Desperate: Anal fissure- BOTOX treatment

Digestive health
1

Good Afternoon everyone,

I know there are a few posts about this topic already and believe me, I have read all of them. Most dating from 2010. Anyways, a little about me. The week my daughter was born, I had a large BM (I was taking blood pressure meds and Percocet from a c-section), both very constipating. I had no idea that I was supposed to take stool softeners after delivering or anything. Anyways I ripped really bad. I have had some terrible experiences. A few times I went for a jog and my rectum spasmed and I reopened. Another time I decided to only eat soup, there was corn kernels in it- I ripped tremendously from the corn kernels!! If I don't poop liquid, I reopen. Anyways, Insurance was giving me a very tough time until I finally got to see a colorectal surgeon after six months of extremely bad rectal pain! I scheduled my BOTOX injection as soon as I could, which was today. I am in extreme pain! Most of the posts from this forum people say they were pain free?!

Please please tell me about your experiences. Any information about Botox or LIS or self healed would be extremely appreciated.

Thank You!

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Hi lee,just like to say sorry for all the pain you must be in.I just my lis procedure last week which I wish id done before(cliche speech)Bt really,anal fissures are caused by a hypertonic muscle and nothing will ease the tightness but the surgery.Ive been lucky,I had minimal pain after the surgery,just a discomfort,some discharge and a degree of seepage after a bw.I take all that than full blown debilitating spasms and fear of a bm.its been just 10days and I have nothing but positive things to say about the procedure.The colorectal surgeon to start was very experienced and just to get an appointment I waited a month.Hope your bitox therapy works,if not dnt be afraid of lis from a reputed colorectal surgeon

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Hey April! I appreciate your immediate response! I have only heard great things about the LIS! I am 24 years old and the colorectal surgeon only recommended the Botox because I am young and would possibly want another child in the future. I heard different things about the LIS. I read online that you can't have any more children but my colorectal surgeon said that I can but can only have a c-section, if I get a LIS. I sometimes wish I can just over ride his decision and jump straight into the LIS. I have a follow up in a month and if it doesn't feel better I will beg for the LIS.

How long have you had the fissure?

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Get a second,third or even forth opinion.Most general surgeons havent ahd a chance to practice lis so their lack of confidence in the procedure reflects in their recommendations.It has its risks,but most overide fissure suffering.People who have less success risk are old or with immunity related diseases,ive not heard of pregnancy being mentioned.

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Hi April, been reading your story. is ils a sphincterectomy surgery? I

have suffered for years with pain and bleeding, went this week to see a colorectal surgeon. He wants to go through all the procedures first to see why I am anaemic,  ct scan, endoscopy and sigmoidoscopy because my iron is so low, I've had bleeding and pain from my bms for about a year now, and I'm sure it's a fissure.

so far he 's given me a lidocaine spray,,and some gtn cream and told me to take laxido every day.

I can't imagine it will heal on its own as I have a rectocele, which makes bms too large to pass, I had a prolapse repair last year that has failed.

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Hi Laura,yes lis is lateral internal sphirectomy.Its whereby the surgeon uses a smal incision to access your internal sphincter and divide it a bit to relieve its resting pressure allowing the fissure to heal.After 6weeks wth a fissure it becomes chronic,it wount go away with conservative gels.I used gtn too,it relieved some of the pain but it didnt heal,I cldnt continue living in pain,im glad my surgeon is confident in the procedure and recommended it immediately.id suffered for 6months!

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I've been like this for years but think the rectocele caused it, he couldn't see anything much, but the pain is so intense and lasts for hours.

i'm guessing the rectocele is making the bm too large for me to pass, and I'm splitting, he thought I could have a fissure that kept healing and opening again.

The anaemia is so bad I feel dizzy and faint, he asked if I had been having blood transfusions?

Maybe it's the sphincter that is too tight on me, will have to see what the tests throw up. 

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Laura, I am sooo sorry you have to go through all of that! When are the results supposed to come in?

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I don't go for the ct until the week after next, the sig and endoscopy are scheduled for the 5th April.

Am taking laxido and rushing to loo every half hour! At least I'm not straining.

I hope you soon feel a bit better, it's miserable when the pain's so bad isn't it, can't sit down or stand up for long. 

I read that the botox injections were painful, don't want to go doen that route if I can help it.

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Here are some suggestions I have for you to help you through:

1. Try somee zinc oxide in the form of calmoseptine which has menthol to soothe the area down there as well. Calmoseptine can be bought at almost any local drugstore and can be bought online too.

2. Try squatting when going on the toilet instead of sitting. This is a much  helathier position and the poop sometimes will just slide out,  no pushing or straining involved.

