Banding/Botox for prolapsing internal hem’s and fissure

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Banding/Botox for prolapsing internal hem’s and fissure

Postby Jon » 13 Jul 2020, 09:41

So I have internal hemorrhoids that prolapse on every single bowel movement. I have had these for many years. Typically they never caused much pain - just a long cleanup and then I would gently push them in and after a few minutes I’d feel normal and forget about it.

In March 2020, I developed a fissure that is in tissue that prolapsed with bowel movements. I’ve tried nitroglycerin, stool softeners, diet, etc....the fissure hasn’t healed.

My feeling is: how can it possibly heal when it is on tissue that basically feels like it is unrolling itself outside the body on every bowel movement - and then getting pushed back into the body?

I am scheduled to undergo a flex sig, banding, and Botox injection tomorrow. I am terrified that the flex sig will rip the fissure open even more?

But my main question, if anybody has ever had a similar situation as me.....will the hemorrhoids continue to prolapse even when they are banded? When I go for my first bowel movement after these procedures - will they still prolapse and have to be pushed back in? I am fearful that pushing them back in, while banded, with an active fissure, after injections and a flex scope, and probably being very irritated and swollen will be some kind of impossible nightmare?

CRS couldn’t really answer this question, beyond telling me “we’re going to try to get it so nothing is prolapsing” - but he hasn’t gotten a good look yet. He just slightly spread my cheeks and saw the fissure(a large one he says), and took my word for the hemorrhoids.

Pretty petrified at what I’m going to feel like in the days after this, but I don’t see any way the fissure can heal until the hemorrhoids stop prolapsing? Thoughts?
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Re: Banding/Botox for prolapsing internal hem’s and fissure

Postby chachacha » 13 Jul 2020, 10:02

I had hemorrhoids banded many, many years ago (maybe 15?), but they couldn't band the ones close to the dentate line, and those started prolapsing about 10 years ago. I'm surprised to hear that yours can be banded, but happy for you if that is the case. I had a fissure and a successful LIS (lateral internal sphincterotomy) 5 years ago, and then a full hemorrhoidectomy, for the prolapsing roids (like you, they came out with every movement, and I had to re-insert them afterward, each time) about 3 years ago. Mine were excruciating though, and I would almost be in tears with every BM. I'm now wondering if my fissure was actually on the hemorrhoids, because after the LIS, I was pain-free for a couple of years (for some reason, the hemmies stopped prolapsing after the LIS for that two year period) and then the pain returned after they started prolapsing again.

I wish that I could answer your questions, and hope that someone else comes by to help you with those.

Good luck with the procedures tomorrow and please come back to give us an update. Information like this will certainly help with others who come after you, and are experiencing a similar situation.
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
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Re: Banding/Botox for prolapsing internal hem’s and fissure

Postby Jon » 13 Jul 2020, 10:17

Thanks for reply. I guess I don’t know for sure that they can be banded? Nobody has actually gone in with anything and looked at them yet. I have one on the right side, towards the back that seems to come from higher up in the anus - and the fissure is on tissue connected to this hemorrhoid. I can feel painful sensations the entire time this hemorrhoid is “dropping” , until it’s out of the body. Then the stool starts coming out, but that part doesn’t typically hurt. The hemorrhoids on the left side come out first, but there’s no pain involved with that.

Yeah, I never had any real pain from the hemorrhoids before the fissure happened. In the past I would sometimes have some minor irritation for maybe 15-20 minutes after a bowl movement but no big deal and it would always go away.

This fissure discomfort is a life changer. I’m basically stuck in the house trying to find the most comfortable position for the next 8-10 hours after every bowel movement. I’d give anything to go back in time 4 months.

I got he fissure the first week that basically everybody was stuck home from COVID. I was sitting around doing nothing all week, and ate a ton of trail mix....way more than the normal servings - because I was just sitting around watching TV and the trail mix was there. I can’t prove it but I strongly suspect some jagged, undigested nuts had something to do with my fissure. I will never eat another nut for the rest of my life.
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Re: Banding/Botox for prolapsing internal hem’s and fissure

Postby Jon » 13 Jul 2020, 10:22

chachacha wrote:I had hemorrhoids banded many, many years ago (maybe 15?), but they couldn't band the ones close to the dentate line, and those started prolapsing about 10 years ago. I'm surprised to hear that yours can be banded, but happy for you if that is the case. I had a fissure and a successful LIS (lateral internal sphincterotomy) 5 years ago, and then a full hemorrhoidectomy, for the prolapsing roids (like you, they came out with every movement, and I had to re-insert them afterward, each time) about 3 years ago. Mine were excruciating though, and I would almost be in tears with every BM. I'm now wondering if my fissure was actually on the hemorrhoids, because after the LIS, I was pain-free for a couple of years (for some reason, the hemmies stopped prolapsing after the LIS for that two year period) and then the pain returned after they started prolapsing again.

I wish that I could answer your questions, and hope that someone else comes by to help you with those.

Good luck with the procedures tomorrow and please come back to give us an update. Information like this will certainly help with others who come after you, and are experiencing a similar situation.


Also - are you back to “normal” now? No hemorrhoids and no pain? Can you exercise and travel and do everything you want to do?

Was the pain from the hemorrhoidectomy as bad as many say it is? How about the LIS?

I am trying to solve mine without being cut, but am concerned the banding and Botox won’t work and that I’m just wasting time. Hope not.

