Hello folks. Been a while since writing here as things have mostly been (comparatively) stable for the past while. Anal sensitivity, weird BMs, and very recently some hemorrhoid changes which got me concerned. But after spending a good part of this year trying to figure things out/have them checked into: the current consensus from the care team is: the main culprit at this point is a combination of hypertonic pelvic floor, as well as hemorrhoids. They're basically "working together" to keep me from usually having complete enough BMs despite all I've been trying to do to help things along.

It doesn't seem to be the sphincter itself, so that means I'm likely not the best candidate for LIS should I ever even want it. In fact the current surgeon I'm connected with said he wouldn't even do it, and I tried to get a second opinion just in case, but the referral ended up getting rerouted back to his practice - in Canada, specialists aren't people you can just see on a whim - and the only thing he said he could do for the one hemorrhoid (the huge one that's been there all my life but recently seems bigger, nothing said of the several smaller ones that have popped up on the opposite side) was straight up surgery. I know there are less horrendous procedures, mainly coagulative, but I'm wondering whether that's not a thing that's commonly done in Canada. Wonder too why banding was out of the question.

This all feels rather defeating, because I already eat pretty well and not a ton, try to be as physical as I can, but have been dealing with daily terror since the resolution of the last flare at the end of last year. Previous bouts didn't leave me so terrified but I just haven't been able to shake it this time. I'm weary of everything to do with a BM, and on a good day there's no unusual or unpleasant sensations and I'm free till the next day...but lately I've been having movements that are like 2-in-1. Hard solid start, maybe otherwise fine but a ton of formless mush behind it, forcing it out too fast. Been pretty painful around the newly giant hemorrhoid. Ugh.

Sorry for the rant aspect of this post, but I'm really wondering if anyone's been in a similar set of combined circumstances. The surgeon made a comment last we spoke that hemorrhoid removal "makes a fissure seem like a breeze" which honestly left me in a state of decent terror. It has seriously robbed me of so much of my life energy as I deal with several other problems (would share but not the point of this forum!), and I feel really at the end of my rope most days. Especially the last few. This kind of BM can just put my mind offline and make spend half the day in bed in the dark. Feeling very broken

Hope everyone out there is doing the best they can be. Love to all of you and thanks for reading <3

Have you looked into pelvic floor physical therapy?

I'm in a similar situation in that I have pf dysfunction, grade 3 hems, and a fissure. I meet with the surgeon tomorrow because conservative measures to heal the fissure have not worked. I've been on creams and ointments for 3 months with no improvements. I most likely am not a candidate for LIS either since my pfd is already causing me leakage.

Yes, I did some years ago a while after my first fissure and there was confirmed global and local tension; I didn't know enough or to ask then but functionality was never assessed. I did some more this winter and spring and things are now to the point where the PT couldn't even get to the pelvic floor, so I was just trying to keep up with the exercises. Surprisingly hard to stay on top of when you have so much other junk in life to stay on top of, ugh.

Today I have this brand new weird sensation deep in the base of my tailbone, if that's something you've ever experienced. How was your appointment? Sounds like you're unfortunately in a rough spot too, sorry to hear...

I spoke to the surgeon yesterday. He wont do LIS on me because of my pelvic dysfunction. He believes my fissure is healed and my spasms are being caused by levator ani. Good news to report is he put me on muscle relaxers and I've had no spasms for 2 days. He also wants me to see a spinal surgeon because I fucked my back up sitting and sleeping in awkward positions to get relief from the rectal pain. My sitting muscles atrophied and I'm in physical therapy trying to rebuild my strenght.