Botox for chronic fissure, experiences please

[MissTulipan]

Hi, I’ve got a follow up with consultant soon and this will be next option as I’m still not fully ‘normal’ in the bottom department, have exhausted all anal fissure creams, laxatives etc. I’m a lot better than a year ago when it started but still feel a bit sore and swollen day to day.

I have read a few accounts of people’s Botox experiences but looking for more, how was it immediately after, few weeks after, did it help? Did you have any embarrassing side effects, need time off work etc. Thanks

Guess it’s not that common....

Im 5 months suffering and had stool softener and rectogesic which worked until i stopped them and now its come back. I not at your stage though.

Booked in for this in few weeks, anyone had this?

I’m now 7 weeks post Botox and I don’t think it has done much. Anyone have any experience of having this done?

As I said before DH had this at the same time as surgery for a fistula about 5 weeks ago.
He thinks that the BOTOX has worked for the fissure but he thinks the fistula has not gone as still getting periodic discharge and pain, things still are not right ...no follow up appt with consultant so has made another appt with GP to ask to be 're referred

Hi, I have read all the posts on here as I’m at my wits end about this pain I’m in now, had a really bad 3 days! It all started August 17 when I was on holiday and had a really bad bout of constipation, I really knew I had done some damage but thought it was piles to start with. I persevered with pile cream for a couple of months but it was getting worse so I went to the GP. She examined me and said she could see a small external pile but no fissure but I was in loads of pain so she had to stop. She prescribed Anusol, no effect so I went back 6 weeks later. She then referred me to a colorectal surgeon. I had to wait 8 or so weeks. I saw a registrar who said I had classic symptoms of a fissure; feeling of passing glass when going to the toilet/ blood on toilet paper/ gnawing pain for hours after. He examined me and it was the worst experience ever, I have never known pain like it, he used an anoscope but said my internal sphincter muscle was so tense he couldn’t see anything. He prescribed Diltiazem and I had to go back 4 weeks later, no effect from this cream at all. i was then referred for a flexi sigmoidoscopy which I was dreading but leading up to this procedure someone recommended trying Anusol suppositories with hydrocortisone which I did and I started to take Movicol. ( I am prone to constipation). I then had another hospital appointment to share results of sigmoidoscopy- ? Area of redness that could be a healing fissure but the bowel was normal. By this point the movicol and suppositories had started to work. The registrar said the next step would be EUA (examination under anaesthetic) with Botox. As things were improving I cancelled this. 6 weeks later all the symptoms started again after a slightly bigger poo 🙈 I had an SOS appointment where I could refer myself again to the hospital if under 3 months. I did in July and have had to wait for an appointment: 3rd October. This can’t come soon enough, the pain is worse than before which I think is from the spasms. I went to the GP in August before going on holiday as I was at my wits end, he prescribed GTN ointment but this has had no effect either!! I find the only thing that helps short term is sitting in at hot bath but I can’t do that when I’m at work 😭. I honestly would not wish this on my worst enemy and I really hope the Botox works, I will do anything to get rid of it now despite any possible side effects!
I was wondering if the Botox has worked yet for those who have had it? Sorry for the long post it’s just nice to hear from people who are going through the same and can understand!

Kirky76 Sorry to hear of your pain, I can relate and it’s horrid. I have another long post on here with my story which you may find useful.
Your journey sounds very similar however your pain seems worse. I think until you can get the constipation under control it won’t heal. Take however much movicol or lactulose needed and lots of water and right foods etc to have soft poo always, it only takes a harder one to set you back, but you know that.
I had EUA and Botox 2 months ago and it has helped a bit, I went last week to surgeon for follow up and he said, as I’m only experiencing mild soreness, to now leave it alone, further procedures may make it worse. I am now in the mind set that I need to wait it out to heal naturally and all doctors I’ve seen have assured me it will heal. I think stress is a major factor, worrying about next appointment, worrying about surgery, worry about the future. Now I know there will likely be no further treatment I’ve strangely started to feel a bit better because I’ve calmed down.
I think the Botox should give you some relief so try it. I had no side affects and that was my biggest concern.

