Skip to main content

I haven't posted in a while. I have UC in partial remission and have not had surgery. What I thought was a hemorrhoid turned out to be a fissure and "sentinel pile." The very kind colorectal surgeon who was able to get me in in quickly, as it is VERY PAINFUL, put me on Nifedipine ointment twice a day for a month and said it had a 50-60% chance of curing it. The next treatment, should Nifedipine fail, would be botox injections. He said surgery should be avoided as it could compromise future j-pouch function. So far he seems to be saying all the right things.
My questions are: Does this sound like an appropriate approach? Should I go ahead and try to be seen by Dr. Varma, our regional J-pouch expert as she would be one of my top two choices to do a j-pouch surgery, should it come to that?
Original Post

Replies sorted oldest to newest

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 Smiler

Add Reply

Copyright © 2019 The J-Pouch Group. All rights reserved.
Link copied to your clipboard.