Advise please- Anal fissure+botox op. Still in severe pain

[Supergirl8]

Hello,

I would appreciate any advise please.

I had an operation 3 months ago for an anal fissure. An incision was made to promote healing and they also injected botox.

The only pain relief I can take is Ibuprofen and paracetomal. Also Instillagel- although I am unable to fully apply to the wound because I am still getting bleeding (the bleeding is on+off).

I got severe headaches with rectogesic gel so I can't use that.

I have been taking lactulose since the operation to keep my stools soft. And I am having a high fibre diet,drinking plenty of water and taking all the vitamins+minerals that I need to help with wound healing.

However I am still in so much pain everyday. Everytime I have a stool, the pain lasts approximately 7-8 hours after the stool, which means I am bed bound most of the day (because I am unable to sit down or stand up).

But I know exercise is important, so I do try to go out for a walk when my pain threshold allows me. I am even doing portion control with my food so that I don't have to pass too many stools. I have lost quite abit of weight because of this.

I had a follow up appointment with the surgeon last month and he said the wound didnt look infected but said it was healing very slowly.

I am just concerned that this pain won't go away, especially since I had the operation 3 months ago and I was advised that the recovery should be 3 months.

Has anyone had similar experience after this kind of operation? I would appreciate any advise.

[Desertsnowflake]

I am sorry to hear about the pain you are feeling. I have been dealing with a chronic anal fissure for almost one year. I have been advised to do the botox procedure by a colorectal surgeon i saw. However According to her only botox would be injected

To paralyze the muscle and allow it to heal. She never mentioned an incision would be made. Also according to her she said that i’d quickly see if it had worked or not and that if it didnt then in some cases another botox injection is needed. Most importantly she advised me against ever having the muscle cut as women would most certainly end up with incontinence as a result. So i am not sure why ur doctor made an incision. An anal fissure is already a cut in that area so i dont understand the purpose of an incision being made in the samw area. As i know it, only botox would be injected without any incisions. I strongly suggest that you see another doctor who might be able be to help you

[Supergirl8]

Hi Desertsnowflake,

Thank you for your reply.

Sorry to hear that you have been suffering for almost a year. I understand how it feels, as I had chronic fissure for a year prior to the operation.

Regarding my operation, the incision was made to enable the fissure to heal better. Apparently it releases pressure and it promotes the anal fissure to heal properly. This was because my anal fissure had lots of scar tissue which didnt heal properly, which is why they needed to make an incision for fresh tissue to heal. Thats my understanding of it.

I went to see my surgeon this week and he cannot understand why I am healing slowly. I explained that it takes me hours after a stool to get to the stage where I am not in pain. He then said to see him in over a month and he will need to do botox again. But if still no progress with recovery, he mentioned that I may need a lateral sphincterotomy.

Am now very anxious. Concerned that my fissure may not be healed in over a month and am worried about this surgery he suggested, has that will cut more into the muscle. I think this was the surgery you were referring to?

Just abit of advise, you probably already know anyway- make sure that your vitamin levels are good, for example; the ones that promote healing...like vitamin C, D and Zinc. Also carbohydrates and protein are good. And plenty of fibre and plenty of water- as alot of fibre can make your stools hard, if you don't drink enough water.

I am not a Doctor-this is only advise from my own experience.

Hopefully botox will resolve the issue for you.

[mipdgal]

I am so sorry to hear about your pain. I have been dealing with a very similar issue. My pain can last 6 hours following a bowel movement and I am pretty much bedbound also when that happens. I know you said you have used a gel before. Do you remember what it was? I am currently using Nifedipine 0.2% compound cream and it seems to be helping a bit. It is not too strong and can be diluted with Petroleum if it does cause headaches. My surgeon recommended doing a lateral sphincterotomy, however, after much research I am thinking surgery is not a good idea due to the chance of incontinence following the procedure.

I hope you are able to get some relief soon.

[Supergirl8]

Hi Mipdgal,

Thank you for your post. Sorry for late reply- its been a difficult couple of weeks.

Sorry to hear that you are in a similar situation

Its coming up to almost 4 months since my operation and I am still bed bound for 7-8 hours after a stool. So I totally understand what you are going through.

I was using rectogesic gel but had to stop using that because I was getting headaches.

I was using instillgel but no longer use that because it was stinging me and only numbed the area for a short period of time.

I have now been prescribed Diltiazem 0.2% which I am hoping will help me.

I am of the same thinking with the lateral sphincterotomy.

Did you have similar procedure that I had done with the incision and the botox?

I too hope you can find some relief soon.

[brycesara in reply to Supergirl8]

Hello supergirl8, are you still on the forum? My husband has at least one fissure, how are you? Did you do the surgery? Thank you, Sara

[Exhaustedpatient]

Hi Supergirl, It's been 9 months since your last post. Wanted to check in and see if your symptoms got better? Or did you end up getting surgery?