Healed fissure but still have a tight internal sphincter

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Re: Healed fissure but still have a tight internal sphincter

Postby Alyssa » 06 Dec 2014, 12:08

I had the pressure test done this week and it showed that I have high resting tone... Next step Botox to the internal sphincter on Monday!
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
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Re: Healed fissure but still have a tight internal sphincter

Postby tight_sphin » 31 Aug 2015, 08:57

Hi Alyssa. did you have a success with the botox? I am at a similar point with my IS and this is the next recommended treatment after 12 weeks of pelvic floor therapy and one month of diltiazem cream with no results.
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Re: Healed fissure but still have a tight internal sphincter

Postby Alyssa » 31 Aug 2015, 10:42

Yes I did have good results from that procedure; I would recommend it to anyone. I did not have any "accidents" either. I had better success when the pelvic floor muscles and the internal sphincter were injected at the same time. In my case, I am dealing with irritated nerves. What PT's and doctors tell me is that tight muscles irritate nerves and those nerves have become sensitive (central sensitization) If you have any other questions don't hesitate to ask.
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
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Re: Healed fissure but still have a tight internal sphincter

Postby Alyssa » 31 Aug 2015, 10:46

I did physical therapy for months and it didn't decrease my pain; Botox helped decrease the pelvic muscle tone... Boy do I thank the person that invented Botox. I continue to use the wand to stretch out those muscles or you might also try dilation.
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
Alyssa
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Re: Healed fissure but still have a tight internal sphincter

Postby tight_sphin » 31 Aug 2015, 11:36

Thanks so much for the reply. it's hard to find posts about experiences with botox for IS. I have heard that the worst that can happen with the botox is that it may not work but there is just something about hearing botox being a "muscle paralytic" that causes me concern. I'd hate to have the IS get completely relaxed and not hold anything in! It's good to hear you had a positive experience with it. I am thankfully not in any pain so I was concerned about making just a daily uncomfortable situation possibly worse. The CRS told me that he has only seen some patients have gas incontinence temporarily. But his explanation is that botox can be a permanent fix as it causes the nerves that are making the IS spasm to die. And the new ones that regrew will hopefully not do the same thing.

What is the wand?
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Re: Healed fissure but still have a tight internal sphincter

Postby Savaici » 01 Sep 2015, 12:32

Before I would try Botox, I would try dilation (look up the thread on the search under the photo between FAQ and Portal), especially if I had no spasms. Believe me, you do not want to have them and Botox can have side affects.
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Re: Healed fissure but still have a tight internal sphincter

Postby tight_sphin » 01 Sep 2015, 13:02

Thanks for the reply Savaici. The PT was doing stretching at our sessions and that relaxed the external sphincter pretty good to where the CRS said it was normal. But after 12 sessions, the internal was still tight. That and the diltiazem failing is what led the CRS to discharge me from PT and consider botox. I was going to contact the PT to see if I needed to continue the rectal stretching to at least keep the external sphincter normal and how to accomplish that. I guess that would be dilation?

What side effects from Botox are you referring to?
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Re: Healed fissure but still have a tight internal sphincter

Postby Savaici » 01 Sep 2015, 19:39

Here's a link on the forum to all the posts about Botox. I think thst the greatest complaints have been aggravated hemorrhoids and pain, but for some it has worked. I would have a read:

search.php?keywords=Botox&terms=all&author=&sc=1&sf=titleonly&sr=posts&sk=t&sd=d&st=0&ch=300&t=0&submit=Search

And self-dilation:

search.php?keywords=Self+dilation&terms=all&author=&sc=1&sf=titleonly&sr=posts&sk=t&sd=d&st=0&ch=300&t=0&submit=Search
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Re: Healed fissure but still have a tight internal sphincter

Postby chachacha » 01 Sep 2015, 21:35

And while I don't want to sound alarmist, there is always a danger that the Botox can migrate, and cause you to have difficulty breathing, if it happens to spread to your lungs.

This is a rare complication, but I think that people should always be informed, rather than just go into any medical procedure without full knowledge of what the risks are.
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: Healed fissure but still have a tight internal sphincter

Postby Alyssa » 01 Sep 2015, 22:30

The wand is used to eliminate trigger points; helps stretch out the pelvic floor muscles

http://www.therawand.com/
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
Alyssa
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Posts: 735
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Joined: 29 Apr 2014, 11:24
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