ButTox in San Antonio — Relief from Chronic Sphincter Tension
A physician-performed treatment that relaxes overactive anal sphincter muscles — ending the cycle of pain, spasm, and discomfort that affects millions of men and women.
ButTox Treatment: Botox for Anal Sphincter Relaxation
ButTox is a medical procedure in which botulinum toxin (the same active ingredient used in Botox) is injected directly into the internal and/or external anal sphincter muscles. The purpose is to temporarily relax chronically overactive sphincter muscles that cause persistent pain, spasm, and dysfunction.
The anal sphincter is a ring of muscle that controls continence. In many patients, this muscle becomes hypertonic — meaning it remains in a constant state of tension or spasm. This chronic tightness prevents healing from conditions like anal fissures, creates ongoing pain, and significantly diminishes quality of life.
Botulinum toxin is FDA-approved for the treatment of muscle spasm and overactivity. When injected into the anal sphincter, it temporarily blocks the nerve signals that cause the muscle to contract excessively — allowing the tissue to relax, blood flow to improve, and healing to occur naturally.
Physician-Performed Precision
At Prime Vitality, Dr. Shiv Goel personally performs every ButTox treatment in a private, judgment-free medical setting. His board certification in Internal Medicine ensures a thorough understanding of the anatomy and physiology involved, leading to safer, more effective outcomes.
Who Benefits from ButTox?
ButTox addresses a range of conditions caused by chronic sphincter tension and pelvic floor dysfunction. If any of these sound familiar, you are not alone — and help is available.
Chronic Anal Fissures
Fissures that have not healed with conservative treatment. ButTox relaxes the sphincter, improves blood flow to the fissure site, and promotes healing — often eliminating the need for surgery.
Hypertonic Pelvic Floor
Pelvic floor muscles that are chronically tight and overactive, leading to pain with sitting, bowel movements, and daily activities. ButTox targets the sphincter component of this dysfunction.
Proctalgia Fugax
Sudden, intense rectal spasms that occur without warning — often at night. These episodes can be debilitating. ButTox reduces the frequency and severity of spasms significantly.
Chronic Anal Pain
Ongoing pain in the anal region not attributable to other pathology. When conservative measures fail, ButTox provides targeted muscle relaxation that relieves the underlying spasm causing your discomfort.
Comfort During Intimacy
Sphincter tension can cause significant pain during intimate activities. ButTox relaxes the muscle, restoring comfort and confidence. This is discussed and treated with complete discretion and respect.
Why This Conversation Matters
Millions of Americans live with chronic anal pain, fissures, and pelvic floor dysfunction — yet the vast majority suffer in silence. Embarrassment, stigma, and a lack of awareness about effective treatments keep patients from seeking the help they deserve.
The reality is that these conditions are extremely common and highly treatable. Anal fissures alone affect an estimated 1 in 10 people at some point in their lives. Proctalgia fugax impacts up to 18% of the population. And hypertonic pelvic floor dysfunction is increasingly recognized as a widespread but underdiagnosed condition in both men and women.
At Prime Vitality, we believe no patient should endure chronic pain because they feel uncomfortable seeking treatment. Our practice is built on compassion, discretion, and medical excellence — so you can get the care you need in an environment where you feel safe and respected.
Why Patients Trust Dr. Goel for ButTox
This is a sensitive procedure that requires medical expertise, anatomical precision, and a compassionate approach. Dr. Goel provides all three.
Physician-Performed
Dr. Goel personally performs every ButTox procedure. You will never be treated by a nurse, technician, or assistant. A physician's hands provide the precision and safety this procedure demands.
Board-Certified Internal Medicine
Dr. Goel's training in Internal Medicine means he understands the full clinical picture — not just the symptom. He evaluates underlying causes and ensures this is the right treatment for your condition.
Non-Judgmental Environment
We understand the courage it takes to seek help for these conditions. Our entire team is trained to provide a judgment-free, compassionate, and completely confidential experience from start to finish.
Comprehensive Evaluation
Before any treatment, Dr. Goel conducts a thorough evaluation to confirm the diagnosis, rule out other conditions, and develop a personalized treatment plan. Your health and safety always come first.
The ButTox Treatment Process
A straightforward, discreet in-office procedure designed to minimize discomfort and maximize your peace of mind.
Confidential Consultation
A private, one-on-one consultation with Dr. Goel to discuss your symptoms, medical history, and treatment goals. Everything discussed remains completely confidential.
Clinical Evaluation
A brief, gentle examination to confirm the diagnosis and assess the degree of sphincter tension. Dr. Goel explains every step before it happens — nothing is done without your full consent.
ButTox Treatment
The procedure takes 15–20 minutes. A topical numbing agent is applied for comfort. Botulinum toxin is then precisely injected into the targeted sphincter muscles. Most patients experience minimal discomfort.
Follow-Up Care
You can return to normal activities the same day. Results begin in 3–7 days. A follow-up appointment ensures you are healing well and allows Dr. Goel to address any questions or concerns.
A Story of Relief
“I suffered for three years before I found this treatment. I had a chronic fissure that wouldn't heal no matter what I tried — prescription creams, sitz baths, dietary changes. The pain was constant. It affected my work, my relationships, everything. I was embarrassed to talk to anyone about it. When I finally found Dr. Goel and learned about ButTox, I was skeptical but desperate. The procedure was quick, virtually painless, and within a week the spasms stopped. Within a month, my fissure had healed for the first time in years. I only wish I had found this sooner. If you're suffering, please don't wait like I did.”
Patient identity protected. Story shared with permission to help others seeking treatment.
Symptom Relief Our Patients Experience
ButTox produces measurable improvements in pain, function, and quality of life. Here is what our patients report before and after treatment.
Chronic Fissure Pain
“Sharp, tearing pain with every bowel movement. I dreaded going to the bathroom. The pain would last for hours afterward.”
“Within 10 days, the pain was gone. For the first time in over a year, I could function normally. The fissure healed completely within 6 weeks.”
Rectal Spasms (Proctalgia Fugax)
“Sudden, excruciating spasms that would wake me up at night. I never knew when they would hit. It was terrifying and exhausting.”
“The spasms stopped almost entirely. I went from 3–4 episodes per week to maybe one mild episode per month. I can sleep again.”
Pain During Intimacy
“The tension made intimacy extremely painful and stressful. I avoided it entirely, which was affecting my relationship.”
“The muscle relaxation made a world of difference. I can enjoy intimacy again without fear or pain. It genuinely changed my quality of life.”
Results may vary. Individual outcomes depend on condition severity, medical history, and treatment response. Testimonials reflect actual patient experiences.
ButTox Pricing
Transparent pricing with no hidden fees. Your initial consultation is complimentary — so you can discuss your condition with Dr. Goel at no cost before deciding on treatment.
Single Treatment
- Physician-performed procedure
- Topical numbing included
- Post-treatment follow-up
- Results last 3–4 months
Package of 2
- Two physician-performed sessions
- Topical numbing included
- Follow-up after each treatment
- Extended relief coverage (~6–8 months)
- Priority scheduling
Free Consultation
- Private consultation with Dr. Goel
- Discuss symptoms & concerns
- Personalized treatment recommendation
- No pressure, no judgment
Frequently Asked Questions
We understand you may have questions about this treatment. Here are the answers to what patients most commonly ask.
ButTox is a medical procedure in which botulinum toxin (commonly known as Botox) is injected into the anal sphincter muscles. The injection temporarily relaxes chronically overactive muscles, relieving pain, spasm, and tension. It uses the same FDA-approved medication used throughout medicine for muscle spasm — applied specifically to the anal sphincter to treat conditions like chronic fissures, proctalgia fugax, and hypertonic pelvic floor dysfunction.
Most patients report minimal discomfort during the procedure. A topical numbing agent is applied before injection to maximize comfort. The injections themselves use very fine needles, and the entire treatment takes only 15–20 minutes. Many patients describe the sensation as far less uncomfortable than the chronic pain they have been living with.
The treatment itself takes approximately 15–20 minutes. Including the consultation and numbing preparation, your total appointment time is typically under 45 minutes. You can return to normal activities the same day — there is no downtime or recovery period required.
Most patients begin to notice relief within 3–7 days as the botulinum toxin takes effect and the sphincter muscle relaxes. Full therapeutic benefit is typically felt within 1–2 weeks. For chronic fissures, the relaxation allows healing to begin immediately, with significant improvement over the following 4–6 weeks.
Yes. Botulinum toxin is one of the most well-studied medications in medicine, with decades of safety data. It is FDA-approved for treating muscle spasm and overactivity throughout the body. When performed by a qualified physician like Dr. Goel, the risk of complications is extremely low. The most commonly reported side effect is temporary, mild bruising at the injection site. Importantly, the effect is temporary — the muscle returns to its normal function as the medication wears off.
Results typically last 3–4 months per treatment. Many patients with chronic fissures find that one or two treatments is sufficient for the fissure to heal permanently. For conditions requiring ongoing management, such as proctalgia fugax or hypertonic pelvic floor, treatments can be repeated as needed to maintain relief.
No referral is needed. You can book a consultation directly with Dr. Goel. Many patients come to us after seeing other providers or trying conservative treatments without success. We welcome self-referred patients and are happy to coordinate with your primary care physician or gastroenterologist if desired.
Absolutely. All medical consultations and treatments at Prime Vitality are protected by HIPAA and held in the strictest confidence. Your visit, diagnosis, and treatment details are never shared with anyone without your explicit written consent. Our office environment is designed for privacy, and our staff is trained to handle sensitive conditions with complete discretion.
