I have a history of Crohn's disease but in remission for 8+ years. First saw Colorectal surgeon 1/13 for hemorrhoid and blood. Again 1/14. Started seeing him again about 10/14 with heavy bleeding and pain/pressure/burning. Between 10/14 and 4/14 he rubberband ligated 3-4 hemorrhoids. Always had a fissure. Since then, bleed about 1/month but pain is severe. Stabbing, spreads to my vagina. Usually have 3-4 BMs in the morning. If I'm on my feet during the day doing usual errands and carpools, by end of the day I'm unable to stand.10/10 Have tried proctosol, lidocaine, nitroglycerin, 2-4 mg Valium, Percocet. Nothing helped. Had Botox injection on 6/9/15. Found only fissure and significant hypertrophy, no evidence of crohns. Pain has been more constant since. Starts after first BM and is pretty much intractable all day. More left side than right. With 10mg Valium, pain is anywhere from a 0-4. Works for abt 6 hours. Without it, varies all day between 6-10. Without meds, wakes me up hourly. With meds, I wake up around 6 in pain. Before Botox, pain would slowly escalate all day. After Botox , pain can get severe any time after first BM. Urge to urinate also brings on pain. Warm baths and sitz baths relieve pain while I'm in them but pain returns almost instantly after. Heating pad and ice help for a period of time but pain comes back with a vengeance after.