I feel like my actual fissures are getting better (well, until this morning's bm, but that's another thread). They don't burn and bleed any more. I think being more careful with them has helped (it's dumb, but when I thought they were just hemorrhoids, I wasn't all that gentle in my wiping habits).

Anyway, the thing that has me worried are the spasms. They come on so suddenly and hurt so badly that they wake me up at night or early in the morning. This morning, I was up at 4am and I hopped into a hot bath (my usual routine). The pain was so horrible that I couldn't take it and went instead to use the nitroglycerin cream. The thing is, when these spasms hit, a bm isn't really imminent. It can take another hour or two before I have a bm. But it's like my bowels start to move slowly while I'm sleeping and that seems to trigger these crazy spasms. I'm just wondering why they're so awful when the fissures themselves are improving. I'm worried I'm going to have some pelvic floor problem. I've had a few days where I felt like I had to urinate, but couldn't get my bladder to feel empty. Plus, I've given birth 5 times, so my pelvic floor has seen better days

Thoughts?

The spasms were the worst part for me too. It's hard to know what triggers them, but once they've started it seems like a feedback loop where the spasms cause pain and the pain causes more spasms. Nitro should relax the muscle, but it never seemed to do much when the pain was worst. I would take ibuprofen, which would eventually kick in and help the pain. Also, since it's not convenient to spend the whole day in the bath, I would sit on a hot water bottle for hours - at work and at home!

If you have topical painkiller like lidocaine that might help.
The urination thing is strange. I used to feel as though I had a UTI, but it was referred pain from the fissure. I think the pain down there makes everything feel wrong and out of wack. Ugh. I hope you start to feel better soon.

Yes the spasms are the worst. I used to only get burning, stinging, but now spasms are kicking in causing me lots of pain. I've been on nitro for 3 weeks, thought it was helping but the few days I'm racked with deep throbbing acheing pain.

I agree about the urination, the bladder sphincter gets stressed from the anal sphincter, they are very close together.