Hi I'm a 27 year old female. Been suffering for about 4 years now with pain. At first I thought it was Hems and tried to self treat but after 3 years of regular pain at first it hurt 6/10 but as time went on it felt like passing razor blades which is what I think people are referring to as muscle spasms, I went to the doctors (back & forth) where I was prescribed lidocaine then GTN and finally Diltiazem.
After a year of these treatments, nothing helped and I was put on a referral list to see a colorectal specialist.
After 4 months on the list with no correspondence, i had changed my diet 3 times,
high fiber = larger, longer more regular bowel movements,
Junk food = less regular easier to manage BM.
There was then a deterioration in my condition (threating to stop eating because of the chronic pain) I was able to sneak into see the doctor before his first appointment.
He said I had 2 fissures and a skin tag (caused in the 4 months of waiting). I was also booked in for surgery for the week after. (Such a relief but scary).
So I went into hospital yesterday. Had general anaesthetic and an examination under anaesthetic (EUA) then he cut the fissures from chronic to acute and I had an amount of Botox.
Woke up with no pain, out of hospital within a couple of hours. Still not in any pain now 24 hours later and just on paracetamol.
I'm not looking forward to my first BM. Will start using the Cream again as I think it helped my previous 3 movements before surgery - no razor blades, but a burning sensation.
I guess I'd just like to know if anyone has had Botox and a bit of surgery recently and what to expect. I'm open to answering questions too
:-)

I had it in March.  Your first BM will be little hard (#2 on Bristol Scale) with absolutely no pain.  The pain will kick in probably, two days after, when the numbness starts fading away. 
For three weeks, I felt a very sharp pain after every BM, that lasted for quite some hours.  However, once this pain is gone, a feeling of fullness will kick in for the next two weeks.  Like I said, in six weeks everything would be back to normal and in eight weeks, you would feel like you have gotten your old days back.
I never took painkillers.  Just sitz bath (3 times/30 minutes), one stool softener after lunch, one cap Miralax at night, Fiber 125-130 g, and sleeping on the side (not on the back), Diltiazem cream 4 times a day for three weeks (I switched to A&D ointment in the fourth week), and lastly walking (very slowly) whenever possible.  Otherwise, complete bed rest.
I avoided sitting for long periods, did not lift anything or pushed heavy things, until 2 months.  Also kept eating the same food, same time, same amount for a little more than a month.  I had a log for everything.  I was totally focused on healing and took good care of myself, because i knew, if this gets screwed then I'll be screwed for another, who knows how long or how many more months.  Like I said, two months .. and then you will get your normal life back !
Good luck on your healing!

That is great great advice. Thank you so much for your reply. It's nice to have a bit of support from a fellow sufferer. You sound like you've been very determined to kick it with a strict routine.
Can I ask what your daily diet it? I've changed from very healthy to very unhealthy as it seemed to reduce my bowel movements. Things like wheatabix and Bran flakes just make me go more regularly and have larger longer (albeit soft) stools that are more difficult to control.
Would love to see your average food log if you wouldn't mind sharing.
It's been 36 hours since surgery and there is absolutely no pain. Fingers crossed for the future. Again, thanks for the comprehensive reply, this forum is a god send, and I only found it the night before my surgery despite researching and suffering for years.
:-)

Hello DWF,
I had Botox 10 weeks ago. I didn't have either of my Fissures cut out though.I  now have one healed Fissure and one that isn't quite healed.I agree with MABS that diet is key, i follow the FODMAP plan for IBS, this has really helped me.Look at ETO'S posts, she has healed 100% naturally and has great tips on how to heal.If you have had surgery and Botox, i would imagine with the right diet and care you should be well on the road to healing...

what does it mean to "cut out the fissures"? I thought with LIS they cut beside the sphincter muscle so it relaxes, allowing healing...

