Botox applications (Botilinium toxin) have been used for years to treat medical problems caused by excessive activity in the muscles, such as muscle spasm and cerebral palsy caused by spinal cord injury. Botox prevents muscle spasm. Giving Botox to the muscles around the anus reduces the tension in the anal area and the muscle relaxes. As a result, the pain disappears and blood flow to the fissure area increases. Thus, fissure healing is accelerated. Botox is recommended as an alternative to surgery in cases where we do not respond to ointments containing GTN (glyceryl trinitrate) and diltisem, high fiber nutrition and stool softeners.
Procedure preparation
No special preparation is required before the procedure. You do not need to undergo bowel preparation or diet. Your standard hygiene cleaning (shower or bath) is sufficient.
Application
The procedure is performed by a surgeon under clinical conditions. Its duration is about 5-10 minutes. You do not need to have anesthesia during the procedure. At the end of the procedure, you can go home and drive. Following the appropriate position for the procedure, the anal area is cleaned. 2 doses of Botox are applied to the anal sphincter muscle. It is an uncomfortable procedure but is completed in just a few minutes.
After the application
When the injection is completed, you are ready to go home. Painkillers such as paracetamol and local anesthetic creams will reduce your pain. Botox effect begins after 72 hours at the latest and continues for up to 3 months. During this time, your anal fissure will heal. To prevent the crack from recurring, you should continue with a diet that will keep your stools soft. You should include fibrous foods in your diet and use laxatives (stool softeners) when necessary.
What are the undesirable effects?
As with all surgical interventions, Botox application also has potential risks. There may be minor complications such as light bleeding, infection, and allergic reactions. There may be a temporary loss of gas control due to the relaxation of the muscle around the anus. More rarely, there may be difficulty controlling stool. However, all complications resolve when the effect of Botox wears off, that is, after the 3rd month.
Rarely, Botox may not be beneficial at all. In such cases, a second application or surgical method may be preferred.
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