3. I would definately take a fiber supplement, specifically metamucil  is what I take evveryday,  in ordr to allow your stools to be soft and to allow them to pass thorugh easily. THis being said, with any fiber supplemetn, you must drink lots of water when using them, or they will not work veffectively. Also, do not take too much as too much fiber can irritate your bowels on the way  out and diarreah actually does worse down there.

4. I would recommend getting a sphicteronomy surgery if htings dont get better. I waited it out, gave up, had the surgery, and was able to heal within about two weeks. I had a chronic fissure, so I knew where you are ocming from with v all the pain and discomfort.

Try listening to music to distract your mind a bit, especially when going to the bathroom. If you are in writing pain, distract yourself with a movie or TV show right after. Also, to prevent myself from screaming and from putting more stress in the area down  there, i bit down on a washcloth in order to make the tensions with my teeth instead of my sphicter muscle.

Hope this helps!!!

Best,

Myles

 

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Hi. Sorry for what you going true. I am my self had chronic anal fissure. I had LIS surgery. I read Marcus said I add few more things . Drink plenty of water . Walk alone when pain free. Eat spinach. Salads , soups. After my surgery I imidatly felt better. I don't wanna talk what I was going true whe I had my CAF. I had my surgery on 19 February. I thing it took around 6 weeks to hill. After surgery I went to see my surgery. He put his finger I had some blood discharge. So he tald me to come back may the 12. That was 3 weeks after surgery. Know I am in my 7 or 8 week . For dose who suffer from CAF . Don't get me wrong dose conservative treatment waste of time it's procedure for the doctors you have to follow. Deep down all experience colectoral surgents know LIS is the way forward. And I know some ppl thing it is hard opp but not. Obviously some ppl suffer from opp more. But what the had before and after opp it's nothing to compare. Good luck everyone

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Good Afternoon, everyone!

I apologize for the late response, I have been going through a tremendous amount of pain lately. I assume some pain is normal for the healing process, but I doubt this much is normal. I will post a detailed day to day update so people in the future can know what kind of to expect from the Botox procedure.

April 7- I was under General Anesthesia at 11:30AM and woke up around 2:30PM. I was then wheelchaired to the car and went home. Of course, you need a designated driver since you had anesthesia. I was prescribed Percocet (for pain), Flexeril (for spasms) and a stool softener. My whole region down there was in enormous pain and was completely swollen. I don’t think this forum has TMI, we are all mature adults here. I was in so much pain by about 7PM. I felt like I needed to have a bowel movement, but it was really just gas. I was so swollen there wasn’t any way of relieving the gas other than doing it in a sitz bath. That night I drank about one gallon of water and I took two ducolax (which is what I have been taking for the last six months). I try not to take the Percocet because it is constipating so I bought some Ibuprofen (anti inflammatory) Every day I try to take at least three stiz baths.

April 8- Around 9AM I had a sub-okay bowel movement, regardless what I eat or how much fluid I drink, I experience soo much pain. Literally if anything touches the area, it hurts so much. Around 2AM I woke up in extreme pain, I sat in a sitz bath, changed the water and sat in another sitz bath to help sooth the area. I was in pain the entire day. I drank a gallon of water throughout the day and took my ducolax. I haven’t taken any pain medication (I would rather feel some pain than mask it)

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April 9 - 11 – I literally slept the entire day, I was still feeling so swollen and just in soo much pain. It is so unbearable sometimes. But staying with my same diet and taking my laxitives. Any time I bend over, urinate, cough or anything, it just seems to cause bleeding along with pain. For some reason it feels like I am sitting on needles and also my bone is super sore.

April 12 – I can tell the swelling is going down today and I started feeling normal. I haven’t taken any pain medication for about three days. But then, I had the worst bowel movement today, it was probably the worst experience of my life. I don’t understand why. My diet is good, I hydrate like crazy. My body was shaking, maybe in anticipation of what is about to happen. I had horrible rectal spasms. I don’t know if this ever happened to any of you, but has your body ever “aborted” your fecal matter? I mean, like it is completely out of your control. Anyways, that happened and I reopened my fissure and I am starting to slightly feel depressed. ☹

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Hi. Sorry for what you going true. As long as I know Botox injection is temporary treatment and your fissure may come back when the medication effect comes down. At this stage calm down try to relax keep positive continue your diet try to walk because it helps your bm come smooth. Try to not get constipated. Botox will relax your mussel with that 1 your fissure will go away . Find out if you can apply any cream on it. Stool softeners are good. Also you can have dry plum, or soak over night dry figs then drink it . In the morning and evening. Eat spinach in any form it's good for inside cuts. All the best hope hearing good news tomorrow

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Thank You, tootailay! I appreciate your encouragement! No good news today, had a very very painful bowel movement around 5AM this morning. I called my colorectal surgeon's nurse and she told me every day it will get better and to keep using the cream and sitz baths. Even though my bowel movement was horrible this morning, I feel ok right now. The pain didn't last long after. So I am feeling hopeful.