Hi 3 years now,
From what I understood from my surgery, they tend to do an LIS on males as they have a longer sphincter. So the CRS didn't recommend it for me. He said he'd do an examination under anaesthetic as it was too painful before and then judge what needed to be done.
He cut away the scar tissue from both my fissures (one on each side) and changed them from Chronic fissures (unable to heal without intervention) to an Acute fissure (which can be healed with creams). He then gave me Botox to relax the muscle for when I had a BM.
Just started taking 'MOVICOL' which should help soften everything. Fingers crossed for my first BM.
Hope that helps.

Hey, longer & larger stools are a must (that is only, if the going is comfortable).  It helps the colon to stretch and adjust after the surgery --- an important factor to note.  I presume you had a Botox and Fissurectomy procedure.
My morning breakfast was brown rice pancakes - (Whole Food Market-gluten free aisle).  Your breakfast seem to be very healthy and if that is keeping you regular, then please do not break that cycle.  It is all about, what your tummy can handle. I tried having gluten-free food as much as possible, and replaced milk, with plain yogurt after breakfast.
My lunch and dinner was canned food.  I needed something to keep a track of my fiber-intake, so the nutritional analysis on the food label helped me.  I would have Progresso High Fiber Homestyle Ministrone Soup for lunch and Health Valley Organic (no salt added) vegetable soup from Whole Food Market for dinner.  These soups didn't have broccoli, so I would add lots of steamed broccoli (this was a wonder vegetable before the surgery.  It helped me to have a complete BM - an important factor, because anything that stays behind, will keep the external sphincter muscle tight. This would further aggravate the incision and prevent it from healing).  Please note here, botox is helping your internal sphincter muscle to relax, not your external sphincter muscle.  External s/muscle will stay relaxed, only if the process of elimination has been good, smooth and complete.
In addition, besides broccoli, I also added  2 tbsp of Organic Olive Oil (cold pressed) to my canned food.  You may incorporate this into your diet gradually.  It gives some gas relief and lubricates the internal system.  Plus, you know... it is a good and natural source of Vitamin E.
My fruits would include Honey Dew melon, Grapes, Strawberries, and Navel oranges.  (Yeah.. you got my "determination" part right...I had exactly 25 grapes at 11.00 am, 2 navel oranges at 4 pm ...and so on ).  I can't recommend the same fruits now, because they are out of season, especially strawberries.  Somehow water melon and pineapple did not agree with me, when the whole world seemed to have been benefiting from it.  This is why, I ask you to create your own schedule and system.  Your total success in food can be determined by reading your bowels..its frequency, color, consistency, and shape.  I went three times a day in the first week, then twice after that.  Chewing (especially saliva) is important for the first two weeks, because any undigested particle can harm the area.  I use to pulse grind food (barely two rounds) for little more than a week...  Helped me to have well-formed and soft stools.
I had one medium glass of lukewarm water every hour for 9 hours.  Yes, life was boring and depressing.  However, to keep off of depression, I took D3 without fail once in three days.  There are many ways to make life fun and exciting during such ordeals.  Like for example, I made sitz bathing fun by sprinkling lavender scent on the bathroom rug.  (My husband almost fainted buying that lavender scent from Whole Foods.  It was tiny and costs $25.  However, splurging makes oneself feel worth it.)  Sorry, this was out of context !  Thanks for listening :o
There will be many members who would help you out here.  Some "reads" can really touch your heart.   I am so glad you have been pain-free so far.  Every one heals differently.  I hope you have a speedy recovery.  Sending lots of healing vibes !

Update.
Day 4. So I haven't yet had a BM. little bit relieved because I haven't had much pain down there since my double fissurectomy. There is still fresh blood when I wipe. That's a bit concerning as its been 4 days and should be well on its way to healing?
I've been taking Movicol and plenty of fibre. Guess its just a waiting game.

Read my PM. 
I think you are doing fine as long as there is no pain.  Pain (without any activity) is the first sign that would raise a red flag.

WELSH. hope that u r doing fine now. I haven't gone through the procedure of fissureectomy but many on this have n they r successfully healed. hope that u will heal also but remember to keep ur self on fissure schedule at least six month after healing to give sufficient time to fissure site to get strong. majority people retear it usually because they consider its healed but it's not actually n they retear it. so do keep this piece of advice with u.