by Ever the Optimist » 18 Nov 2013, 11:19
Hi Goaway!
It does sound like a Sentinel pile you could be dealing with especially since it's at a time when your fissure(s) are noticeably healing but don't rule out a regular pile & I would say just keep a mild eye on it.
If your diagnosis is that you are healed from the fissures, I personally would be reluctant to undergo further treatment and Botox might not actually be necessary as this is really only used to help an open tear heal. On saying this, it wouldn't harm to go for an internal EUA just to see exactly what is going on internally and to check that everything has healed up as it should.....but it's unlikely a CRS would perform Botox if there is no real need.
If it is a Sentinel pile, they tend to reduce in size or settle over time, possibly leaving a little mound of fleshy skin that shouldn't be too bothersome. It does take time though and I really would avoid any hemorrhoid type creams - I find that natural Aloe Vera (straight from the plant) or Coconut Oil to be helpful in soothing and reducing some of the friction in the area and these can be used safely too. Nitroglycerin will not help a Sentinel pile - again, it only should/ tends to be used in helping an open fissure heal up.
The best course of action generally is, if they are doing you no harm and causing you no major irritation, leave them alone to settle, which they tend to with improved dietary & toilet habits & use more natural based creams.
It just takes time :) All the best :)
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups