Reply to "Fissure"

Jan DollarModerator, RN, retired

Yes, the proposed treatment is the appropriate solution, and the same as anyone would prescribe. Be sure to also do hot sitz baths also, to aid in healing and pain reduction.

If the nifedipine is not effective, Botox is a reasonable choice. These injections offer essentially the same treatment as sphincterotomy, without much of the risk of potential sphincter damage that sometimes occurs with sphincterotomy. The Botox relaxes the muscle for approximately 3 months, giving time for the fissure to heal (the constant spasm that the fissure pain causes prevents healing). With the surgical sphincterotomy, there is increased risk of permanent incontinence issues.

If you think you may need a j-pouch in the future, good sphincter control is imperative and can make the difference between pouch success or failure.

Jan

6/24/1212:21 PM

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