What this experience covers
This experience covers the side effects people report after botox injection for an anal fissure — particularly temporary incontinence, worsened pain, and other unexpected complications. It is a composite drawn from many anonymised accounts and represents common patterns, not any single person’s story.
Botox works by relaxing the internal sphincter muscle. That relaxation is the point — it creates conditions for healing. But for some people, the muscle relaxes more than expected. When the sphincter is temporarily weakened, side effects can follow. Most are short-lived. Almost all resolve as the botox wears off. But living through them without warning or context can be distressing.
Understanding what others have experienced helps put your own situation in perspective. Side effects do not necessarily mean the treatment has failed.
The pattern
The first days after injection
Most people describe mild soreness at the injection site. For some, this is the only side effect they notice. But a subset of people begin to experience something else within the first few days: a change in how much control they have over gas, urgency, or bowel timing.
People describe this shift in different ways. Some notice they cannot hold gas reliably. Others find that the urge to go comes on faster and more insistently than before. A smaller number describe minor leakage — enough to need a pad for reassurance.
This is the point where anxiety tends to spike. The side effect is unexpected, and the immediate fear is that it might be permanent.
The peak of side effects
For people who experience temporary incontinence or altered control, the effect typically peaks within the first one to two weeks. This is when the botox is at its strongest. The sphincter muscle is at its most relaxed.
During this window, people commonly describe:
- Difficulty controlling gas, especially when standing or walking
- Urgency that comes on suddenly and requires immediate access to a bathroom
- Minor soiling that is unpredictable and embarrassing
- A constant low-level awareness of the anal area that is distracting and exhausting
Some people also report that their fissure pain gets worse rather than better during this period. This is a smaller group, but their accounts are consistent: the injection site is sore, the fissure has not yet begun to heal, and the added side effects make the whole experience feel like a step backward.
When side effects begin to fade
The botox effect is temporary. As it gradually wears off — typically over eight to twelve weeks — the sphincter regains tone and control improves. Most people who experienced incontinence-related side effects describe noticeable improvement by weeks three to four, with full resolution by the time the botox has worn off completely.
The emotional recovery takes longer. Even after control returns, people describe residual anxiety — a watchfulness around gas and urgency that lingers.
The emotional weight
The side effects people describe are not just physical. Temporary loss of bowel control carries an emotional burden that is difficult to overstate. People describe embarrassment, isolation, fear, and frustration. Many say they did not feel comfortable telling anyone what they were going through.
The most reassuring thing people report hearing — from a doctor, from a forum, from anywhere — is that temporary incontinence after botox for a fissure is a known and relatively common side effect, and it almost always resolves.
What comes next
Side effects from botox for a fissure are, by their nature, time-limited. The botox wears off. The muscle regains its strength. Control returns.
But going through it alone and uninformed makes the experience far harder than it needs to be. People consistently say that early communication with their surgeon and hearing from others who had been through the same thing were the two factors that made the biggest difference.
If you are experiencing side effects after botox for a fissure, speaking to your doctor sooner rather than later is always worthwhile — both for reassurance and to rule out anything that needs attention.