This might sound silly but I had Botox back in December and a Skin Tag removed and today I had a GP appointment and saw the letter from the hospital to the doctor saying they'd performed a Chemical Sphincterotomy, is that the Botox? Cos as far as I was concerned that was all that happened? My GP didn't seem to know if it was Botox or not. It also said in the letter that I had generous amount of piles there was no mention of this to me I was led to believe all my pain was the Fissure. So will this Glyceryl Trinitrate stuff help piles or do I need to treat them seperately?
Also after 18 months of suffering with this bloody thing and the Botox in December and various creams and supositorys I've finally been given Glyceryl Trinitrate which I've heard a lot about on here causing headaches. I've got Rectogesic 4mg Glyceryl Trinitrate. My GP said after all the problems and the Botox that he'd recommend this then if that fails refer me to the specialist who performed the Botox as he's the best local specialist guy. What worries me is am I going to get awful headaches all the time, and the cream doesn't come with an applicator so do I have to use my finger? And what are the succes rates of this stuff? Has it helped anyone?
Sorry for the questions its all stuff I forgot to ask my GP always forget something.

Hello fedup,
Yes both Botox and Glyceryl Trinitrate (GTN) are classed as Chemical Sphincterotomy however since this was performed in hospital it obviously means Botox.
GTN relaxes the internal sphincter to help relieve the pain of spasms associated with fissures (basically the pain that you endure for a few hours after you have been to the toilet)
The strange thing is you seem to be things back to front - you normally get GTN first and if that does not work then they offer botox.
As you have 0.4% GTN (the UK version) this has to be applied internally although you're right it does not come with an applicator. You have to cover your finger (the little finger is best) with cling film and insert it up to the knuckle.
The success rate of GTN is 70% so you do have a fighting chance of healing this. Ohh and unfortunately GTN will not help with piles - you will probably need to buy something else to resolve this (probably anusol)
Finally the headaches..... this is a very common side effect but i was fortunate enough to only have a very mild throbbing that i only noticed the first three times after applying the ointment. What i suggest is to not use the full 2.5cm dose on your first application, maybe just use a small pea size amount and see how you react to this. If everything is ok then slowly build up to the full dose
Davo