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Have anal fissures. Used botox for numbness. Severe pain. Need surgery?

I have had anal fissure for a number of years. It was injected with Botox to numb it for six months to see if it will heal itself. After these six month period, it was fine for a while when I use frequent steroid ointment(Rectogesic Rectal ointment) precisely. Since November 2012, I have been in excruciating pain. I eat and drink fibre, with my stool even soft, I still feel pain after the activity. The pain start usually after I've been to toilet, it often start of gradually and severe as time progresses. It can last for 6 to 7 hours regardless of the ointment or pain killers. I have been scheduled for another treatment under general anaesthesia, I don't know if another Botox or surgery. I need your candid professional advice.
Asked On : Sun, 24 Mar 2013
Answers:  1 Views:  88
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Internal Medicine Specialist 's  Response
Jan 2013
Thanks for posting your query.
With the available described details, there appears to be possibility of persistent constipation induced anal fissure.
Passage of hard stools may cause injury at anal verge.
You should consult with internal medicine specialist/ general surgeon and should go for thorough check up.
You should also go for complete blood count, blood sugar, serum electrolytes, and thyroid profile.
You should take plenty of water, high fibre diet and laxatives containing lactitol and isapgula & movicol. Passage of soft stools will help in recovery.
You should perform increased physical activity to maintain gastrointestinal mobility.
You should also take proton pump inhibitors along with prokinetics.
Combination of liquid paraffin and glycerol is most effective in constipated cases.
Take care,
Dr. Mayank Bhargava
Answered: Wed, 15 May 2013
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