Thanks for your reply MissTulipan. It’s good to hear you have had some relief from the Botox. The problem I have with the laxatives is I really don’t want to go to the toilet more than once a day because if I do I then get pain all day, rather than if I go once in a morning then the pain usually subsides by about 4 or 5pm then I’m relatively pain free on an evening. It’s so hard to know what to do! I hope you continue to improve and I’ll let you know how my operation goes 😬

Oh forgot to ask, how long did you need off work after the EUA and Botox??

Hello, I had 4 days off including the day I had it done, I was cautious and took extra time as had no idea of the after effects. I think I could have gone back sooner in hindsight. I was so concerned that it would make me fart uncontrollably but I really didn’t notice any difference following the procedure except swollen and sore. Not long long until you get yours, good luck and keep positive. I know what you mean about trying to only go once a day, I find I often go twice but still find it better to take the lactulose. Let me know how it goes

Thank you, will do.

Hi. I had been having lots of pain in my bottom area and saw a colorectal specialist back in late January,early February who did a sigmoidoscopy whilst I was asleep. When I woke up they told me that I had 3 haemaroids banded and a Botox injection on a fissure. Anyway for first 5 days or so I did get some sharp pains after going to the toilet like something was going into spasm. The pain did ease some but I found the Botox left me feeling slightly incontinent. I would just pass wind without meaning to and I found that when I needed to go for a poo that it would start coming out before I even reached the toilet. It's 7 months since the procedure and although the wind isn't as bad I can pass the odd one still by accident and I feel weaker down there if that makes sense. Sadly my pain has come back now so I'm no better off. The trouble is I have a stomach condition which the worst symptom of it is chronic diarrhoea so I can be on the toilet a lot so think this is just putting to much pressure down there. My medical insurance said they would only cover 1 Botox treatment so can't have it again but I wouldn't anyway as the side effects I experienced and it's only a temporary measure. Fed up with always having some degree of pain and discomfort down there. Hope you get sorted.

Ah that’s not good ipswichmum 😔. I don’t think until anyone goes through this will totally understand how difficult it is to deal with! I think my problem is haemorrhoids aswell as a fissure, so I’m hoping they can do something when I’m under anaesthetic. The side effects are worrying me a bit but tbh the pain gets so bad most of the time I will risk anything just to see if I get any relief!! I can imagine diarrhoea would make things a lot worse as people with chrones and colitis suffer badly with fissures.
Do you not get the Botox on the NHS?? I thought you could get it twice and if that doesn’t work there is the LIS (lateral internal scphincterotomy) that is meant to have a very high success rate but again comes with possible side effects 😔
I hope you start to feel some relief soon.

ipswichmum - my Botox was with the NHS.

So after counting down the days until my appointment which was meant to be in 2 days, today I got a phone call from the colorectal surgeons secretary asking if she could postpone my appointment by 2 weeks! I said I was in agony every day and had waited 12 weeks already. I asked if the clinic had been cancelled, she said not, they had just had a lot of cancer referrals. So I couldn’t say no to that but I can’t believe I have to suffer another 2 weeks then however long until I have Botox. I feel bad saying that because I haven’t got cancer but it’s unbearable today 😢

Kirky76 that is so disappointing for you, really sorry to hear that. Have you had to change all your plans around that? So sorry I have no words to make the pain stop but take comfort in that after 16 months I finally feel I am on the mend and soon hopefully you will be too

MissTulipan I am glad to hear you are on the mend, I had a couple of good days last Thursday and Friday but then back to pain again Saturday, I just can’t work out why or what improves it or makes it worse!
I had flexi from work but my boss said it will be fine to change that to the 18th. I just hope the wait for treatment isn’t too long. Will keep you updated

Hi again! Just thought I would update you. I had my appointment yesterday (eventually!) luckily I saw the Consultant this time. Thankfully he didn’t need to examine me as he said everything I was telling him was classic signs of a fissure. He is booking me in for EUA with Botox and possible haemorrhoidectomy. He said if the haemorrhoids are big they can cause a cavity which stops the fissure healing. He said it will be very painful post operatively but I said I don’t care as I can’t go on like this!! I’m really nervous for the surgery but know it needs doing. How is everyone else feeling now??

