I am posting this even though I have never seen anyone on this forum, or indeed when I google search this problem, to have this unusual condition.

The comfort we all feel when we find somebody else battling the same problem is a release, a person to relate to and offer advise and that "I know, you are not alone" reassurance. It helps us doesn't it? When we lose faith in our CRS or drs who don't have all the answers I have come to realise.

A year ago I had an LIS at the same time as two fissurectomies. My recovery was slow but I knew something wasn't right. When sitting down or squatting down I would feel sharp twinges in the right hand side of my rectum. At my 6 week check up I mentioned this to my CRS who said I should be completely healed and "we all have little twinges from time to time". I began avoiding sitting down for fear of this feeling which made me feel venerable to further tearing. Then two months after the LIS I sat down one day and can only describe the feeling of intense, searing pain ripping up the right hand side of my rectum. I thought I had torn inside rectum. EUA confirmed no fissures or tearing. I was referred to a pain management specialist who put me on Gabapentin which didn't help. I suffered weeks of agony and hopelessness as no CRS (I have seen three), 1 gynae, 1 PF physio, dermatologist couldn't find the reason for the pain.

Eventually my CRS sent me for an ultrasound scan. Two things showed up. High resting pressures and a thin, stretched sphincter muscle on my right side, I believe the result of the "sitting" injury. There was no sign of a parting of the internal sphincter muscle showing on scan in accordance with the LIS. Conclusion, it was a very conservative division.

My resting pressures were dealt with Botox (two rounds) and a thrombosed peri-anal vein removed but the constant pain I live with from the damaged sphincter never has and as far as I know cannot be addressed. It isn't really discussed only to say it is permanent. I live a very much reduced quality of life now. I am 49. I was fit, walked everywhere. I cannot drive, sit or walk without pain and making the pain and muscle worse. No one knows how to help me. I have found some coping strategies, ie. not doing very much and taking a 5mg dose of Diazepam twice a week which helps on a few levels. I feel there is no hope, I feel sad and I morn my old self. I feel hopeless and an isolated case. I have never heard of anyone else who has suffered with this chronic condition. I have no forward care from CRS, it is all down to me to just learn what helps and what doesn't.

I apologise for the long, rambling essay. I thought it might be worth a shot posting on here where I have received such good advise and support for other colorectal issues I suffer from. This is a fantastic forum, without which I would probably have given up. I wonder how many CRS's read this. This is where you hear the real issues relating to our problems and get real answers and help. We are not all text book cases.

what-causes-high-resting-anal-sphincter-pressure-t8676.html

I will send a message to owmybum and suzyljank and see if they might have some thoughts.

Hi, I'm not sure how to address this situation but I'll give it a try because I also had this intense charlie horse type feeling on my left side for a very long time on and off. First, fissurectomies do not help a tight muscle. They can make it tighter because they just remove the fissure and stitch it closed. If your doctor used a flap it would give the skin room to stretch when it needed to. Kind of like elastic in a waist band. I also had a failed LIS. It added to anal stenosis from a hem. surgery. Is pain your only symptom from a damage sphincter? Usually that muscle would have a tendency to be too relaxed if it were damaged. Because yours is still very tight I wonder why they don't do something to relax it like a second LIS or flap surgery. Botox is short term. For me the pain was coming from the scar tissue and it's inability to stretch. It would hurt when I walked up the stairs, stretched my legs and stood too long. The only relief I would get was when I was lying down and sometimes that didn't work. How did the fissurectomies heal? That scar tissue could be part of the problem. The anal opening has to be able to stretch so you can have a bm or even to pass wind. I feel bad for you because I know how awful this is. I had 2 flaps down a few years ago, best thing I ever did. I'm not perfect now and I never will be but things are functional, a daily dose of miralax and dilation once a day is a small price to pay for me. Have you tried and muscle relaxers? I went through a bad bout of discomfort a few months ago because I wasn't taking enough miralax, it took me a while to figure that out. My doctor gave me a muscle relaxer over a year ago and I never took it. I've read how it doesn't help. I remembered I had them so I tried one. For me it relaxed my muscles especially my stomach muscles so much so that I couldn't tighten them up when I started to panic. It doesn't help with pain or make me drowsy but if your pain is caused by tightening muscles it could helps you relax them. They might be worth a try. If you have an question please feel free to ask I'll answer whatever I can. Suzy

Suzy, thank you for taking the time to reply. Our situations are similar in some ways ie. scar tissue, which I am having a lot of problems with atm from the removal of a thrombosed vein. The unexplained, untreated and not talked about problem is the damage from "sitting down". It is hard to explain the pain Suzy. Sometimes dull, sometimes sharp like a tear. I feel something hard in there just on the damaged side. I think it is stool pressing against muscle. I don't always feel pain during bm just all day afterwards. The Diazepam helps, it knocks out some of the tightness. I take Movicol everyday. Walking is painful though for so many reasons just now. Its all a bit depressing really. I am just lying on sofa, hoping something will heal or improve. I am wondering whether levator ani is affected in some way. Damaged sphincter is opposite side to all fissurectomies. Hope you are continuing to stay well and thank you for replying

Hi, I know that after all my surgeries if a stool pressed on the surgical sight it's not pleasant. The hard mass might just be scar tissue. When my doctor did my surgery he removed a lot of scar tissue before he moved the flaps into place. The pain you are feeling after a bm are spasms. They can last a few minutes to all day long. For some reason your muscles are spasming and maybe a doctor can help you find out why. Good luck with everything. Suzy

So sorry to hear of your suffering Copycats. Can I ask what your pelvic floor physio did? I have pelvic floor dysfunction and see a PT for it. We haven't been able to go rectally yet but we can work some of the rectal muscles through the vaginal wall. Of course working them more directly would be best but I am not there yet, mentally at least...

I'm so sorry to hear of your suffering, and although we can all sympathise to a certain extent on this forum (Frustration with health care professionals, feeling of hopelessness and continual pain) I cann't relate on the level that you are suffering. It sound so horrific and I wish I could offer some advice - It's that horrible situation where surgery has made a situation bad and further surgery has a high risk of making things worse.

Any advice I have would have been spoken to you a multitude of times I'm sure however what I will offer is a prayer for you, and as many positive thoughts as I can muster will come your way tonight.

Good luck and if you ever need to vent, we are always here...

FF x

msimon, Thank you for replying. Yes I do see a pelvic floor physio from time to time. She has found tightness and spasm in puborectalis and levator ani and has worked her magic on them. I made an appointment yesterday infact to see her next week as I have had a few surgeries since my last visit to her. I suspect she will find a few knots. Sometimes worries me though as I can feel worse for a few days and regret the interference. Take care msimon.

I am wondering if your pain is down to scar tissue.? The nerves are super sensitive and sending off major pain signals at the slightest thing. Two fissurectomy s may have caused this.
I often get sharp pains and twinges ... But I just put it down to the scar tissue playing up as its not as flexible as normal tissue.

Yes, I agree, it's good to share with others who truly know how debilitating this condition is.

OMB x

Sorry to bump this but I am in the same exact boat and frustrated at the lack of discussion online. If anyone has any further information it would be greatly appreciated.