Botulinum toxin A is a toxin protein produced by bacteria called clostridium botulinum. When injected into a muscle, it temporarily blocks neural signals for muscle contractions, causing the muscle fibers at the injection area to relax. Botulinum toxin A has been successfully used for treating a variety of medical conditions involving unwanted muscle spasms, such as strabismus and cervical dystonia. It is also commonly used in cosmetic care for removing unwanted wrinkles.
Most patients experience at least some amount of pain relief after being treated with Botox. The success rate for an anal fissure healing following an injection is 70 percent. Some injections might need to be repeated, especially in patients with functional anorectal pain.
There is no special preparation needed before the injection procedure. However, patients are encouraged to have a bowel movement and to carry out their normal hygiene routine before coming into the procedure room. The entire procedure only takes a few minutes, and no anesthetic is needed.
Patients are free to drive home or return to work afterward. Botulinum toxin A will start to take effect in a few days, with effects peaking within 1-2 weeks and typically lasting 3-6 months. During this time, the anal fissures slowly start to heal.
Although most patients do not experience any side effects, potential side effects include the inability to control the passage of gas (gas incontinence), pain from the injections, bleeding, infection of the injection site, and fecal incontinence (extremely rare). Symptoms of incontinence typically disappear after several months.
Be sure to keep stool soft during this period by avoiding straining during bowel movements, regularly taking sitz baths, increasing fiber intake, and drinking enough water.