I had Botox about three weeks ago. Diary here: af-diary-conservative-botox-t7418.html
However, I also had a tag removal, which complicated things a bit.
Best of luck to you during your recovery! I look forward to hearing how it goes!
I go to the doctor on Nov. 14 to check in post-surgery. Hoping for good news!

Sugarspice, you should judge your diet by your stools, not what people in here thinks about it. It may work fine for one person, and not for the next.

You should take a look at this Bristol stool chart: http://en.wikipedia.org/wiki/Bristol_stool_chart
Ideally, you should be between 4 and 6. Personally, I found 4 would retear my fissure, and 5-6 to be ideal for me. Others in here aim for 4 and find 5/6 too irritating for the fissure. Regardless, you also need to keep the stools soft.

So, to tell you what to change in your diet, we need to know how your stools are, and what stool type works best for you without retearing your fissure ;-)

Hi Sugarspice,

I too had Botox, at one point I had 3 Fissures, 2 very chronic hell pain suicidal ones! My life was on hold and I was so depressed. AntiDepressants helped me and the Botox really helped. It took 3 weeks to kick in, and it was a ongoing process of lubrication,Movicol and diet changes. I have IBS so I have overhauled my whole diet and followed the FODMAP plan under a dietician. I think everyone is slightly different with these damn bum problems, depending on IBS, Sphincter tightness and stool consistency and size.

Echoing what OMB said be careful with too much Fibre, as this can bulk your BM more, I did it and I felt like I was passing Bricks... Ouch. Be careful with Eggs as they can be binding, again I found this out when I ate an omelette and had a retear. Also red meat is hard to digest for me, so I avoid it and stick to fish and white meats.

I have a Botox Hem diary which you can look at, I was definitely more than moany, suicidal was the feeling. Things will improve for you. We are here, and remember we all can share and discuss all things relating to bottoms here!

Good luck. Xxx

Hi....
It looks like you have a very healthy diet to me.... But like the others have said... Our digestive systems are all so different, so what works for one, could spell disaster for another.
What are your stools like?? Do you feel they are large??
One of the things I would ditch for sure would be the bran flakes... I would switch to porridge/ oatmeal for breakfast. It's very good for you, and contains soluable fibre as opposed to in soluble in the bran.

Remember to drink plenty of water to keep things soft and moving!

OMB x

Hi AFF buddies, I have great news, I had a pain free BM this morning with no pain during or after...woo hoo

...I am sore and itchy though, but I don't care!


Now my main aim is to keep my BM's soft. It is so difficult to tell you what a normal stool is like because at the moment I am on 15ml of Latulose twice a day and a senokot extra strength, so at the moment they are very soft. Should I move away from my laxatives yet? I am very reluctant. I also only go every other day EVEN on all these laxatives and a high fibre diet! I keep hearing everyone talk about something begg with M that has Magnesium in, what does this do?

Thanks for all your helpful posts

Ok really worried now. Further to my happy post above I now have pain again. I didn't mention that my BM this morning was harder than it normally is, it 'plopped' into the toilet which I haven't had for ages. It wasn't hard hard, it was still softish but much more forned if that makes sense? So all morning since my post I have been feeling uncomfotable and a little bit sore and now I have pain again. Have I re-teared???? Argh, please god no!!!

Hey Sugarspice,
Calm down poppet! & a few deep breaths......Stress makes things so much worse but I do understand that it's so hard not to feel the way you feel right now because I was there once too (although I didn't get the Botox treatment - just the Diltiazem)
The problem with fissure recovery, whether it be through Botox or cream or whatever, is that it doesn't happen overnight as much as we all want it to. It really does take some time as you will read in people's healing diaries. Fissures are unpredictable & relentless at times and your healing can't really be monitored on a day by day basis - it's better to look at things week by week or sometimes month by month, depending on how quickly you seem to be healing.
It's best if you can try to get yourself to look at things that way because then you won't feel so disheartened and down if you do have another bad day or two in the meantime. The main thing is as long as your pain is reducing gradually then this is always a good sign. Perhaps keep a diary of your pain levels & symptoms & of everything you eat along with your BMs ? - this may enable you to see some patterns and make some connections with what you eat?
It's often easy to think that after one bad BM that you have retorn, but this isn't generally always the case....yes, you probably irritate things again somewhat and suffer more discomfort but you can be still healing - it doesn't mean you go back to square one again. This happens to an awful lot of us and a few days on, you realise it was just a "blip".
At times like this, try really hard to shift your focus off your bottom (again - difficult I know) but it really helps if you can "lose" yourself in other distractions - whether in your children or music or films or inventing new fissure friendly foods (that was one of my faves!)....Dealing with a BM alone is hard enough at these times, so if you can shift your focus away from your bum when you are out of the bathroom, it does help.
Your diet sounds absolutely fine to me too - I never had an issue with bran flakes myself but I get even better results with porridge oats, so what OMB has advised is a great idea for breakfast. I sprinkle oats with cinnamon and pour honey over them and it's delicious - Soft tinned figs mixed with Bio yogurt are also yummy too. The one thing I did note was your Cottage pie however - I have a few issues personally with mashed potato (possibly due to the mixture of milk & butter when I make it) so I tend to steer clear - That with the minced meat, is a bit too binding on my system creating the soft but hard "ploppy" stools you described, so the combination does not work for me - I also try to substitute minced meat for Quorn these days because it's much lighter on my digestive system.
The main thing is you seem to be doing OK with your diet but it's always good to keep experimenting to see what improvements can be made. Please check out the website for fissure friendly recipes & tips because there's loads here that will help you - Also, if you haven't already, check out the Bristol Scale on stools that JHH has posted because this gives you a great idea of what you need to strive for at such times!
As far as your stool softeners go, I would just say be careful right now because you do need soft stools. Lactulose is fine to continue to take regularly and I'd say persist right now - just be careful with Senokot. That's a stong laxative & not recommended for ongoing use. I think you might be thinking of Milk of Magnesia - it contains Magnesium Hydroxide and although is effective again, is not a laxative to be taken all the time.
A lot of people here (including myself) supplement with a regular Magnesium tablet once a day, which helps me personally maintain soft stools & you could try using additional Olive Oil, which is natural & safe. You can add loads to food or even take a spoonful orally. Other than that Miralax (Movicol) comes highly recommended but you might need to experiment with your dosage a bit....
You just need to experiment generally right now using some of the great tips on this site to see what works for you but the main thing is to stay as calm, strong & as practical as you can about it all too. Stress really does not help.....
Don't fret too much about going every other day either. Maybe that's just you...We all have totally different BM patterns. The main thing is the quality of what we produce is far more important than the quantity of times we have to go!
Take care Sugar & stay calm.....you will figure out what works for you for sure but please use this site to your advantage. It is undoubtedly the best place to be on the net with an anal fissure!!! x x

