HI! It's been 3 weeks since I had botox and cauterization of my fissure. One of my many problems is I go to the bathroom 4-5 times/day. My GI doctor just put me on Clonestid last tuesday,( to lessen the BM) which I'm not sure is working and maybe making it harder for me to go. By my 3rd BM, I am still having throbbing pain (pain level is a 10), which is horrible. I have been alternating between advil and tylenol and when those meds kick in, the pain subsides. Yesterday, the pain got ahead of me and I was too late taking the pain meds and I was in agony. Finally, after 4 hours the pain lessened. It is throbbing pain that I can't even describe, though I'm sure most of you know what I'm feeling. I feel like my fissure must be healing because I went from having a tremendous amount of blood to very little now. Is the throbbing from the sphincter being in spasm? or do you think that it is still from the fissure? Have any of you continued to feel this throbbing pain 3 weeks post Botox. Let me know. I haven't worked in 2 months and this has taken over my life. I can't live on tylenol and advil. Help!!!!

Hi, so sorry you're in pain, I know how you feel and it is just unfair.

I have not had Botox, but I have throbbing burning pain for hours after every bm, especially when I'm doing anything but lying on my side - but my fissures are all healed up.

My sphincter is noticeably tight, and my surgeon and physiotherapist believe that the LIS surgery is the best way to alleviate the pain. They believe the situation is the same as when the fissure was open - the nerves in the area are sensitive and there is still an injury even if it is "healed over" on the surface. So the same pain cycle is in motion - pain with bm causes spasm, which causes more pain (throbbing, burning) and more spasm, etc.

Maybe that is also what's going on with you. I have ibs so I understand how hard it is to deal with these fissures when bowel movements are difficult to get ideal. Have you tried amitryptiline? That was my gastro's first recommendation for my diarrhea, it also helps with sleep and can help manage gut pain (and maybe even fissure pain at some doses).

Hoping that this helps you a little - sorry you have to go through this.

Believe me, I do understand - it's been 6 months bedridden for me

Thanks for responding to me. I just spoke to my CRS and she wants to see me tomorrow. She said something about a suppository that is a muscle relaxer. We will see. I will keep you posted. I feel so bad for you as well. Maybe you should have the LIS surgery. It will probably make you feel better. No one understands this pain that we are all in. It's just terrible

Hi Corn,
I too can, if I don't take my meds or if I'm having a bad flare even on my meds, can often go 10 plus times a day...often 3 times an hour...it's horrendous I was still getting pain after the Botox and after my LIS was getting spasms even up to week 4/5 after LIS.
Firstly my CRS says that watery frequent BMs are the worst thing for a fissure even worse than being constipated.
I would ask about psyllium, loperamide, amytriptiline and if needed and you can tolerate it strong codeine. You need to try and slow your BMs down or the healing will take so much longer.
The pain is beyond imagining....I didn't know that level of pain could actually exist...no pain killer has ever come near to touching the level 10 spasms, apart from gabapentin which takes it down from a 10 to a 6 so for me it's a life saver.
The Botox could still heal you even if you can't get a handle on your BMs....are they loose or formed as it's better if they are formed as they are less acidic and don't strip and burn the fissure.
Really good luck and don't loose hope my fissure is now 90% healed and I only have pain on days when I go more than twice

HI My poor butt!!! I think I should change my name to yours...LOL

My BM are formed. I do take Konsyl fiber which has psyllium in it. It has worked with the last Fissure and healed me within 3 weeks. This is a total nightmare. Today I went 6 times. but the thing is..... I feel like it's all the same BM, but not coming out all at the same time.. This morning I went 4 times in 2 1/2 hours, but I feel like it was all the same BM. I will see what my CRS says tomorrow, but at this point, I am ready for her to do the LIS. I haven't worked in 2 months and it is almost impossible to get out of my house. Thank G-d 2 of my 3 kids are in college because I don't think I could function taking care of all of them. No one understands the pain and I am thankful for this support group. I am glad you are almost healed.

Ah I see if your BMs are formed then you probably don't need any of the above meds, although amytriptiline could still help as it's used for both constipation and diarrhoea.
Yes LIS is always the best option but I do know members who have been healed by Botox.
I agree I don't know how people manage to look after young children while in this amount of pain. Do try the gabapentin though as it really can help.
Good luck with your CRS