This is a response to an old thread (which has been closed). Unfortunately, I never got back years ago to post this but I was thinking about it tonight for some random reason and decided to post the results of my experience with Dr Feingold / Kenalog Procedure
https://anal-fissure.org/kenalog-procedure-for-anal-fissure-t8162.html
I did have the procedure done with Dr Feingold. The recovery was really hard. He predicted anywhere from 5 days to 4 weeks and it was over 3 months until I was out of pain. The procedure failed and while it may have helped a bit, it ultimately did not heal the fissure.
Dr Feingold was fantastic up until the procedure. The whole team at the hospital was amazing.
At the 3 month follow up, Dr Feingold said that given the # of times he had done the procedure, it was bound to eventually fail. (not re-assuring). He said he could try it again and I had no emotional energy to go through again. I was literally in excrutiating pain every day for 3 months after the procedure.
Again, from what I know, this usually succeeds so I am not saying the procedure is bad, it just did not work for me.
The thing I didn't like thoughis that Dr Feingold pretty much stopped reaching out to me once he knew it failed. You think he would have been interested in the outcome and follow up of a failed surgery but I felt he more brushed it under the rug and tried to forget about it. I believe he didn't return messages etc at that point.
After bearing pain for another 6 to 12 months, I went to Edison Colorectal in NJ with Dr Joseph Notaro. I believe Dr Feingold actually was a post doc with him at one point. I told him about the experience and he seemed skeptical about the procedure and recommended Botox. He said that the fears are overstated for Botox and that they have actually found recently they could increase the amount of Botox given and have had zero issues So, I finally went ahead and did Botox.
i IMMEDIATELY felt better the day after Botox. Botox did cause one week with no control about 3 weeks into it. I think I didn't make it like once and it wasn't a huge issue. It probably took 1-2 months (maybe 3) for Botox to heal it most of the way. I think adding Coconut Oil got me over the final hump.
Today, I have occasional itching once in a while but I generally have no pain and it feels completely healed. I do put a combination of vasoline and coconut oil on the fissure everyday still (probably paranoia on my part).
So my summary
1) Feingold's Kenalog procedure may work for some but not everyone and it might be far more painful and drawn out recovery than other solutions
2) I suggest eating things that keep your movements soft. I still take Citrucell and ProBiotic and Colace daily. I also eat a salad daily and find almond butter great if you are looking for a good healthy food that won't irritate down there.
3) Coconut Oil really seems to work really help. Get it up there daily or multiple times a day. Maybe combine it for short periods with Cortisone
4) Botox works really well with the right doctor. With the chance of a problem being so low and the chance of getting better quickly so high, don't be in pain forever like I was because you are afraid to take a chance.
5) Just a note about my fear of Botox making me incontinent. The muscle in question only holds back stuff at the very end of the bowel ready to come out. So incontinence is a risk there but honestly, once you go in the morning, everything is then mostly held back higher in your bowel (the way you learned when being potty trained) so incontinence is a bit overblown to me around this. Go in the morning and you are probably safe for the day.
6) Don't overdue the Advil. I took it everyday for like a year and a half and now can't ever tolerate it because the damage it did to my stomach. Work with your doc to find a better solution.
7) None of those creams and preparations o Amazon work. Diltiazem works a bit and coconut oil.
Hope this helps someone else
Jeff