Hello everyone.

Long time lurker here...

For approximately 15 years, I’ve suffered from on and off anal fissure. Truth is I get flares very rarely (maybe once every couple of years, usually when I don’t drink enough water or get very stressed). Last November after having my baby (elective c section), the fissure opened again. Never had what people describe as spasms, only constant burning that after taking ibuprofen went away until the next bm. I went to a new CRS back in January ( my 3rd one, after going to one who blew me off and said “ surgery is the only way, bye” and another who did an anascopy without my consent and traumatizes me for life), told him I was already diagnosed with a chronic fissure, he took a quick look and said there it was in the posterior midline, gave me an 8 weeks course or Nifedipine, fissure healed back in March, no pain, all good. After that, I noticed my skin tag was irritated and I still felt some irritation, went back 3 weeks ago and he noticed some discharge coming out of anus, very minor, non smelly, yellowish/greenish discharge. He says it looks infected, gave me a 7 days round of antibiotics but says the definite option is having LIS, cut the skin tag in order to get rid of the problem forever.
Anyways, I have my follow up appointment tomorrow, but I have some questions:
1. Should I have LIS even though pain/burning has been pretty much gone for the past 3 months after Nifedipine? Doctor says my issue is hypertonic sphincter ( or basically a tight ass, vagina, everything) though I never feel awfully tight when having a bm.
2. Can this minor discharge lead to a fistula? Doctor said it’s not common, but I will just have that annoying discharge until it eventually stops or have LIS.
3. Can a fissure be opened even though I have no pain during or after bm? Just minor irritation and very minor itch in skin tag now.
4. I honestly just want to get rid of this and enjoy my new life as a mom without constantly thinking about my ass, but I don’t know if surgery is the answer given my lack of pain.

Appreciate any insights.

I can't answer your other questions......but I believe the "burning" you are talking about are actually spasms.

Although I haven't been diagnosed with a fissure (I had fistulotomy surgery 5 weeks ago) I believe my extra sphincter muscle spasms after a bowel movement which is cause for the burning pain sensation.

Why do I think so? I'll put my finger just outside my anal area before a bowel movement and press along the skin. You won't feel a thick role of muscle tensing up.

After a bowel movements I'll go to wash with the hand water sprayer. If you put your fingers in the same area you feel the thick rope of muscle flexing up and down while you run your fingers across it.

You Ned to actually get in the tub, crouch down, spread your knees apart, and use one arm to reach behind and underneath to your analysis area and pit your fingers in that spot. Feel for the muscle.