I have had an anal fissure for almost 15 years. I went to a colorectal surgeon (CRS) about four months ago. He prescribed me .2% nifedipine ointment and advised me to start taking fiber. I had tried to take fiber many years ago, but the fiber powders were too unpalatable to me, and I didn't think that the fiber powder would help. So I only took the fiber powder for a very short time.
I used up the bottle of nifedipine that my CRS prescribed to me in one month. Then I went two months without taking nifedipine because I didn't have any more nifedipine. Then I acquired more nifedipine a month ago, and I have been taking nifedipine for the past month. I have been taking fiber pills for four months now. They do seem to help somewhat, but I still have an anal fissure.
I used to have severe pain after bowel movements, but now my only symptom of anal fissure is my anus itches after a bowel movement. Sometimes it is a severe itch, but it is just an itch. The problem is that after one month of treatement, my symptoms were no worse than they are now. In other words, my symptoms have not improved at all since one month of treatment with nifedipine and fiber pills.
Do you think I should go back to my CRS to seek treatment with botox?
It's my understanding that botox is an injection (shot) into the rectum to treat an anal fissure. Is my understanding correct?
How painful is the botox shot?
Is botox usually a more effective treatment than fiber pills and nifedipine?
Is there anything else I should know about botox?