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

@mumof2bambinos so sorry to hear it didn't help! I'm alright, the first lot of Botox was amazing and thought I was in the clear but at about 4 months I tore again, it isn't anywhere near as bad and the pain only lasts for a day or two but it kept happening so I'm booked in for it to be 'cleaned' and to have Botox done again in 2 weeks. My understanding is that my surgeon will try and remove some old scar tissue to promote it healing better and hopefully less like to tear again in the same place.

I am a bit stuck though as I've had no pain since my surgery date was agreed 4 weeks ago so I'm worried that I have the surgery and it's awful afterwards or I don't have it and I tear again and have to go back on the waiting list. I think I'm pretty decided on having it done and will speak with my surgeon on the day of to discuss the possibility of her assessing it and making her decision based on what she sees 😳 thinking she may just do the Botox again to allow it a bit longer to heal if it isn't currently tore.

Have you had much follow up since your Botox?

@GaslighterDenier fingers crossed this procedure works for you. I have heard removing old scar tissue helps it heal much better. I had a follow up 2 weeks ago and now on a waiting list for another set of botox but they will increase the units of botox slightly this time. I would definately go for the procedure because if you cancel it no doubt u will retear after cancelling it (although i pray you dont retear). How can a small cut cause so much misery

@mumof2bambinos that was the exact thing I said to my husband, if I don't have it I'll end up back at square one!

I honestly wouldn't believe how bad it could be if I hadn't experienced it myself.

Are you getting any relief from anything? I found daily lactulose and GTN cream in small amounts spread over the whole day was the only thing that remotely helped but it was still awful ☹️

@GaslighterDenier absolutely. I feel fissure pain is like no other. Hell on earth

I have been taking laxido for 2 years but i missed a dose a few days ago and the stool became formed and it seems whenever i have any formed stool it retears the area. If i have loose stool its ok. Do you experience the same?
The consultant said gtn is not being used much anymore for fissures and he gave me diltiazem

@mumof2bambinos @GaslighterDenier @kirky76 @ipswichmum @MissTulipan @Timaa hoping of reviving this thread for help! Healed a fissure via self-care after 8 long months in 2021 after first child. However it returned with a vengeance in December 2023 following second child. Suffered for 12 months on and off so have today seen consultant who wants to do Botox.

My experience is so similar to many on here. Thanks to Laxido, a lot of water and 1 million punnets of blueberries a month, I can keep my stools that loose that for the last 3 months, I have had little to no pain after BMs. I thought I'd cracked it! However the minute I have a formed stool then it's game over. And it's just a normal formed, relatively small stool. Not constipation or an overly large BM. This always sets me back both physically and mentally! The consultant is going to 'scrape' the fissure and give Botox. Apparently a top layer can form that isn't fully healed and it then it stops it from full healing. So they remove this, and give the botox. Then it's back to months of self-care and loose stools. In the hope that it's able to fully heal.

My question is; those that have had botox, can you now have a normal/formed bowel movement as this is currently my dream?

For anyone that is suffering now, I have a lot of experience on the self-care front. Hopefully it can help to get you healed. This all worked for me first time round and I was able to fully heal myself (I think this second time something is just stopping that final bit that means it can very easily open back up!)

• 3L of water everyday - sugary cordial in this helped me too
• Laxido - by far the best laxative for soft stools. However you must dilute it in a small amount of water (200ml) so it's super concentrated still.
• Take the Laxido before you go to bed - in the morning- strong coffee as soon as up (I don't particularly like it), and this made me regular
• Fruit and Veg - 5 a day. Fruit particularly served me well. I had a large serving of blueberries each night (to trigger the laxido/BM for morning). Blueberries and grapes did best for me
• Everywhere says high fibre diet but there is a diff between soluble and non-soluble fibre. I actually found one bunged me up. Like porridge oats. So instead of getting preoccupied with fibre, just think fruit and veg!
• Sitz bath with Epsom salts and a few drop of tea-tree oil. Buy a sitz bath that goes on your toilet. Much quicker that using your bath so you're much less likely to not have time to do it. Have a sitz bath after each BM and if you're only able to do for 2 mins, then do again later in day, when kids are in bed for 10-15 mins
• Anusol ointment with hydrocortisone in it helped with post BM pain
• Nurofen (better than paracetemol) for post BM pain