I am going for a walk this evening with my husband. And I eat a lot of spinach. Did you have the Botox or only the LIS?

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I'm sure you're going the right way now Lee.

It's been a horrible experience for you, but hopefully day by day you will see a little improvement.x

 

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Hi. Sorry to hear that as nurse said you will get better. Try to keep you bm as soft as possible.try prune juice. Take fibre cerials in the morning but before have your cerial have dry figs soaked overnight in the water, and few cup hot water wait for about 40 minutes then have you cerial.again drink plenty of water. After hour inhalf have some fruity salad Grapes ,apple,kiwi,pearl. Strawberry,etc... after fruit salad have prune juice. If you can go walk it will be gr8. After couple hours have lunch . Before lunch have stool softener . Try to eat lunch with salad . Don't eat any meat at this stage ,maybe fish some chicken with plenty of vegetables try to steam them at this stage.again plenty water. If you can walk will be gr8. At dinner have soup. I had ginger tea with honey mixed it's good for diagasting. Well I kept this regime for about 4 months it help me. I had LIS . About spinach my wife's friend had fissure after birth of her children, that's what her doctors was telling her. She will get better after 6 weeks. After bm you don't have the pain or etc... that's because the ottoxtakes effect . It relaxes you spinktrome musul and you don't get the spasm . So hopefully it will help heal the fissure. I got a question why the doctor tald you to not have LIS. As you mention you want have baby again. Find from good colectoral surgents on that. Keep strong you will get better .all the best

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So when I went to my consultation (first appointment) with my colorectal surgeon, he was telling me all of my options. I think the surgery he said that will limit me to only a c-section was NOT the LIS, I believe it had to do something with cutting the spincter muscle and sewing them back (and the pressure of a vaginal delivery would jeopardize that repair). So my apologies for the misleading information.

So updates: It has been ten days since my BOTOX procedure. Lately I have felt like the pain to be very very deep and like my coccyx bone feels sore? I suppose that is the best way to describe it. I am feeling very hopeful though, perhaps not for this procedure, but perhaps the LIS.

As I mentioned in my first post (prior to the BOTOX), I have accidentally reopened my fissure. But usually I take my laxatives and give it two days and the bleeding stops and the healing process starts again and I heal a little bit until I jog or eat corn or something and my fissure rips again. ANYWAYS, the reason I bring this up again is because at this moment, I have very sharp pain from the procedure. It could be because my Surgeon burned the fissure to prevent it from ripping. The original post-surgery swelling and crazy bleeding stopped. But I am still experiencing this really bad pain. I was trying to figure it out and the only thing is because my surgeon burned the area and that’s what I am feeling? The pain lasts throughout the day and is probably about a 5-6 on a painscale of 10. So not tooooo bad, but definitely can feel it. It is still extremely painful to have a bowel movement. It still feels like glass, but I am not having any bleeding. So therefore I know it is not the fissure opening, again, why I think it is possibly the burn.

My bowel movements has been very soft and great consistency. I have been walking every day and started juicing (I don’t want too much fiber and I need the nutrients). I am still taking my sitz baths and rubbing the cream.

Two days ago, out of nowhere I developed a very painful skin tag right outside the opening of the anus. I have skintags from pregnancy on my upper thigh, but it has absolutely no feeling. But the one that I developed two days ago on my anus is very hard and verrrrry painful, unfortunately it happens to be in a very bad spot.

Well, these are just a few updates from the Botox if someone in the future is curious as to what to expect.

For those of you who had the LIS, I always hear about “immediate relief” from the surgery, I am just curious, how immediate? Like is there swelling and bleeding? How did the surgery go? What to expect?

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In my case, I wouldn't describe as immediate relief. However, you do notice the pain descrease significantly. A lot of the pain is due to the sphincter muscle spasming, and having it not spasm is what provides the relief as the pain associated with it spasming is gone. 

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Sorry to hear about the pain - I know it's so miserable and depressing I had my Botox 8 days ago and so far I guess it's going well as the pain is nothing like it was ! During my surgery I also had a skin tag polyp removed from the inside which basically because the muscle was in spasm prevented the skin growing over the tear and that's why they grow as skin tags - it sounds like maybe maybe your Botox isnt relaxing your sphincter and maybe you need more units because with the Botox the only pain should be passing the stool because it scratches over the tear / I hope everything works out for you !!