Caffeine can help reduce or prevent headaches. If your anal fissure fails to respond to other treatments, your doctor may recommend an anal sphincterotomy. What are the symptoms of anal fissures? In some cases of rectal pain, you may need an endoscopy for better evaluation of your symptoms. My surgeon has talked about a Botox injection also. Health Information A-Z Our index of medical information authored by professionals Community Join the discussion in our forums Medicine directory Drug treatments, dosage instructions and side effects Medical Professionals Information for medical professionals Symptom Checker Assess your symptoms online with our free symptom checker. Have low blood pressure Have recently had a heart attack Have heart or blood vessel disorders Suffer from migraine or recurrent headaches Are pregnant or plan to become pregnant.