I'm off to see my CRS tomorrow after 10 weeks on Dilt cream and the fissure has not healed. I feel like the dilt has helped to an extent but the threat of an agonising time is just one hard bowel movement away. I think the only way to go now is botox. My crs said the fissure looks partially healed already so maybe botox will push it up to 100%. What i'm unsure about is how it's carried out. I've read that you have to have a general anaesthetic while they inject you and i've also read that a simple numbing agent is all that's needed. Did you have to go to a hospital to have it done or was it injected in the crs office on the day? Do they have to do anything special to locate the sphincter or do they just know where to aim. Most of all did the injection cause pain to your fissure?

My crs has always said botox is an option but he's never explained the procedure to me. I think he was very confident the dilt would heal it and I wouldn't have to bother.

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Hope this helps for a quick answer!

I had Botox, this april. And in all honesty I'm very glad I did! It wasn't nice for the first few days and had a bit of leakage but it was worth it. Only issue was I was left with scar tissue but 3 weeks ago I went back under again and had that taken care of. whilst he did the EUA he checked my existing chronic fissure and said it's now healed, all thanks to the Botox.

As soon as this new anterior incision site is healed, I should be back on my feet again.

Good luck xx p.s, keep up with GTN, religiously if you have it available.

FF x

I had botox injections last July. After the hell of an active fissure, it was really not that bad at all. My CRS did it right in her office. I won't lie, it was anxiety provoking to have your a$$ in the air and I had to really breath deeply and meditate to keep myself calm and relaxed. That is key as if you are tight and clench it will not be helpful. But it was very quick. Two injections, one on each side and it literally took a few seconds. The second one hurt a little more but it was so so quick. It did not bother my fissure at all. It did make me external hemmie bigger for a while but it didn't hurt and went back down in a few days. It does take some time for the botox to work but it did heal my fissure. You can do this! Just be calm and breathe. Good luck and let us know how it goes :)

Thanks everyone! A little update, I saw my CRS again today. He said he wants to put me under and have a look properly with a proctoscope. He's concerned the fistula I had a few months ago might still be open on the inside. He didn't seem too bothered about the fissure which annoyed me. He said when he has a close look if it looks like it's not healing he will give me a shot of botox while i'm asleep. Quite uncertain about what the future with this.

Hayleyw - I had Botox last Thursday... I'm in the US - my Doc was going to do General Anesthesia, but then the Anesthesiologist ended up just really heavily sedating me. If your insurance allows it - I would highly recommend it!!! My doc also pumped in a lot of local anesthetic - so the rest of the day was a GOOD day!!! Good Luck to you!

Thank you itsjustme :)

I'd be quite looking forward to the procedure if botox was a guarantee but the way they are talking I don't think it is. They said if the fissure looks chronic on camera inspection they will give me a shot but i've had it for over a year, I have a sentinel tag and I've told them how much pain i'm in, why would they still at this point not be sure if it's chronic or not? I just feel like the fissure is not taken seriously. When I meet with the team they only ever talk about my fistula and any talk of the fissure is started by me. I have this feeling they are going to put a camera up there and tear me up so much worse only for me to wake up and be told the fissure looks like it's healing sufficiently by itself be sent home no better off and be in agony for weeks after. I'm so frustrated. I just wish they'd guarentee me botox because that will be decent enough jusitifcation for ripping me up again with another invasive exam.

I can't say no because I know they are concerned that the fistula tract might still be exposed on the inside but the thought of what it's going to do to my fissure is terrifying. I've made some progress with Dilt cream. Not enough to heal me or even come close but enough so that the pain is livable. This will set me back. I'm so depressed at the thought of going back to agony but I will say this, this is the last time they do any kind of exam on me unless they give me botox.

Hi Hayleyw, Any updates with the botox injections? Did you get them?

I'm still awaiting my rectal exam under GA. I went for the pre-assessment last week but I haven't heard back with a date for the surgery. It's just a waiting game right now. When/if I get botox i'll be sure to let people know what experiences I have with it.