I had three sphincterotomies because of an anal fissure. I am better but not well -- I'm still suffering from severe constipation and my bowels only work with multiple laxatives. I had Botox injections that did nothing to me. A second surgeon told me that they should be given under anesthetics, and that wasn't my case. So he wants to give the Botox injections again, but I'm scared of the results. And what good it is going to do to me? Is that going to help me with my constipation?
Please give me your opinion. I feel like going to the toilet all day long, like my poo is there but it won't come out. I'm sixty-one years old with diabetes and pernicious anaemia. Thank you very much.
Dear Grace,
The whole idea of getting a botox injection in the anal sphincter is to get the muscles to relax enough to be able to heal the fissures. It is not intended to cure constipation. That has to be dealt with from the other end, by drinking plenty of fluids and consuming enough fiber and/or supplements to prevent the constipation from occurring in the first place.
Using botox in conjunction with the sphincterotomy procedure is a relatively new practice, and it is not known how effective this therapy truly is. Studies have shown the healing rate to range from sixty to ninety percent. Botox has become the drug of choice for this type of therapy due to the severity of side effects of the other commonly used medication, which was a diluted nitrogen paste. This paste apparently causes incapacitating headaches in many patients, rendering it less than desirable.
According to the research that I saw, it is common to have to have the injection repeated at least once during the healing phase of the surgical procedure, but full recovery is expected with no long-term side effects from the botox. The paralyzing effects of botox is what allows the healing to take place, but that means there can be some anal leakage for a few months. This is usually minimal, however, and does clear up once the botox wears off.
Thanks for asking Motherload!
Motherload is Certified Nurse Assistant as well as an IBS sufferer, which means she knows a lot about poop. Got a question for her? Ask it here. [1]