My fissure started about 9 days ago....incredible spasms, and pain with my BM. Felt like I still had to go, so I tried awhile longer, which made it worse!
Went to the urgent care last Saturday because I thought it was a hemmoroid problem.
On Sunday, went to the emergency room, because I was sure that I had an impacted stool (felt like I had to go and couldn't go!!!)
Finally, got to a colorectal surgeon who diagnosed the fissure on Thursday, and started the nitro 0.2% then.
The spasms have more or less quit, and the pain is not nearly so severe (though I'm on Darvocet for the pain). I'm using docusate sodium (400 mg per day, 2 in morning, 2 at night). I basically have been on a liquid diet since last Sunday (with a little soup, some yogurt and fiber one, berries, and double fiber english muffins mixed in).
Here's my question: I have almost a constant feeling of needing to have a BM, but there's nothing that comes! I'm guessing that I haven't been eating enough to need to have a BM, but that doesn't stop the feeling that I need to have one! I'm guessing that the feeling is related to the fissure and the pain and pressure on the sphincter--but I'm not sure....can anyone tell me--is this a common occurrence with a fissure??? Or do I really have a BM there that just won't come!!! (that's my fear, and it doesn't help me relax!) Thanks in advance for your answers!

Hey Marvin, when I first got my fissure, I also had painful and very uncomfortable sphincter spasms and the feeling that there was still stool that needed to come out even though there was nothing (or very little) there. In fact even urinating would cause the spasm to hurt more and make me feel like I needed to poop.
For me the sensation lasted until I really got the spasms under control. In my case, it took stool softeners (Miralax), a high fiber boiled veggies diet, nitroglycerin ointment, Percocet, and Valium for a few days in order to really get things in check. So I'd say that what you're feeling may not be abnormal.
But that would depend on how you got the fissure diagnosed. If your doctor somehow visualized the anal canal and saw it, then I'd feel comfortable that the feeling will subside with time. If no one has visualized the fissure yet then maybe have them do that (under sedation if necessary) if the feeling doesn't go away soon, to make sure there's no absess or anything.

Thanks!
The surgeon saw it right away....apparently it's right on the anal opening. I'm just concerned that I'm so constipated (or will become so) that I'll make the issue worse!
My wife tells me to not worry because I haven't been eating much, so I'm not likely to need a BM....but after the pain I've been through, I don't want to get bound up again!
I'm going to try some Milk of Magnesia tonight just to be sure....I may be switching from docusate sodium to miralax very soon....

If they saw the fissure then that's a good sign. I'd give it a bit of time and see if it lets up. The nitro ointment does take a few days to give any relief so hopefully that'll for it for you.
The first few weeks I had my fissure, it felt like, for lack of a better description, like my sphincter wanted to ummm pucker itself outward. And even after I managed to get some level of control over it, the feeling would still come and go at times. It made things like driving walking on stairs very painful.
Also, diet wise, Miralax and a diet high in boiled veggies like broccoli and cauliflower has been the best for me. It does make you a bit flatulent but that's a small price to pay for the relief!

Hello Marvin,
I know and completely understand the feeling. I talked to CRS about it and he suggested (after having tried the Milk of Magnesia) that I use Magnesia Citrate. It is a liquid that is flavored and fizzy (kind of like 7-up). I ended up drinking 10 oz of the Magnesia Citrate for two days and made sure I drank plenty of water. It helped.
Miralax helps some, but I still have to take a softner or two a day and drink lots of water. The 60 oz suggested per day is about the minimum. Cooked veggies are excellent.
Btw, yogurt has the possibility of slowing your system down due to the dairy. I have had to give up most of my dairy for the time being.
Good luck.

Hi Chrishell,
Thanks for your reply. So you drank the Mag Citrate two days in a row, 10 oz each day? Were you able to go then? Or was it just satisfying to know you weren't "plugging up?"
I was wondering about the yogurt. I don't eat much, between a half cup and a cup every other day, mixed with the fiber one and berries....thought they would weigh out in the positive. But I'm curious since they do talk about the activia for digestive health.....does the probiotics outweigh the other?
Biggest constipating issue I probably have right now is the Darvocet. But I've been taking stool softeners right along, and started miralax last night. And ibuprofen alone doesn't touch the discomfort so I'm not sure what to do. Took MOM last night and nothing.....used a glycerin supp today and only a little water and a very little stool. Sure feels like I have to go, but nothing comes.....It's been a week since an actual BM, and even those were puny (and painful!). So...since that last BM, I had 3 days of liquids only, and very little else to eat (lost about 10 lbs in the last week)...is it possible that there's nothing there to go, and it just is the spasms that make me feel like I have to go?
Also....from a dietary standpoint....it's not really a food, but anyone have any experience with jello? good or bad?

The Mag Citrate helped, but I was also taking stool softners (3x a day). I think the combo was helpful, but it was still hard to get the "soft" bm to happen.
At one point, I had to call the colorectal surgeon and tell him "I have to go but can't!" and that was after a week of no bm but feeling like I needed it immediately. He prescribed me "MoviPass" which is drink that is given to people prepping for a colonoscopy. I drank all of it and the required water, it still took over 2 hours before my body would allow a bm. The dr suggested I make sure to stay on the Norco and take advil before, just to minimize the pain. I cannot describe the pain when the bm finally hit.
I am not sure if you the spasms are making you feel like you have to go or if because you have to go, the spams get worse (they do that with me).
When you say the bm is puny, do you mean around? IF that is what you mean, then that is from your sphincter being too tight. I think that is part of the joy ride we are currently on. I ended up having to have loose stools for about 2 weeks before I could start having more formed stools. My CRS said to have the loose stools to allow the muscle to relax. I'm also on the Ned pills and diltiazem gel. They have helped (I know this because I took myself off of them for about a week and felt like I was at the beginning of the nightmare again!)
Jello, did not have any affect one way or the other for me. I had to start drinking Slim Fast shakes because of weight loss. It gets scary after a while, I lost over 30 lbs in the last 3 months and the weight is still kind of trickling away.

Thanks for all your answers! Saw the surgeon today and he said it appears to be healing, based on the amount of inflammation he's seeing compared to on Thursday.
Talked to him about the BM problem and he advised two measures of of MOM (which would be 8 TBSP I think) and if that doesn't help to repeat. I asked about the Mag Citrate (had a bottle chilling in the fridge) and he said that would work too....just want to get the magnesium to help bring water into the stool.
So that's the joyride I'm on right now--took some miralax, drank the bottle of mag citrate, lots of water, took an ativan and some ibuprofen, and now I wait. I will repeat later tonight if I don't have success!

Oh, and as for the weight, that's not an issue for me...I still have probably close to 100 lbs to lose...at least 80. I've lost 80 since July when I was diagnosed diabetic. Switched to low carb eating which helped me get diabetes under control, and lose weight, but I'm sure was a contributing factor to this!!! Oh well.....

Thing is Marvin, that now you have had a fissure there that spot is (from all the info I've found) weakened. Again reading and the info from my doc suggests at least 18 months to two years to fully heal so be careful.