Hi Nick,

How are things going for you now your are a bit further post botox?

It does sound like you have been suffering from spasms to me. With regard to my own situation, I don't know if I have a low pressure fissure or not to be honest, I'm still waiting in a long queue to be properly examined. Although I suspect I do. However I have responded favourable in the past to diltiazem (if short lived) which relaxes the sphincter so maybe botox will be beneficial, I don't know.

I'm certainly hoping it can be fixed. I guess I'm just saying if the methods to fix a fissure are based on lowering the sphincter tone, and you already have normal/low tone then a different approach is probably needed, and I think that basically means an advancement flap as the last option.

I did go through a period when I thought it was fixed - only to relapse, but I wouldn't say this was a regular heal/tear cycle like you have experienced. I'm lucky in that I don't have terrible spasms, I just suffer from general burning and soreness, and more recently bleeding when I 'go'. This might have something to do with Manuka honey that I am using.

At the moment I am still wanting to get this thing fixed. However given I have an anterior fissure, and suspect I have normal pressure, then I think this lowers my options. The following slides I found useful, particularly page 46 - which may describe where I am. I'm hoping to get the chance to talk it through with a consultant on the 3rd of March :-)

http://www.slideshare.net/thedukes/anal ... management

Best LemonMan

Hi LemonMan,

I am really sorry to hear that you had a relapse. I hope it didn't bring you down too much. But it seems like you are well on top of it and your appointment isnt too far away. In regard to the Botox, I am doing a little better now. The incontinence has settled down a lot and is very minor now. I suspect either due to the adjustment of the internal sphincter or potentially the reduction of Botox levels after a period of a few weeks. Unfortunately, I am still experiencing worse pain levels than pre Botox. It certainly seems to have increased my pressures and I can literally feel the pressure when the need to pass gas arises (something I did not experience before the botox). I entered one of my healing cycles about 5 days ago and am not bleeding anymore. I do however still have days where it burns several hours after a bowel movement. Prior to the Botox, I had no pain at all during my healed phases.
If it is something you are thinking of doing yourself, indeed, even if you aren't, you should ask your hospital for an Anorectal Manometry to test your sphincter pressures. It will help you make more informed decisions regarding treatment. It seems that some doctors dont order this as standard. Even though my doctor did refer me for this test, I still had to push the hospital to do it as they lost the referral and had some other issues.
I believe the advancement flap is going to be my next surgery. I am in the process of trying to find the best surgeon to do this. From what I have read, the success rate of this operation is largely due to the skill of the surgeon. So it may take some time for me to find one that I am happy with. I will write it up once I have had it done in the advancement flap section of this website if you are interested. Also, please feel free to message me with any questions after I have had it done if you think it is something you may want to do in the future yourself.
Let me know how your appointment goes on 3rd March. I hope it proves helpful for you.
Nick

Good to hear you've had a little improvement, if not a lot. As I understand it, it takes at least three months for the botox to wear off, so hopefully over that time things will get better and better for you. Fingers crossed. If I do go for botox, I think I will definitely ask for a Anorectal Manometry. Thanks for the advice. I think you are absolutely right in getting as informed as possible. Looking forward to hearing how things progress for you.

Best, LemonMan

I just suffer from general burning and soreness, and more recently bleeding when I 'go'. This might have something to do with Manuka honey that I am using.

What makes you think that honey is the culprit for this? I'm currently also using Manuka Honey and so far I am not sure if it helps much. What's your experience with it so far?