Hello, glad to hear you are booked in for the EUA and Botox. Hopefully this will help and at least the surgeon can take a good look at what’s going on whilst your asleep, it’s too hard and painful otherwise.
My Botox was about 3 months ago now so I’m assuming most of it will be out my system now. I’m actually a lot better which I never thought I would say, I think less and less about my bum and can now imagine a future without a fissure. I can still feel ‘something ‘ a slight soreness whilst going to the loo but that’s about it. I still take lactulose daily and this has really helped. I will continue doing this for the foreseeable future. I still eat well, drink loads and keep active.
There is hope. Try and chase your surgery appointment, ring the appointments line at hospital and try and get a cancellation. I managed to get an earlier surgery date by having a chat, explaining I had young kids etc, all honest stuff and they slotted me in. Good luck and keep us posted.

Ah glad to hear you are feeling loads better. Does the lactulose not give you stomach cramps? Did you ever take Movicol? I’ve had a pain free day today but only because I haven’t been to the toilet at all! I know that’s not great as I normally go every morning, but I was up early to go to my HIIT class and haven’t needed to go, will probably suffer tomorrow but I have enjoyed having a pain free day! But hoping after the surgery every day will end up being like today fingers crossed 🤞

Lactulose I take just before bed, 2 spoons, can make me a bit windy straight after taking but only occasionally. Just keeps everything a bit softer. I never took softeners before the surgery as my GP told me not to and just to eat lots of fruit and prunes. Straight after surgery I was given massive bottle of lactulose and told to take it daily and to ignore what GP said. I still eat the fruit and prunes but added the lactulose and I think it helps.
I really hope you get your date through soon. Stay positive...

Hi! Just thought I would update you, I had my EUA and Botox 2 days ago. I was home the same day and didn’t get to see the surgeon afterwards but was just told by the nurse my symptoms were from the fissure and I didn’t need a haemorrhoidectomy which I was dreading! I had to have an enema before the surgery so due to this I didn’t need to open my bowels yesterday (the day after surgery) this am I needed to go though and I thought I had managed to get away with pain but as soon as I had been the spasms started really bad! I had to go straight into a hot bath! Luckily the bath eased things and after a couple of hours the pain subsided. I just have an ache in my bum now and still a bit of blood. I did read that it can take 1-2 weeks for the Botox to work though. I was told I would be reviewed by the consultant but I don’t have a date for this yet! I really hope this is the end of everything now. I was told to take paracetamol and brufen but wasn’t given any laxatives! I still have movicol which I took this am but it’s making my guts bubble and gurgle like mad I am wondering if to try lactulose 🤔
How is everyone else doing? I hope you are all pain free now.

Hello, glad you have got the surgery done, it’s not nice waiting for it. It’s hard to know what’s going on straight after. I was horribly swollen and the whole area was black with bruising for a few days after. I never had spasms with my fissure, just a swollen, sore feeling, so can’t offer advice on that.
I think give it time, it’s early days but I understand your frustration through all this. I’m about 5 months post Botox, I am feeling better than before the Botox but whether the Botox did anything or whether time and lactulose has been the healer I don’t know. I’m still not ‘normal’ have some days where I feel pretty good and other days a bit sore and swollen in side. But I feel, given more time I could get back to normal. I hope this gives you some hope. Keep taking movicol or try lactulose. It does make me windy though sometimes.

I had 3 piles banded and a fissure injected with Botox in January as I think I have already commented earlier on in this thread but all my pain is back with a vengeance,feels more painful than last time. I'm seeing my colorectal consultant this morning. Worried what will happen next as Bupa said they would only cover 1 Botox injection. Making me miserable the pain being back. My whole buttocks feel tender to sit and the skin feels quite hot and sore. Don't know what's going on. Thought I'd get the consultation over with before Christmas as I don't want any procedures before Christmas. Not going to let him examine me this morning as I'm in to much discomfort as it is and last time he couldn't really see much. It wasn't until I was under general anaesthetic and he could have a proper look that he found the piles and fissure. Wish me luck . 🤞😬 x

I've been reading this thread and I'm wondering how everyone is doing. I'm 4 weeks post second round of botox and I'm still not healed x