Hi,
I had my first visit to the CRN last night and he told me to stay on GTN for six weeks. If the fissure has not healed in that time he intends to put the camera inside me to ensure nothing else is going on before any further treatment. He then said if all is ok the next step would be botox injections
Reading online i have yet to see a positive account of somebody having Botox - most people said they experienced gas, pain and ended up having LIS. If this is the case then i will question the need for botox as i would rather just solve the problem rather than just trying every treatment until it works. Therefore can i ask for your experiences whether good or bad?

Hi Dave, I had my botox 7 days ago, and quite frankly, think it was just a huge waste of my money! I have had no relief from the pain and it should have kicked in by now if it was going to! The only thing it HAS done is numbed my rear end but that hasn't taken away ANY pain, just means that its hard to tell if everything has been squeezed off if you get my meaning! My next step is prob the LIS operation but the wait to get that is at least 6 months! I don't know how I am going to be able to wait that long when my pain is just so constant and intense! I'm sorry for sounding dreary - I wish I could be more positive as that is normally my nature, however, this has just really got me down. I wish you all the best!

Hi, I just have to write that I'm feeling a LOT better about things since I have just talked to my surgeon. Yes, the botox has worked, in that it has numbed my rear end, and the pain I am feeling is due to my open, gaping wound that will hopefully start to heal, now the blood should be flowing more freely to the area due to the botox! He has given me a script for some stronger painkillers than my over-the-counter ones so fingers crossed that things can start to heal and the pain MAY be lessened by the stronger painkillers! I'm feeling more positive today! Lets hope things can start to feel better for us ALL, especially so we can enjoy the Christmas season!

Excellent, I am glad things have started to look better for you
How long did the Botox procedure last and did it hurt?

Well, I don't want to lie to you and tell you it was a breeze, cause that is certainly not the case! When I had mine, the surgeon wanted to check on other things too, so did an inspection with a scope thingy, that, when opening up my rear end to insert it, of course opened up the fissure too resulting in my current agony of an open wound that needs to heal! The actual injections themselves were "just another pain", when we are dealing with so much already so don't be concerned about them! My main suggestion would be, to make sure that you have some pain relief at least 1/2 hour before you have the botox/inspection, to hopefully relieve some of the pain. It's not nice, but I hope it is a "means to an end" for the pain for you! The surgeon reminded me this morning, that the fissure is an open wound, and not at all in an area conducive to healing, when we have to do our BM's daily, which irritates the wound every time it passes! He stressed the importance of keeping the area clean after each BM, so I leap straight from the loo to the shower or bath. Good Luck - I'll keep you posted with my progress!

Thanks for the information - currently i am into week two on the GTN and it seems to be working so far so i am keeping my fingers crossed.
My CRS said if it does not clear up in six weeks the next step would be to put me to sleep and put the camera inside (to make sure there is nothing else going on) and then it would be botox injections.
So i am just doing my Botox research now in case i need to prepare for the worst. I have read lots of posts by people saying that LIS is the ONLY way forward - I would like to think it isn't but if i heard many negative comments about Botox i would probably push for LIS.
Please keep me updated on your progress and I hope you have a great Christmas.

Hi Dave, I am in the UK and had botox about 3 and a half weeks ago. I also had a camera examination to check there was nothing else going on and the two injections. They found 2 fissures. For the first 2 days I was fine as they injected an anaesthetic into the area too. I'm not going to lie though, the first 2 weeks were absolute hell pain wise. Due to them using the camera and examining me I re-tore both fissures, really struggled in work and sitting down was awful. I have survived due to painkillers!
But at this point things have started to improve, still have some pain during bm but it goes away quicker and I'm hoping this is a sign I am starting to heal. Overall I'd say its worth a try and you do need to give it time. I did bleed after the botox and have been in pain, but have not experienced any gas, and only minimal leakage for a few days. My whole experience is in the thread 'botox today......fingers crossed'. Hope you don't get to the botox stage and that things improve! :)

I must admit i dont like the way everybodies fissures seem to re-tear after getting the camera and i have read so many pain stories following Botox i really dont know if i want to stop using the GTN and to opt for botox.
Why dont they just offer LIS in the first place???
Sue - did you get the camera at the same time as the botox or was this on two separate visits?

They haven't offered LIS for me because of my age and the fact I'm female due to complications it can cause. I had both at the same time, they checked with a camera (think it was like a mini colonoscopy), and then did the injections so that may be the cause of my aggravation. I've had quite a few examinations with the camera and had no problems before from just that. If you're with a good CRS a camera examination should have minimal pain I think :)

Well my experiences were a little different perhaps because I am from USA, Boston.
I had a chronic fissure for about 18 months and in the meantime I did 2 Botox injections. Now, they first offered me Nifedipine which didn't do anything for me!
Botox on the other hand provided great relief and I was able to function pretty well. My pain went from a constant horrible 8-9 to perhaps an occasional 3. The procedure itself was done under general anesthesia, and I felt NO PAIN worth mentioning afterwards! It took maybe 4 days until my sphincter loosened and my BM became better. I had absolutely no incontinence problems and I was finally able to resume work reasonably.
Now while Botox greatly improved my life quality it never really healed the fissure completely. I realized at 30 years old I don't won't that always hanging over my head and that I want to be able to do EVERYTHING, including bodybuilding that I love.
So in the end 4 weeks ago I had a LIS and it is the best decision I EVER MADE IN MY ENTIRE LIFE! Again the operation was a breeze, I was perhaps one day in a moderate pain (comparable to fissure) and for about 3 weeks I experienced some pain. (Nothing major but unfortunately still enough that I knew I wasn't completely healed) Then suddenly pain basically stopped, I saw my CRS and he thinks I am healing really well. A week later and I have no pain except an occasional zing that I am optimistic will be gone soon as well.
Now I would like to stress that my CRS advised me from the very begging against Botox and that I should have LIS. His opinion was that Botox has mixed results, but more importantly his experience with LIS is 100% success rate. Furthermore he literally laughed when I talked to him about my biggest worry incontinence. He told me that if done right the chance of long term incontinence are virtually 0% and he never had a patient with any. I should mention he does over 800 surgeries a year. True enough I didn't have incontinence for even a day, and I can control pretty much everything.
Now I don't know if my situation is applicable to LIS in general because I only have my personal experience and my surgeons word as a reference. It might also have helped that I had my procedure at MGH (Harvard Hospital) and my surgeon also teaches at Harvard but it seems to me that THERE IS NOTHING TO FEAR BUT THE FEAR ITSELF :)! Just find a really good surgeon that you trust and you will be able to get your life back in no time :)!
All the best,
Morningstar