Hi everyone-

I read these boards regularly (they've been a great emotional help) and I posted over the summer about what I'm going through. I just want to get your opinion on the situation now a few months later.

I've been dealing with the uncomfortableness in my rear area for most of the calendar year now. It's not usually pain during a BM, but rather soreness and discomfort immediately after and throughout the day. People on here talk about pain, and I don't think I'm experiencing the same level of "pain"...I initially characterize it as discomfort. Sometimes it's a slight stinging in a certain area of my anus, and sometimes it's a soreness in that whole area. I have had periods over the course of the year where hard stools did hurt coming out, and doing the recommended things to soften the stool has helped that (so that doesn't happen often). Of course, I've had some bouts of diarrhea over this time, which complicates things.

I saw a GI in July who said it sounds like a fissure. He said he didn't see any hemorrhoids and didn't feel anything inside doing a rectum exam. He prescribed Rectiv, which I used but didn't feel any results (I hope I was getting it up there far enough). When I went back to him a month later, he said there's nothing else to try and that I should have a colonoscopy just to rule out anything else (which I haven't done yet and I'm worried about).

I do sitz bathes after every BM and once in the evening. I try to keep the area clean. I watch my diet and take fiber supplements to keep stools soft and formed. I'm fairly active (not sitting on my butt all day). I've even had some good periods...last month I had about 2 weeks where the area was sore for an hour or 2 after a BM, but then I was pain free for the rest of the day...IT WAS AMAZING! But then my kid was in the hospital, my stomach became upset, and I'm back to where I've been.

So...does this sound like a fissure to everyone? From reading these boards, it's hard for me to compare, since there are so many different experiences of this.

I also have some other questions...

What exactly is a "spasm"? People mention that a lot. How do I know if I'm having a spasm during the day? Would that be "pain"?

With my symptoms, does this sound like a fissure that's external or internal? Perhaps I just don't have a good idea of the anatomy, but it feel like it is very external or near the surface.

Would a colonoscopy 100% diagnose a spasm? (i.e. do they "see" it?) My GI was not easy to talk to, so I didn't leave quite understanding that.

I've been trying to use the Rectiv externally after the internal use didn't help. Will that harm me?

I've also used lidocaine sometimes to numb the area. It obviously creates a different sensation...it's not like I'm back to normal...but sometimes it's preferable to the discomfort I'm having.

Thank you so so so so much to whoever has time to respond. I really appreciate this community!

You said your GI dr said "it sounds like a fissure" could he not see it. I too suffered way too long with a fissure and my advice would be to see a CRS soon. They deal with this all the time and would probably be most helpful. Plus you said your dr was not easy to talk to, you need answers.

Hi,
It does sound like a fissure and not everyone gets spasms...I did and boy I pray every day never to have them again. I never had pain during a BM but mine came on 20 mins to an hour after started with stinging climbed to burning and then the full on spasms hell could last for up to 24 hours.
I saw 3 CRS that couldn't see my fissure but were certain from my symptoms that is what I had. I then say my amazing CRS who saw the incriminating offender the first time sneakily hiding between a hem and a skin tag. Mine went quite deep inside and only a millimetre was visible outside so easy to miss I guess.
If you are having pain there on a daily basis I would suggest Botox or LIS under a GA as then your surgeon will be able to have a proper look while you are asleep....mine told me my fissure was nearly two inches and was one of the worst he had seen in 22 years yet 3 surgeons had missed it during examinations when I was awake.
If it's not a fissure then they won't do any procedure but will have more of an idea of what's going on down there.
As for a colonoscopy I have 2 a year for my crohns, they aren't half as bad as we think and although the prep isn't pleasant it's not always bad for everyone and if you tell them you have an active fissure they should use the smaller scope.
Really good luck