Would botox help my fissure?

I wouldn't expect the anemia to be a significant contributor to slower/reduced healing. Your blood flow would be the same, or greater, though the oxygen carried by that blood is reduced a bit. There are still plenty of reasons to get your iron stores back up, of course. 

Stool consistency is important for fissure healing/prevention. I'd recommend a texture like pudding. Are you anywhere near that? Are you having to strain on the toilet?

I had a small amount of Botox injected for a fissure back in october and I would say it helped but I had to be careful about not making any sudden movements and I couldn't do certain strenuous activities without having an accident for about 3-4 weeks. I also had to wear a pad on my boxers at night. Hey, at least you know to wear off in 3 months if you don't like it. 

I do get Botox for other reasons and my doctor told me that they do give Botox to patients that strain while having a bowel movement. This allows the fissure to heal because you're not constantly causing pressure every time you go to the bathroom. It makes sense. 

Janie

Hey guys, thanks for the replies!

Scott F - yes my consistency is fine, i wiuld say porridge like, but i do often get a strange thing that happens whilst mildly straining on the toilet, what happens is the stool is coming out as normal and then all of a sudden i experience a kind of blockage, only way i can describe it is that it feels like something square trying to get through a round hole, then if i push a bit harder the stool pops out and carries on as normal, but the whole process i can feel it slicing open the fissure, then i'm back to square one.

I mentioned this to the surgeon and asked if it could be a stricture, he said he doesnt believe i have one from what i told him, especially how most of the time the stool comes out fine without lots of straining. 

I guess anything else i can do to help the healing of the fissure would be appreciated, i currently use sudocrem before a BM to try create a barrier, then baby wipes, then rectogesic, the headaches from the latter are pretty difficult though.

Thanks

You might want to replace the rectogesic with diltiazem or nifedipine to avoid the headaches. 

There's some chance you're experiencing a small pouch prolapse, which behaves a bit like a stricture that comes and goes. A defecogram would be the test to clarify that. 

Scott F - is that all a pouch prolapse is? The name sounds pretty serious, but yes it comes and goes and its almost as if the anus is constricting in that very moment causing the stool the block up and stretch the fissure, yet the consistency is always the same afterwards so i know its not that.

I have got a tube of Diltiazem but have not used it yet, has it got a better reputation for healing than rectogesic?

I will try do a bit of reading on everything, thanks for the help! 

P.s. Do people with prolapsed pouches generally have the problems everytime they empty? As what i experience only happens maybe 3 times a week.

The diltiazem's key advantage is that it doesn't cause headaches. It's hard to predict whether it will be more or less effective for you  than the nitrate in the rectogesic - their mechanisms are very different. 

Pouch prolapses can vary a lot from just loose mucosa getting in the way of pooping sometimes to the extreme version where the pouch protrudes (inside out) from the anus.  I don't know that you have  a prolapse, and the infrequent symptoms could make it harder to detect with a single defecogram, like the car that never makes that noise when your mechanic is there to hear it. In any case, I'm not sure you'd feel the spasms, if that's what's going on rather than a prolapse. In either case the straining tends to cause the resulting fissures. 

Thanks again Scott

I actually asked the surgeon how i would know if i was having spasms, he said that i would feel a cramping type pain down there (which i never do) only pain from the fissure. 

He said if he were to do the botox he would first scope the pouch and check everything is ok, then would check if the fissure is internal or external. I asked him about incontinence and he said he has a very low % who suffer that and that he would only yse a very small amount on me.

I hear you regarding the defecogram, a bit like having an ECG in the GP's office for random heart palpatations.

I'm really not sure what to do, i'm at a crossroads, i'm currently sat at work with a big headache and irritation from the Rectogesic, and this seems to be a vicous cycle of the fissure almost healing, but then going back to square one again, i might switch to the Diltiazem and give that a good try before opting for botox or sugery.

Thanks again