All I really like to do is climb mountains, kayak, jog, play basketball, go to workout classes, etc. I have been severely limited in what I can do the last 4 months and feel like I’m simply surviving day to day. I can’t plan anything ahead of time, can’t really go anywhere, or live life. I hate all of this so, so much.
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Re: Banding/Botox for prolapsing internal hem’s and fissure

Postby chachacha » 13 Jul 2020, 12:11

The one that is higher up might be bandable, so if that is the one with the fissure, you might be able to get your life back. But if the CRS could see the fissure, to me, that would indicate that it is much lower down?

And I can soooooooooooo relate to the pain, and how long it takes to recover after each movement (10 - 15 hours wasn't unusual for me). You can read my success story here lis-success-for-me-t9369.html. This was just after the LIS, but before the hemorrhoidectomy, but explains how awful things were before that time.

The pain from the hemorrhoidectomy wasn't as bad as I had expected it to be, but I believe that having had the LIS first helped with that. Much of the hemorrhoidectomy pain is a result of spasming, and since my sphincter no longer spasmed, the only pain I had was during the movement itself. I have to admit that that aspect was unbelievably painful, but only about 25% worse than when I had been at my worst just before I went in for the procedure.

I am ALL good now though, and wish that I hadn't waited so long to go through with them.
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
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Re: Banding/Botox for prolapsing internal hem’s and fissure

Postby Jon » 13 Jul 2020, 12:36

chachacha wrote:The one that is higher up might be bandable, so if that is the one with the fissure, you might be able to get your life back. But if the CRS could see the fissure, to me, that would indicate that it is much lower down?

And I can soooooooooooo relate to the pain, and how long it takes to recover after each movement (10 - 15 hours wasn't unusual for me). You can read my success story here lis-success-for-me-t9369.html. This was just after the LIS, but before the hemorrhoidectomy, but explains how awful things were before that time.

The pain from the hemorrhoidectomy wasn't as bad as I had expected it to be, but I believe that having had the LIS first helped with that. Much of the hemorrhoidectomy pain is a result of spasming, and since my sphincter no longer spasmed, the only pain I had was during the movement itself. I have to admit that that aspect was unbelievably painful, but only about 25% worse than when I had been at my worst just before I went in for the procedure.

I am ALL good now though, and wish that I hadn't waited so long to go through with them.


So glad to hear that everything worked out for you.

I had another CRS who wanted to do LIS/banding. I figured I could try Botox first, and if it doesn’t work I could do LIS later. Gotta be honest though - I’m kinda second guessing that as I don’t see a ton of success stories on here with Botox? And I’m concerned that it won’t work, banding won’t work and I’ll be all swollen and miserable afterwards for nothing.

On top of that, I’m having one of my least painful days after a bowel movement today. I can feel some spasms but they don’t really hurt. I’ve probably been a 2/10 today so far after my morning bowel movement 5 hours ago(and I usually go once a day). Normally this would be good news, but it’s got me second guessing. If I was having a miserable day today, I probably wouldn’t be second guessing anything.

So tired of all this!
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Re: Banding/Botox for prolapsing internal hem’s and fissure

Postby chachacha » 13 Jul 2020, 12:49

You'd be surprised how many people have good days, or even weeks, just before surgery. But even those who then cancel, usually regret it because they're back to square one shortly afterward. I suspect that it might be a psychological response somehow. Not trying to persuade you one way or the other, just pointing out that what you're experiencing is quite common. Also, have you read our "Success Stories" forum, or have you just been searching random threads. You can find it here, if you haven't https://webmail.bell.net/loginr/wmwrap.jsp Some are success stories after LIS, and some are successes after other treatments.
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
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Re: Banding/Botox for prolapsing internal hem’s and fissure

Postby Jon » 13 Jul 2020, 12:52

chachacha wrote:You'd be surprised how many people have good days, or even weeks, just before surgery. But even those who then cancel, usually regret it because they're back to square one shortly afterward. I suspect that it might be a psychological response somehow. Not trying to persuade you one way or the other, just pointing out that what you're experiencing is quite common. Also, have you read our "Success Stories" forum, or have you just been searching random threads. You can find it here, if you haven't https://webmail.bell.net/loginr/wmwrap.jsp Some are success stories after LIS, and some are successes after other treatments.


Yeah, it’s definitely a mental game. As much as life has been tough the last 4 months, I do know that I can at least function and work, and occasionally have fun on a good day. It’s a bleak way to live forever though. The unknown and possibly being worse and being in an insane amount of pain is what’s scaring me now.
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Re: Banding/Botox for prolapsing internal hem’s and fissure

Postby chachacha » 13 Jul 2020, 12:59

Yup. I hear you there and was stuck for years in that boat. I just got to a point where I really wanted a normal life, and not have to do everything around my bowel movements. It's tough, I know.
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
chachacha
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Re: Banding/Botox for prolapsing internal hem’s and fissure

Postby Jon » 14 Jul 2020, 16:46

So I had my Botox injection and bandings this morning. CRS banded two internal hemorrhoids.

My issue now.....I’ve got two large external hemorrhoids that can’t be reduced. I believe I was told before that they’re connected to the internal one on that side. Usually if they inflate at all, I can just kinda push them in and they reduce, and for the most part stay that way - it usually just feels like a tiny bit of loose extra skin.

But right now, they’re inflated and annoying feeling and slightly painful and I can’t do anything to get them smaller. Is this just related to swelling from the Botox and from the internal being banded? I sure hope so because this isn’t fun. I’d be doing fine, otherwise.
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