To make a very long story short:
1. Noticed one day that I had a bit of bleeding along with pain when going to the bathroom.
2. Diagnosed with a fissure by a regular doctor after an anoscope exam.
3. Prescribed steroid cream and told to use prep h products as well (which I did for awhile).
4. Went to see a general surgeon (colorectal surgeon was booked for months) - he couldn't see the fissure but gaze me diltiazem.
5. Seemed better, almost healed after using the cream for a few months, but had a re-tear (slight bit of bleeding and return of pain) when going to the bathroom one day (I had had no bleeding for at least 1 month, probably longer).
6. Go back in to see surgeon because I had no more diltiazem refills, doctor does another exam and STILL can't see the fissure. He gave me a refill, though. Which is both good and bad, since it costs $30 for a TEENY TINY bottle.
This all took place over the course of 3-4 months.
What in the world is going on? Has anyone had this happen to them? I know SOMETHING is going on, since I have pain (not horrible, though) with a BM as well as anal-muscle spasms. Please note, however, that these spasms are completely painless. I've seen people describe the spasms as painful, but mine is more like a muscle twitch, like the ones you sometimes get in your legs after walking for a long time. There is NO pain involved. I also still sometimes have that pinching sensation. So if there is a fissure, it's not healed, and if there isn't, well... I don't know what to think. The surgeon didn't really say anything much. I wanted to see if anyone had had a similar experience, because I'm just baffled. A little nervous, too, because if it's not a fissure, what is it? :(

The nerve bundles down there are so complex. You have a history of fissures so there's a good chance the two things are related.
Some bleeding is not uncommon even in a "healed" fissure as strange as that sounds. It tales a long time, over a year perhaps, to really get tissue integrity back at the site of the fissure.
Just take care in your diet and don't strain, and I think continuing with the diltiazem is a great idea.

Well, to me it does sound like... perhaps... the beginning stages of a minor fissure. It also sounds like you were able to heal it, which is good because that means you aren't dealing with a chronic fissure.
I couldn't really say what is going on, but I would try to get into a colorectal surgeon soon. If the first guy is booked, then try to find someone else with a more flexible schedule. A real CRS will be able to tell you what's going on. Then you won't have to play this guessing game.
Glad to see you on the board. I am sure other boardies will give you their feedback and perhaps that will be helpful.
good luck
Kate

Sometimes fissures are so microscopic that it is hard to see unless they put you under and do a thorough exam but it could be possible that you do not have a fissure. LIke Kim was saying, that area is so innervated that a slight injury that has even healed can still feel traumatized. It will get better if that is what it is though. I think staying on the diltiazem will help give you reassurance that if you are starting to get one that this will help prevent it from enlarging.

I would also guess that it is a small fissure. I had one doctor tell that I have no visible fissure just to be told by the other 3 days later it is deep to the muscle. Second one squeezed anal area perpendicularly to make it open and clearly be seen !
Right now I have some irritation and some minor pain and fissure is not visible but my CRS told me that they can close on the surface but not below or that they can be hidden in the crevice and not easily seen . BUT, according to the symptoms he said he is 90% sure that it is there !!! So, I would guess , same might be happening to you. Just keep up with good diet and creams !
All the best !

I think you do have a fissure problem. I think they heal fast with some people, but the skin is weakened and it breaks easily and also sometimes they can heal on top but not underneath like Fiss said.
The same thing happened to me. No doctor saw my fissure in a year. They kept telling me it was hemmies, and the pain would come and go and get worse and worse. Finally, I demanded to see a CRS and now 7 months later I am finally getting LIS.
I think you should keep using your creams, continue with the fissure diet, and get on the waiting list to see a CRS. I was healed the first time I saw my CRS, but they still saw the scar tissue from the fissure, which is something all the prior docs could not see.
The spasm thing still confuses me too. I think everyones spasms are different. Some are unlucky and jave painful ones, so just consider yourself lucky.

In my experience, scar tissue in the area can hurt long after the fissure is healed. it can get inflamed and sore. The feeling is a bit different thought, not an open stinging feeling, but a sore, weepy, irritated one.
Also, in my experience, Drs can not always see fissures. Sometimes the put the scope in so that the cut is not apparent. If you feel and open wound, there probably still is one.

Does anyone have an opinion on how long one should use the cream before saying, okay, that's enough - it's not working? Also, does it really matter if it's used internally or externally?
I'm not sure when I'll be able to see the colorectal surgeon, as college is starting tomorrow, and I don't know what type of hours she works, or when her first available appointment is. But I'm guessing I'll end up seeing her eventually...not that I really want to! :roll:
I've been a little more sore this past week due to harder stool caused by my period, as well as a bout of diarrhea I had while at the fair. Because I was out I took an Immodium, and now I'm worried that'll cause me to get constipated. Gah!
I can't believe this problem lasts for so long...

I think the cream should be inserted up to about 1 inch inside. That is the way I used it for about 4 months--still use it off and on as needed. Good luck! I am not familiar with immodium--have never taken that.

It can possibly last forever if you don't stay on top of it. I have heard tales of people enduring it for ten or more years!
In the end you will have to judge when to stop using the cream. I stopped once, thinking it wasn;t helping,and my pain levels shot back up worse than while I was using it.