Starting sometime in February after straining during a BM (I know, I shouldn't have), I developed pain in the anterior area during a BM. I began using nifedipine and muscle relaxant suppositories, and I felt healed when March began. Yesterday night I had terrible constipation that I blame on Prevacid that I was taking for a week, and now the pain is back. I've sworn to never take that medicine again.

I don't have the typical spasming and tight muscles that I had a year ago with a posterior fissure. Can anyone who's had anterior pain help me out here? Do anterior fissures usually not result in a tight sphincter? I really do not want another chronic fissure so I'm going to use nifedipine regularly until I'm fully healed there.

Hi patience, I have an anterior fissure and have also read that they often aren’t associated with higher resting pressure. That said, while my fissure may not have been caused by a tight sphincter muscle I now believe that my muscle has become tight after 6 weeks with the painful fissure. I feel a burning sensation about an hour after BMs that lasts for several hours. My CRS says this means I’m spasming in response to the pain and that the spasms cause the muscle to become tighter and tighter over time. So while I think my AF was initially caused by the increased rectal pressure of late pregnancy in combination with pregnancy hemorrhoids that made me more swollen and inflamed down there, I now think that I’ve developed a tight sphincter in response to the AF and this is making it even harder to heal. (It’s become hard for me to even pass gas, which I’ve read is a sign you’re really tight down there.) I’m using diltiazem faithfully and keeping BMs soft and doing my site baths, but I worry that only LIS will finally relax my poor butt enough to allow the AF to heal.

Thanks for your reply! I'm sorry that you're dealing with this along with pregnancy. I hope you will get the appropriate treatment once your baby is born and then never have to deal with an AF again.

I have an anterior fissure and I don't think I get the spasming that most people describe, but I'm not 100% sure. When it's at its worst, I will have pain for most of the day but it doesnt feel like spasms to me. It just burns and aches like I imagine any open wound would.

Some people describe spasms as a burning sensation too. Mine definitely feel like burning.