Hi guys,
I have an anal fissure at 6 o'clock ( towards the spine ) one inch ( 2 cm ) inside my anus. I cannot see it but by doctor saw it and he made it bleed when he touched it.
It gets worse when sitting for long periods which is not helped by my office job. It bled only twice in the last two years and the pain is not unbearable but just annoying, especially the referred pain toward my testicle and pubic area.
One thing I noticed when comparing my symtoms with yours is that I do not seem to have any sphincter spasm.
Well, if I do not have any spasm, does it mean that any surgical procedure to stop the spasm ( such as LIS ) is not gonna work and let the fissure heal is not gonna work ? If I do not have any spasm, why isn't the fissure healing ?
Thanks

Hi Juniper! Welcome to the forum!
I'm not sure why you aren't healing if you don't have spasms. I'm not a doctor, so please take what I say with a grain of salt: perhaps you are not healing because your sphincter is too tight, rather than always spasming. Perhaps that's something you can ask your doc - if they are specialists, they can usually tell with a digital exam if your sphincter muscle is too tight.
Also, you may be having spasms, but they are not as bad as what people have described here. I think it's possible that you are having mild spasms, especially since you describe pain radiating toward your testicle and pubic area. That's perhaps another thing to ask your doc about.
It may be the case that the surgery isn't for you at this point. Have you tried any of the standard ointments, like nitro or Diltiazem? If not, one of these might be what you need, but, unfortunately, the longer the fissure exists the harder it is to heal with conservative measures.
Are you taking stool softeners and many warm baths?
I seem to recall other boardies asking a similar question about if surgery with no spasms is an option, and if I'm not mistaken a few of them were told by their doctors that they actually were having spasms after all and so they had the surgery. If I come across those posts, I'll let you know. Meanwhile, keep reading through the posts here - they are really helpful. :D

That is odd..
Eventually your bodies natural response will be to have a Levator ani spasm to protect itself.
It will realize that the stool is harming or cutting and go into spasm.

A chronic fissure is any fissure thats lasts about 2 months or more, so yours is in this classification. Not all chronic fissures are associated with pain/spasms. You may be similar to me. I have had the type of pain described in other threads here in the beginning, but not of late. I thought it was odd but wasn't going to complain about that one. I did however have an underlying 'tight' feeling and that I always felt I needed a poo.
Anyway having told my CRS this I was sent for a test where the sphincter is tested for pressure. I had over-pressure but oddly a slow rise and fall in muscle pressure too, like a pulsing pressure. Apparently this is unusual but not unheard of in people with an AF.
I'm not a doctor and I'm only speaking from personal experience but you might have similar symptoms. If they have been present for a long time you might not think to tell your CRS about them especially when the most talked about symptom is extreme pain.
Hope this helps.

Thanks a lot for all your replies.
One more question. My fissure is towards the spine, 6 o'clock. Why do I feel pain on the right side of my anus then ? Is it common with most of you ? I also feel like I have a foreign body in my anus. Always on my right side. Do you have the same feelings ?

Juniper,
My fissure was in the back and most of the pain felt like it was coming from the left. There are so many nerves down there that it can be hard to tell where the pain is coming from.

Hi, I also feel like I do not have spasms and was wondering if this was normal? I have mild pain/irriatioan all day long. Only if my bm is very sold do i have more pain- for about 30 minutes. Does anyone else experience pain/irritaion all day long? It feels like a couple of bad papercuts up my butt all day. Once and a while I feel a weird tight sensation down there- but doesn't cause any extra pain. Is that a spasm? My surgery is planned for 2 weeks from today

Hi,
I don't have spasms. I'm really not sure what the ratio is for those who spasm and those who don't. A lot of people come here because they are in extreme pain. o to judge by this forum might be misleading. I suspect though, that there are more people with chronic fissures who spasm.
Often, even if you don't spasm, you tend to hold your sphincter muscle too tight as a reaction to the discomfort and pain.
I feel discomfort all day when my AF is inflamed and twinges like a papercut. I have to be careful not to make sudden moves. It's always more painful after a BM. But things have gotten better the last couple of months.
-Tanya

Tanya- your pain sounds much like mine. I also feel like a papercut all day - or like a sharp sliver. I haven't ever seen blood. Have you? Mine is internal- though so far no doctor has ever "seen"it but the CRS did a quick exam by just touching the area- from this I yelled and from my history he immediatly said was AF.

Mine is long so somewhat internal. I get a bit of blood about once a month with a BM,... usually at that time of the month. :(
But it was almost healed there just a week ago. Then an inexplicable setback. So I am trying TCM, at a chinese clinic near me. If that doesn't work I will go back to dilating, but slowly increase the size. It is all so wearying.
But I am kinda liking the TCM in that I haven't had to stick my finger up my butt in days! lol!
:)
They do that for me!
Sounds like you are going to take the surgical plunge?
I wasn't even offered that option. I think they think it will heal on it's own or I will learn to live with it.
-Tanya