I had Botox administered (100 units delivered via 3 shots) three weeks ago. I can't say I notice that much of a difference, the BM itself is not that painful, but the spasms that kick in afterwards do last for 3-4 hours. I thought that it would numb me down there and that I would not get any spasms.

Can anyone comment on what to expect and how this thing works? Did I just waste 500 bucks?

I do not think you wasted money! I had botox in July and if I remember correctly, it took a while for it to kick in and fully work. I was having terrible many hours long spasms.........so I understand.
Hang in there!!

I am facing the next elevated step according to my doc. I had open heart surgery in May to replace my aortic valve and repair an anuerysm. The doc said this makes it a big deal and I would have to have it done in an OR. Has anyone else faced the challenges like this? I am on Coumadin for life. My concern is the fissure becoming chronic due to the length of time I have had it. Any suggestions...?

Re: Botox .. as it has been explained to me, it stops the sphincter muscle going into spasms.

That sounds simple enough, just have to be cautious if any surgerical procedures are involved I will have to work this through my cardio doc to change blood thinners, etc, for me it is a much bigger problem I guess, but appreciate the your answer.

Can well understand your difficulty Mechman, and Botox is administered under full anaesthetic, but anal fissure pain, at its worst can be debilitating enough to change your life. I wish you good luck with getting your problem resolved.

You can get Botox done under just a local anaesthetic ... I have read some board members have had it done that way.

Hello Owmybum .. I have had Botox 5 times .. two different hospitals, and neither would offer me local anaesthetic. The hospitals being : Addenbrookes and St. Marks (the colorectal hospital) in London.

I believe alyssa had it done a few weeks ago without sedation. I think she is from US though.

Having Botox 5 times is alot anothersufferer... Can you not have LIS?.... How do toy find St.Marks? I'm thinking of looking elsewhere.

Hello again Owmybum, yes three of the Botox procedures worked for a while. The fourth went wrong, and the spasms went from10 out of 10, to 20 out of 10. And all us AF sufferers know what those spasms are like. And when it went wrong, that particular surgeon told me the only way forward was pain management. You and I know that we can only take pain control that does not cause constipation .. So that wasn't the answer, and I wasn't happy with that decision, asked to be referred to St Mark's. I had even contemplated flying to the USA to see Dr Feingold, who does the Kenalog procedure, but obviously that needed big cash outlay (a second mortgage no doubt) and in all honesty, on a bad day, I would not have been able to get there. but the lady surgeon I am now seeing at St Mark's is great. I had another procedure on December 23rd. She used Botox (different brand to the last one), and also used a steroid injection which is what Kenalog is. Also examined me to see if I would be a candidate for LIS but I am not. Apparently men have long sphincter muscles, women short ones which is why there is reluctance to do this procedure on women. More chance of incontinence. My fissure was found to be "very big", and much too early for me to know whether what has been done on December 23 will be successful. Will have to wait a few months. However, if I am unlucky enough that it doesn't put me to rights, I was told "they would not give up on me", which I felt the previous guy did. St Mark's is a very busy hospital, waiting times for appointments quite long .. But it is the specialist colorectal hospital, so as far as I am concerned, worth waiting for.