First off the folks on this forum are terrific! Sharing quite openly on a subject only spoken to your GP in a whisper lest anyone hear.

Aug 2022 - rectal bleeding. Insert my body weight of Prep H and Anusol in my back passage. Constipation and hard stools.

Sept 2022 - no luck and speak with GP. Colonoscopy done but, nothing of note aside from 2 polyps.

Late Sept 2022 - constipation is terrible. Laxatives not helping. Should have drank more water. BM that likely was the source of my anal fissure. Horrible pain for days. Continues into Oct.

Mid Oct - follow up with colonoscopy Dr. He says it’s an anal fissure. Use Diltizem cream and will heal it in no time. BTW yours is the largest fissure I have ever seen.

Oct-Nov use the cream religiously. This is despite it burning my skin to the point of shoe leather.

Nov back to the previous Dr. Used cream for 2 months and no improvement.

At this point should mention the pain is gradually dropping. But, each BM is still terrifying and very bloody. Fortunately still working from home so doing the siitzbaths and showering after a BM. Very tough to sit for prolonged times.

Get a referral to a surgeon to look at Botox or the cut. Surgeon looks at me and says give the cream more time. Make sure u press in to your first knuckle and pull up as u pull out.

Mid Jan in for second appointment with the surgeon. He asks how it is going. Still the same. Early Feb appt for my photo shoot. Camera up my butt. Nurse says to try to relax. Said relaxing usually is having a drink without a camera in my butt.

Dr says it is a big anal fissure. Schedule to get the Botox. Will be a couple of weeks at least. In the meantime what are u doing to keep your BMs going? Told him. Restoralax. Some laxatives and water. Some fibre such as raisins etc.

He suggests to double down. Suggests some additional efforts. Now I am having 3 bowls of Raisin Bran with Wheat Germ. Drinking a pint glass of water every hour or more. Pineapple, salad, prunes and more.

Now after all that my question.

Now I am having 2-3 BMs a day. There is no to very little blood. The BM itself is easier but, not every time. The BM feels pressure but, not the stabbing pain as before. Plus, the spasms are far less. In some cases very soft BM and no spasms. The spasms I do have might require a med but, less and less.

If my spasms are almost gone is there any value in getting the Botox done? Hoping I am on a slow road to recovery.

If you read this far much appreciated.

I would definitely get the Botox. You may have some initial trouble with urgency with BMs, but it will reduce in a few weeks. Fissures are tricky, you may think they have healed but they are prone to reinjury.

Even if I am not in pain? I am under the impression that Botox is used to deaden the muscles to not spasm. If I don’t have that is there value still?

By reducing the spasm it increases blood flow and allows the fissure to heal. Only your doctor can tell you if it's a good option if you don't have pain.

I had my second lot of botox today in the clinic. Was fine. Over and down in 4 minutes. The botox helped last year. I made the mistake of having a hard stool that reinjuired it in mid September.
It's all about the tightness of the spincture muscle for me.

How are you doing since the Botox? Do you feel any improvement in pain?

I had it 5 days ago. Yes I do have hardly any pain. I remember last time I had it and it took about 5 days to notice a difference.

Might be looking at the Botox. Drinking over 160 Oz of water a day and 30 grams of fibre. Feel the urge to go but nothing. Will try a few times a day but nothing unless I strain. Also have a mucous right at the exit of the anus. It’s like the last 6 inches my butt just gives up.

Lemonwater925 wrote:Might be looking at the Botox. Drinking over 160 Oz of water a day and 30 grams of fibre. Feel the urge to go but nothing. Will try a few times a day but nothing unless I strain. Also have a mucous right at the exit of the anus. It’s like the last 6 inches my butt just gives up.

Since I may not reply for weeks I'll ask and comment now.

Do you have any stress in your life? Hate your job? Anxiety? If the answer is yes and you are straining to have a BM, the Botox may not be the solution. At best it is a band aid that will allow you to treat your fissure but you better treat it within 6-9 months because it wears off. I had Botox. It was a waste of time for me. The LIS fixed everything. That was in 2020.

But let's say you try Botox before surgery. In addition to the typical medications and home remedies you will continue to do you also have to stop straining, you have to relax and you have to eliminate the cause of your stress. Imagine all the stress you are under going straight to your sphincter making it tighter and tighter which does not allow blood flood and proper healing. The Botox can help relax the muscle, sitz baths help, and relaxation techniques help. Or... skip all of it, get the LIS and be done with it!

By the way is this surgeon you saw a general surgeon? If it is, go to a colorectal surgeon from now on. It's amazing how a CRS doesn't need cameras to see the situation. I've been to both types of surgeons - night and day. Stick with the expert!

Hi All
Well had botox 4 weeks ago first 2 weeks was good then 2 weeks ago had days of too loose stool which created pain again. Still taking Physillum but not firming up the stool so pain for last 2 weeks.