finally do the surgery.

Though very important, make sure you research and choose a reputable specialist to perform the surgery. Don’t just go with anyone, find and choose the best that you can cause for me it was the 3rd specialist that ended up fixing me with the  fissurectomy/sphincterectomy. The first specialist caused the problem, the second specialist didn’t help and made my pain seem trivial until finally I researched and found the best in my area and the 3rd guy fixed me. So it’s worth it, pay a little more, travel a little farther if you have to but see the best that you can or at the very least someone with a lot of experience with exactly that surgery. If you’re in Sydney Australia then the Prince of Whales private hospitals “Sydney Colorectal Associates” really have a great team; Dr. Newstead fixed me and I am so thankful for him but he’s part of a group of several specialists there that all seem good.

Until then though, heat pads, use heat pads to relieve the pain.

I have just joined this forum, and really glad to find as i am going through this problem like I read here and any advice would be really good.

I have been advised by the Consultant at the hospital after the dr  had seen me many times as I am dreading going to the loo every morning because of the pain that I suffer due to an anal Fissure sometimes it is great a normal passing of stools then there are days when I nearly hit the ceiling, then I dont want to sit down all day as I have spasms there also is blood which looks much worse than it is because the loo paper acts like a blotting paperand the blood spreads, then there are days when there is no blood, I amnow waiting till oct to go to hospital this is just a consultant so I will again have to wait till they do the job, which I am told will be botox , I am advise that I will break wind because of this and that this treatment is just a tempory thing while the fissure is healing.

I try and help myself by the following,

have used various creams 

I am using fybergel husks

I am drinking water

I have wholemeal bread

I eat apples, pears, 

I eat plenty of veg

But I do have days when even doing all this I suffer pain when using the loo.

Sometimes, without trying to be rude herin this forum, to pass stools its often the very first stoul that comes which hurts then as more stouls pas out the pain gets less but sometimes, I have to use my arm muscles as if I am lifting weights to help me through the pain.

Any help wouldbe great thanks in advance