LIS or Botox (for AF)? Please help!!!

Are you having, or have you had a Lateral Internal Sphincterotomy (LIS)? Please share your experiences here, or ask any questions.

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LIS or Botox (for AF)? Please help!!!

Postby spasm_hell » 26 Jan 2013, 18:16

Hi,
I have been suffering from reoccurring Anal Fissure for over 3-4 years now.
The first couple of years have been bearable, but it gotten worse in the past 2 years.
Actually the pain during the BM is bearable most of the time, but about an hour later i get the worse spasm, i get the worse pain from it for usually about 3-4 hours or even 6-8 hours (until i go to sleep). then in the morning i am usually OK until the next BM....
My last anal fissure episode was about 3 weeks ago and it still didn't heal, and i am just not getting any relief from the pain. I am not functioning at all and afraid to leave the house in case i have a BM outside.
I should mention that i have already tried almost any cream out there and also changing my diet and drinking lots of water.
So this is my dilemma:
1. Have Botox shot - and in the meanwhile try biofeedback physio therapy. Had anyone tried biofeedback physio therapy for AF and spasm? did it help?
2. LIS surgery.
I am totally horrified from the recovery of both.
I thought that there is no harm in trying the Botox shot until I have read some experiences here in the forum. Is that true? will i need to recover from the Botox shot???
If i am ready to go though recovery pain isn't it better to do the LIS already?
What is the difference in the recovery?
Regarding LIS, i am afraid for the complications and not being able to control my BM.
Is the complication just not being able to control gas and in the worst cases feel a tiny bit of leakage that doesn't even reach the underwear? or can it get worse to not be able to control your BM at all?
Also - can anyone recommend an DR in Manhattan? i am currently seeing Dr Daniel H. Hunt, did anyone have the LIS with him and can share the experiences?

Please help! Please respond! I am at a breaking point here, and have to decide one way or another, I can't live this way anymore. :(
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Re: LIS or Botox (for AF)? Please help!!!

Postby cherylk » 26 Jan 2013, 19:35

I cannot answer all of your questions because I've had neither botox (in the butt at least Image or LIS), but could you get another opinion at NYU? I listen to their various specialists on "Doctor Radio" and have been very impressed. Sometimes a second opinion can sway a person towards one procedure and away from another. Personally, I would not be fearful of the Botox--that is what I was going to try if the ointments didn't work. Good luck and let us know what you decide to do (and your outcome) so others can learn. You might want to do a search for an already existing thread and post your experience there.
Image
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Re: LIS or Botox (for AF)? Please help!!!

Postby spasm_hell » 26 Jan 2013, 20:27

Thanks for responding!
I think getting another opinion in NYU is a good idea.
I wonder if can you recommend anyone in NYU? maybe a name you head on the radio...
I also hope someone can respond regarding the recovery difference between the Botox and the LIS (maybe someone who has done both).
I have been though hemorrhoidectomy in the past and the pain was unbearable post-op (and i am actually quite traumatized from it) and i can't think of going to though Botox recovery if the success rates are so slim and the recovery is similar... maybe if i am ready to go though a very painful procedure and hell of recovery it is better to do LIS where the success rates are much higher.
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Re: LIS or Botox (for AF)? Please help!!!

Postby cherylk » 26 Jan 2013, 20:55

I think that there is less chance of incontinence with Botox as it is temporary. Don't think there would be much post-op pain, but that is just my opinion. I had Botox on my face a number of years ago, and don't plan to try that again. It was expensive; it hurt, and it was only temporary. But I had no adverse reaction to the Botox. Lots of people have tried Botox for AF, and there are a lot of posts on this site about various results. You might try doing a search for those. As for a doc at NYU, I am sorry, but I have never heard AF's discussed on the Doctor Radio program. They do have Ira Breite on regularly; he's a GI doc. Maybe you could start with him (make an appointment), and he could refer you to a CRS. OR you could look on the NYU website and try to find a CRS on your own. If I lived in your area, I think I would try NYU. The docs seem to be very caring and knowledgeable. They are on Sirius Radio--"Doctor Radio." Channel 81!! Good luck!!
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Re: LIS or Botox (for AF)? Please help!!!

Postby Badd825 » 27 Jan 2013, 12:55

I had Botox in April and unfortunately it didn't help me at all. I was incontinent to gas for a few weeks but it went away. I haven't had LIS. I had anal dilitation 2 days ago and fissurectomy. I'm very uncomfortable but I also think I'm super sensitive in this area. I also had hemorrhoidectomy in August and that was the worst most painful experience of my life and that includes 2 babies delivered naturally. The Botox was very painful. The dr gave me 4 shots of lidocaine and 3 shots of Botox in under 5 minutes. I work in dentistry and we give lidocaine a few minutes to work before proceeding with treatment but that wasn't the case. If I ever had that done again I would want to be asleep. Other drs Ive discussed this with said they don't know why he would give me shots before giving me shots and some of them use sedation for Botox. I was sore for several days. Because all the trauma I've undergone in that area I'm trying to avoid LIS which is why I did dilitation. That said Botox has helped some people and I would try it before doing more invasive procedures. I saw the head of colorectal surgery at mt Sinai for botox but would not recommend him he told me immediately after injecting me with his super huge and rough hands that it wouldn't work and I would need LIS. He didn't tell me these odds before hand. I hope you heal whatever you decide
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Re: LIS or Botox (for AF)? Please help!!!

Postby Savaici » 27 Jan 2013, 17:44

It is worth having a look at wecc's posts on here. He did not have either Botox or LIS but went with Standardized Anal Dilation. He is a former marine and he had immediate relief. The doctor is on Long Island, I believe. The advantage of SAD is that there is no recovery from surgery. Results from SAD are 86% success rate, while LIS is 92% or in that vicinity. This 'little' cut, once it becomes chronic and forms scar tissue, is one of the nastiest things Image I have experienced in my life, so know how you're feeling!
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Re: LIS or Botox (for AF)? Please help!!!

Postby Badd825 » 27 Jan 2013, 18:50

It was wecc's post that led me to anal dilitation. I saw the same doctor and wecc has been instrumental in helping me find the dr. I had surgery on the fissure so I'm having a bit of a rough recovery. Pretty sore so not sure what's going on down there. I sure hope its healing. This dr does Botox as well so if traveling isn't an issue it might be worth a shot. We went right to anal dilitation because I had tried all conservative therapies first. He's about an hour from the city in Long Island. When I was in the hospital I asked the staff about him (an article I was reading about surgeons in the waiting room said ask the staff if you want to know if a dr is good) they all said he was an excellent surgeon and a scientist at the cutting edge of the latest treatment. I'm hoping it was worth the trip.
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