Please advise on Botox vs LIS - I have had anal fissure for nearly 3 months

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I've been suffering from anal fissure since almost 3 years now. It had almost healed at one point but it started hurting badly again. I went on a soft food diet and added lot of liquids in my diet along with 300 mg of Colace every day. But it resulted into loss of weight and went down from 125 pounds to 95 pounds. Though I am at 108 pounds now.

As a result in the last 6 months I have started eating much more to gain some weight as loss of weight was leading to lot of fatigue. But since I have been eating more I am getting BM at least twice in the morning. Earlier I had BM only once. I am trying to avoid gassy foods but I do experience gas in the BM as well which is very painful. For the last 6 months also since the fissure has been there for a long time now, i have started getting severe muscle spasms in that area as well.

Earlier my pain used to start 15 - 20 mins after BM and used to last for a few hours. For the last 6 months it has been lasting for the entire day.

The doctor who was working with me on this has retired and I am seeing a new doctor for the last few months now. She has suggested me to get either get Botox or LIS done. I had a rectal exam last week and my pain has surged and is totally unbearable even though I am taking muscle relaxants.

I have read about the side effects and I am somewhat concerned about LIS but at the same time very few of you on the blog here have had success with Botox.

I have a few questions as I have to decide between Botox vs LIS in a day or two.

  1. What would you suggest - Botox or LIS?
  2. How much time does it take to start getting relief after Botox?
  3. I know it takes 6 to 8 weeks after LIS to completely heal but is there any immediate relief that you have experienced after LIS?
  4. After Botox and LIS does it hurt if someone has gas?
  5. Is it important to have the scar tissue and skin tags removed during Botox or LIS? My doctor hasn't mentioned so but I read that some of you had Botox and your doctor removed the scar tissue.
  6. For those of you who did LIS, does the incision in the muscle heal? I mean the cut that is made in the muscle to divide it, does that cut in the muscle heal. I am asking because I did read that a few of you had to the surgery multiple times? Does it mean that everytime a new incision is made in a new place in the muscle. So will the muscle have 3 cuts in it permanently if someone were to get a surgery 3 times.
  7. Finally does the muscle become weak in the long run after LIS?



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    hi i am somewhat similar to you.I changed my dietband lost lot if weight which has resulted in fatigue and in my blood test the doctor found out i was anemic.So he has given me iron tablets to take three times a day which im taking since three days time.I completely know what you are going through and the pain associated with it and the fatigue-It is demoralising but continue to stay optimistic.I would advise youto get a blood test to check your iron levels as sometimes low iron levels will certainly make the wound heal slower. I was 70 kilo in december and now im 63.5 so i get bad fatigue and exhaustion.How is your fatigue.Also look at homeopathy as an option for fissure

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