So everything had been going really well since having botox 3 months ago, no pain during or after BM and I was actually enjoying going to the toilet. Unfortunately I had really bad constipation over Christmas and had to strain whilst having a large, painful BM. That was about a week ago and now I'm back having pain during BMs (not quite as painful as before but still painful enough for me to worry about going to the toilet). I'm wondering whether I have re torn? Or whether it just aggravated everything that was on its way to healing? If it has retorn, Will the botox still be working or am I back at square one? Is it worth me calling my CRS for advice?

Sorry to hear things may not be going so well Gilly. Do you have any ointment (nifedipine, nitroglycerine, or diltiazem) you could use to help heal any damage that may have occurred? I would think the botox would still be effective and I have found that the ointment is sort of super-charged even if it has worn off some.

Really sorry to hear, i hope you get well soon.