I've been dealing with a fissure for over 2 years. I was able to have very little pain after a few rounds of diltiazem and then daily Miralax, but I'd still occasionally tear even with this regimen so I spoke with the doctor and decided to try Botox for hopefully a more permanent fix. Both surgeons I've seen are pretty against LIS for females (even though this is how it seems everyone else has success with healing).

Anyways, I got Botox yesterday which only seemed to completely retear my fissure. It had been a few months since it had been torn open and this has really gotten me down again. I'm not sure how I will get it to heal again. I'm hoping I can still take Diltiazem after Botox, but I'm not sure. I'm so over it. It feels like there's no hope of a permanent fix. I've already spoken with two different surgeons about LIS, but they are both so against it that it terrifies me. I don't want incontinence issues, but I can't imagine living my life with this constant pain.

Has anyone else had Botox and had it get worse before it gets better? Anyone else had multiple doctors against LIS? Or any suggestions on doctors near Indianapolis would be great. Thanks!

Sorry to learn you are going through this. If you read through the posts on this site - the search function is very useful - you will find many accounts of experience after LIS and Botox. With LIS, the outcome seems to be mostly positive, while with Botox the results are often rather mixed. I've reached an age where doctors routinely express reluctance to perform LIS, and offer Botox only with reservations. I haven't tried it, but keep going mainly with the help of pain management (regular doses of the anti-convulsant pregabalin) and macrogol (Miralax).

I hope others who have tried Botox and/or have had LIS will come online and add their experiences and opinions, and also that you can get some decent help from a medical professional soon.

Thanks for your response. I have read through quite a few of the stories on here and it seems that most people are finally cured only after the LIS. I just don't understand some doctors reluctance to perform the surgery. The doctor I'm currently seeing seems to think that Botox is effective, but I didn't set my hopes to high on the procedure. She was supposed to do an examination while I was under, but my husband said that she didn't tell him much after the surgery.

Are you taking Miralax long term? I had been doing pretty well with just Miralax and Diltiazem on occasion, but I was worried about taking it long term. Nothing else I've tried has been as effective though.

Can you get the surgeon's notes? Your family doctor may have received them and could give you a copy. At least you'd know more about was was found that day. My own surgeon told me that Botox simply didn't work, and was a waste of time and money. I had LIS and it did the trick for me. I wouldn't want LIS from a surgeon who didn't recommend it though, because they probably don't have as much experience with the procedure, and also wouldn't have the stellar results of one who does it regularly. Can you see someone new?

Yeah, if I do end up going for LIS, I think I'll find a different surgeon because she only does like 1 a year. She's actually the second one I've seen and the first one also said that he rarely does LIS on females. I've tried researching doctors, but I'm not sure how to do find one that will be good for the LIS surgery. I feel so stuck. I don't think it's likely to ever heal completely without the LIS (it's been over 2 years with lots of treatments), but these doctors have made me so anxious about the whole thing! Most studies I've read seem to show little issues with incontinence with maybe the exception of gas incontinence, but when I talk to the doctors, it's like a guarantee of problems. And then almost everyone on here seems so happy to have had the LIS! It's so confusing and all I really want is for my butt to stop hurting!

You need to see a CRS (colorectal surgeon), and not just a general surgeon, or GI specialist. A CRS does far more LIS procedures than anyone else and would therefore have better stats on good outcomes. My own surgeon had never had a bad outcome (after doing LIS for 35 years), and had only heard of one colleague who'd had a bad outcome, which was one case of a patient with just gas incontinence. Here's a list of the best colorectal surgeons in Indianapolis. You could take a look at their patient comments and perhaps get an appointment with one who you like? https://www.ratemds.com/best-doctors/in ... ctologist/

Both of the ones I've seen have been CRSs. I wish I could see the same surgeon that you used! That sounds so much more reassuring. I'll check out the list of Indianapolis doctors though and hopefully find a good one. Thank you for your help!

You're welcome. Good luck.

Just a quick note to say that I am taking macrogol (Miralax) long term. I've been assured by several CRS that it's safe to do so, and have been on it now for nearly 5 years, mostly without adverse side effects.

That's good to hear dcmff! I was actually doing really well on Miralax but would have an occasional tear every few months. If I stopped it, I would definitely have issues, but I was pretty happy while taking it. I decided to get the Botox because I was hoping to heal enough to not have to rely on Miralax. I'm only in my 30's so I was concerned with taking Miralax for potentially the next 40-50 years. I feel like I've reached a point where I'm either going to have to stick with the Miralax or get the LIS procedure. Living in pain is simply not an option.