I am a 35 year old female. I have been having hemorrhoid issues since I was pregnant with my son in 2003. Finally in 2008, I saw a doc about the issue. During several different visits, the doc banded the hemorrhoids. They kept coming back. In 10/2008, the doc let me know that I now had an anal fissure. I felt no pain from the fissure. I knew it was there, just as I knew the hemorrhoid was there, by the skin tag. He gave me a compound and said it should heal in a couple of weeks.
Well a year and a half later, the fissure was still there. I went back to see him and found out that I had 2 fissures. He now said I should have a fissurectomy, hemorrhoidectomy and botox shot.
So on Monday, 4/26, I did that. The 2nd fissure was actually self healed, so it did not need to be operated on. The overall surgery went well. I did not feel pain and the start of the recovery was ok. I was really worried about the first BM. It actually went ok. I started taking stool softeners to make sure I would not suffer any hard BM.
But... Yesterday, I started having pain after my BM. I knew before my surgery, after a BM, my anal muscles tightened up, really tight. I didn't pay too much attention right after my surgery if the muscles were doing this. Well yesterday, I KNOW they are tightening up!!! The pain is unbearable! The BM is ok. It is the minutes following the BM. After i get off the toilet, the pain is so bad that I cant walk, crawl or anything. I've just been screaming. I don't know how to relax those muscles so I don't have this pain.
Does anyone have any suggestions? I am scared to have a BM just because of the aftermath. I have been taking vicodin (trying not to take as this med can cause constipation) to deal with the pain. I see the doc on Monday for the post op visit, but i don't think I can last a weekend of BM (I am a very regular person - and especially regular with the stool softeners). i appreciate any information/suggestions that you can give me.

Wow. The pain you describe following a BM actually sounds just like a fissure to me. Was there any blood? Maybe you re-tore the 2nd fissure? When my fissure was in the acute phase, it would leave me in extreme pain following a BM where I couldn't get up from the toilet.
Some of us have gotten relief from Valium for bad spasms. Could be worth asking your doc about. Sitz baths have never done much for me personally but I know some folks just right into those after a BM to ease the spasm pain.

That's what I'm worried about NeuropathicGuy. I am dreading the fact that the 2nd fissure could be back. There hasn't been much blood. so the blood I've seen, I thought were from the sutures. Today I tried sitting in a warm bath to see if that would help, nothing. I called the doc office to speak to the oncall doc. Surprisingly he said that this type of pain was common after a fissurectomy and hemorrhoidectomy. Had I been told the pain was this bad, there is no way I would have gone through the surgery. I had no pain prior, just ocassional discomfort. The doc told me to get some lidocaine and apply to the area. He said that would numb it and would ease the pain. Again, nope! He also told me to continue the vicodin, and even double it if I had to. I'm not going to double a dose of vicodin just so I can have a BM. I guess I will have to suffer (tear sniff- actually more like "AAAAHHHHHH!!!!!!!" & cry) until I can see my doc on Mon & hear what he has to say. Fingers crossed that he has some pain remedy.

I would seriously ask about a bit of Valium, at least just to try. If the pain is from a spasm (rather than just trauma) the Valium could relax it. It's only indicated for short term use but could be enough to get you through the worst of the recovery period.
I haven't had either a fissurectomy or hemorrhoidectomy but understand that the pain can be bad from either. Supposedly hemorrhoidectomy is one of the more painful anorectal surgeries. But the post-BM spasm pain does sound suspiciously like a fissure... Hopefully the doc has some ideas tomorrow. If it's a spasm he should be able to feel it, assuming you can tolerate the exam.

So how'd it go with the doctor today Susie? Things any better?