Hi Everyone,

I wanted to see if anyone had any ideas about this. It seems like the treatment plan for my AFs, both doctors I've seen (GP's, neither have been surgeons) have suggested catch-all treatments: stool softeners, benefiber, nitroglycerin, lots of water, high fiber diet. This makes sense as it seems like it takes a lot to heal a fissure. However, neither have pinpointed the cause and I'm starting to wonder if something like pelvic floor therapy would be helpful, if my fissure's are from Levator Ani or if Botox could help if the cause is from high resting pressure. It would really help me decide my next steps if I knew the cause behind the tearing/re-tearing.
I'm curious whether your doctors were able to pinpoint the cause of the fissure eventually or whether you had to see a CRS/another specialists to determine this?

Also random but what does a "spasm" feel like? Is it the "glass-shard" pain during a BM or is it the dull ache that sometimes randomly happens or is it the burning during/after a BM? I've had all kinds of pain but I have no idea whether I've had "spasms"!

Thanks! I really appreciate the replies and the community here.

Hi there, this is late response but hopefully you will see it. If you suspect that pelvic floor tension is the cause then finding a physical therapist who specializes in this would be the best thing to do. They can determine whether you have muscle tension. You don't need to jump straight to Botox, there are many trigger point exercises that can help.

As for spasms , they can cover the full spectrum of what you've described. An injury to the area causes the surrounding muscles to go into protective mode resulting in pain that can be aching or burning, or other types depending on the person.