GTN cream (two courses) I think has helped propel my healing this second time round and it didn't give me headaches like it does some people so very worth trying. Might not be the final thing that fully heals you like in my case but it's certainly helped. I was also prescribed scheriproct ointment to try. It's actually for piles so it won't help fissure however just one application of this if a BM had caused me a lot of after pain (throbbing, soreness, feeling pressure and swollen) and it really took the edge of (alongside ibruprofen). Don't know what's in it that does it but worth a try just for pain management.

I had to do the above first time around for 8 months. And it does consume your life but it did work for me so really hope it helps someone.

Now I'm praying that this one just needs a little helping hand but it can be sorted! I plan to do all of the above yet again for at least 6-8 months after the botox.

Hi, it’s been 6 years since I’ve had my surgery (Botox) and I have had absolutely no issues since. I’ve even had episodes of constipation where I was worried it would happen again but it hasn’t. I try and ensure I am well hydrated and have fruit and veg but I’m just prone to constipation unfortunately. I carried on with Laxido for a good amount of time (I can’t remember exactly how long) after the Botox to ensure the fissure was fully healed.
I feel for you as I would never wish this on my worst enemy!

Thank you. That’s really good to hear. It gives me some hope!

Im going to do at least 6 months still on laxido and strict diet afterwards in the hope that it fixes me for life. Consultant seemed positive

I also seem to just get constipated easily. Can’t seem to have a couple of days off the diet/water without going backwards but when it comes to things like holiday or Christmas you’re going to fall off the wagon sometimes. I’ll have laxido in my cupboard forever for these occasions!

Yeah I think constipation can be hereditary as mum my and my daughter all suffer too. Being active definitely helps too.
good luck with the procedure, I’m sure you’ll get relief and it will heal. It’s unbelievable how a tiny little tear can cause immense pain!!

Thank you! I know it's awful. As you say I wouldn't wish it on anyone!

Hi @SassyScroller i am still suffering. Due botox again next week. Currently struggling with trying to bulk up the poo

Hi @mumof2bambinos how many times have you had it? I found some fibre bulked up. Which is the opposite of what I wanted. I was also told by GP that there was two different types of laxatives. One is a softener (like your Laxido) but the other - like Senna and those similar - were bulk forming laxatives. I'm not sure they would be want you want for a fissure however I do believe chronic loose stools can be bad for fissures because the muscle will still spasm so maybe something to ask your GP.

@SassyScroller i had it once in 2023 and now need it again. I never healed. Everytime my poo forms even if its thin it retears. So i might just have to have loose poo from now on. Which fibre bulks it up please. I need it to bulk a bit cos its easier trying to poo with bulky poo than thin poo. Even tho its painful

Ah - fingers crossed it works for you this time. My consultant said they would scrape the fissure first, almost removing the top layer, then give the botox and that has a better rate of fully healing because it's just not doing it on its own. Maybe ask about that if you're having the procedure next week. I think it's insoluble fibre but do a bit of researching as I'm not 100%!

Hi @SassyScroller sending you lots of love (and everyone else) as fissures are truly the worst most debilitating pain I've ever experienced. Since my last update on here I have had a second round of Botox and agitation of the fissure to aid healing. I still take lactulose daily and think I probably will for a long time.

As you mentioned most of above I found gtn cream, scheriproct ointment and pessaries, regular laxatives, lots of water, watching what I ate and lidocaine was the only things getting me through whilst waiting for my Botox. Even then it was still unbearable most days and I was at my lowest mentally I think I've ever been.

Really hope the Botox helps, I feel like a different person after my 2nd round and have everything crossed I never have to deal with it again. Don't get me wrong it still has a chance to be painful on the odd day and I have to be careful bit it's so much better than it was.

My surgeon was amazing and discharged me pretty soon after my 2nd surgery as that way I would be eligible for the Botox again if needed in the future. Only 2 lots are funded per treatment here but a new referral would class as a new treatment.

@mumof2bambinos really hope your second lot helps!