Wow ETO, what an amazing post, thank you :-) I have been researching throughout the day and I have been looking into soluble and insoluble fibre. The impression I get from this forum is that soluble fibre is better than insoluble, so I was thinking of making 75% of my diet soluble fibre and 25% insoluble. How does that sound? I know that if I have a more insoluble fibre day that I have to drink a lot more water to compensate.

Can I ask what magnesium tablets do to help? Also, although I intend to keep taking laxatives, won't that deplete me of vitamins in the long term or is Movicol different to most laxatives?

The other thing I am slightly confused about is the use of vaseline, do I just use it around my bum area or insert inside?...very reluctant to do the latter due to the pain!

Also, after my injections I wasn't given any antibiotics, do you think I should have been?

Many thanks in advance
SS

PS - I plan to walk in to town with my baby tomorrow and try on a new dress for Christmas :-)

Hi Sugar,
Guess what I just spent this evening doing?? The same as you by the sounds of it!!
I naturally veer towards soluble rather than insoluble these days but I guess that's because I've been experimenting for 2 years to achieve the perfect BMs!!.......This works for me, so I'd definitely advise you to give it a go. I always drink tons of water & herbal teas daily, so I'm OK there!
My tips would be to substitute bran cereals for oat based cereals (as you know I'm a porridge convert) and rye bread is so much better for my system than wholemeal too. That list of soluble/ insoluble foods in the diet tips section is really helpful, so you could try making a list to figure out some recipes??......
Lactulose & Movicol won't deplete you of vitamins if you are already eating a proper balanced diet - They just help to create softer stools for you. I just take a regular (ASDA) own (if you're in the UK) 300mg per night capsule, just before I go to bed and again, this has a slight laxative effect, which helps to keep things soft (especially first thing in the morning) - I definitely don't get those hard-tipped stools that some people have issues with! I actually took Lactulose myself for about a year, which worked fine, so I didn't try Movicol myself but a lot of people here highly recommend it (normally once they've figured out the dosage that works for them)
I've always eaten a really balanced diet with my 5 fruit & veg a day +, I also take Zinc (aids Immunity & wound healing) so I've never worried that I've been depleting myself of vitamins.
The Vaseline I've also found really helpful & continue to use to this day. It does help if you get a large dollop and try to push it very gently in (only 1/2 a cm or so just inside the anal opening) Don't push it in too deep though to cause any damage and I know this will sound gross, but the motion of actually pushing a little there actually helps move the stool motion along for me, so it comes out easier too. There's no shame on this site!....Anything goes, that helps here..
There would be no need to give you anti-biotics for injections for Botox because the procedure would be done under sterile conditions. It's only if infection came into the equation, that you would be ever given these and that's highly unlikely in this case, so don't worry about that at all.......
Enjoy your walk into town tomorrow - let's hope we get some good weather! and yes, focus on shopping........it's far more exciting than worrying about your bum! :) x

Hi SS

I see you ETO gave you some great info :-)

Stay on the stool softeners until you are healed, and maybe for even longer, because the area continues to build up strength for quite some time after the pain has gone down.
I'm still on lactulose and magnesium, and will be for a long time. A harder than usual BM will still make me sore even if it doesn't retear me.

As for soluble vs insoluble, then you really need to experiment. No two persons are alike. But I'm sure a good starting place would be 75% vs 25% like you talk about. Personally I hardly get any insoluble at all.

Try not to stress about all this, and remember to measure your progress in weeks, not in days. It's a roller coaster, but the good days will be more and more.