I thought it would share my story for whoever is interested in reading it.
November 2015: I had my daughter 14 months ago. It was a bad delivery, she was in distress and had be born very quickly with a vacuum and episiotomy.
December 2015: 5 weeks post partum I developed an anterior anal fissure. It was the worst pain of my life. Weird this is I had no constipation or anything. My bowel movement that day was perfectly normal. I had no idea how it happened, maybe my pelvic floor had trauma. Anyways, I went to my GP. He said it was hemmorhoids. One week later (I am loosing it with that amount of pain) my OBGYN diagnosed it as an anterior fissure. He prescribed me nifedipine .2% and said to call him in a week if I wasn't feeling better.
January 2016 - March 2016: I wasn't feeling better a week later, and was also getting a constant pressure/strange feeling down there pretty much all the time. He referred me to a general surgeon. The general surgeon found that my levator ani muscle was of normal tension. He did note the anterior fissure. He told me to stop using nifedipine and gave my a steriod ointment instead. I used that for a couple weeks (and then stopped because I didn't feel comfortable doing this for any longer). I also did 3x/day sitx bathes, increased water, increased fibre, and bought a squatty potty. I went back to him in March. I had had bleeding several times over the course of the past 2 months, and an ongoing daily pressure/burning feeling in my rectum. He said this was normal and hopefully with time I would heal. He told me to come back in June. At this time I asked for more nifedipine ointment.
April 2016: Start attending pelvic floor physio. She said my levator ani and internal inside my rectum (?internal sphincter muscle) was high tone. It was relieved by muscle massage; but, this would only help for several hours at a time. I was still using nifedipine for a 6 week course. Once I stopped the nifedipine I had increased pain/ bleeding within 2 weeks of stopping. I kept going to physio 1-2 times/week until June.
June 2016: Saw the general surgeon again. Said all he could offer was LIS. I wasn't ready for this step at this time. I wanted to exhaust more options and wanted to speak to someone about botox. But, he didn't do botox and didn't know of anyone in my city who did. Plus I was still breastfeeding my 7 month old daughter. He told me to come back when/if I wanted surgery.
June-September 2016: I decided to do a 12 week course of nifedipine .2% after reading a study about the effectiveness of a longer treatment. I went for physio throughout this time as well. I continued to have a pressure/fullness/burning feeling around the rectum and pain when having a bowel movement on and off. Once I stopped the nifedipine I had increased pain and bleeding again within 2 weeks
So I started using nifedipine again, all the way up until November. November 2016: finally got into a CRS I had asked my GP to see who apparently did botox. He is a newer grad. He took a quick look at me and said I was healed. He told me to stop using nifedipine. I asked him why I still had pressure and discomfort if I was healed and he said I needed more fibre. I was so irritated when I left. I eat 30g of fibre per day and am so SICK of fibre lol... Anways... I stopped the nifedipine and within 2 weeks I bled again with increased pain. I started the nifedipine again to do an "experiment" and see if it would happen again after another 6 week round.
January 2017: stopped by 6 week round of nifedipine. I found the pressure down there got worse after stopping. The day before I had pain and bleeding again I had a hard time going to the bathroom because I felt my internal sphincter or muscles wouldn't relax. The next day I had bad pain/bleeding again. I called the CRS and asked to see him that day if possible so he could see what was going on with me. He took a look at me and said I have a posterior fissure. I was like what?! not anterior? (because that is what I had initially). He said nope, it's posterior. I don't even think he checked for an anterior one though because he never commented on me being healed there. He told me to up my fibre. I blew up on him and started crying. I said I have been eating crazy amounts of fibre, I'm not constipated, I drink tons of water and every time I stop the ointment I start bleeding. He told me he would prescribe me .3% nifedipine. That I wouldn't want surgery because I could be incontinent if I have more kids. I can't use the ointment while pregnant though and I would like to have another baby at some point.
Where does this leave me? I feel like no one is listening to me or offering solutions.
I'm also worried about a what came first the chicken or the egg type of situation?! Do I have dysfunction that is leading to fissures? Or is the pressure feeling the internal sphincter spasm from having chronic fissures?
I'm willing to pay out of pocket to go anywhere, anywhere where there is someone who can give me an answer.
PLEASE HELP. Thank you for reading.
to the forum though. 
