Hi - yet another post.

After about three months, my two fissures are completely healed over. I have had no bleeding for several weeks and they are not sensitive to the touch. Spasms are reduced - I feel completely relaxed until I have a bowel movement, then I have burning on and off and sharp pains throughout the day. They are particularly bad when standing or sitting for long in one position.

It is making life difficult to get on with, as the more I do the worse I feel, and I'm scared it's getting worse again. Tonight is the worst I've been in about a week, thus the post.

Does anyone else have this problem after healing?! Will it go away in time or do I really need the LIS?

I'm doing physio (only one session so far) and nifedipine, and still doing sitz baths twice daily. I'm just so darn tired of sitting around all day, and I'm so ready to be pain free but I'm not seeing improvement beyond my current state.

Thanks all for your help.

PS - also doing miralax and Metamucil - go frequently but soft

Hi GG,
If your fissures are healed you really shouldn't be getting pain from them....is there scar tissue perhaps or maybe stenosis.
As for LIS that's up to you and your doctor but I would want to know what was causing the spasms before I had the op. Maybe you need to give your physio a bit more time to work everything is really heightened down there with what is a major design flaw of way too many nerve endings.
Do you get stressed before your BM and are you having to strain or do enemas on a regular basis as this could point to some pelvic floor dysfunction.
It really is downheartening Hun I truly do understand that...all I can say from years of having crohns and IBS is to try to carry on as normal...do your normal daily activities as long as your pain is under a reasonable level as that area is so sensitive I think some of us will always experience some form of discomfort.
I truly wish none of us had ever had to go through this I really hope you manage to get some answers as to what is going on
Hugs

hello, i too feel like my fissure healing.. but spasms and this upper tightness is always there... seems like it takes a long time to settle down..does anyone else have this higher up pulling tightness wuth off and on spasm i cannot sit down.. its been months.. surgeon wants to do botox this week...

Thanks mpb - it is SO frustrating as I feel completely pain free when resting! Then the burning pain builds when I am active at all. I'm really hoping the physio will help so I will give it time. I have an appointment again with my surgeon on the 19th January to re-evaluate so I will have time to give physio a chance. I can live with this level of pain - for sure! It's just restricting myself from things I want to do that is so disheartening.

I'm wondering about Botox now - it may actually be worth considering if my issue is simply one of muscle hypertension - something to ask the physio next week!

My mood continues to swing up and down - still trying to get a psych appointment to help me deal with this life upheaval.

Thanks as usual mpb

Mamafizz - have you seen a physio? It is worth a shot if you can find a specialist in the pelvic floor. They may be able to advise you more about Botox - I will let you know what my physio says.

My physio has had me try the following everyday:

Concentrate on relaxing the pelvic floor through breath - you can probably just YouTube a video that will explain this well, but the idea is to take a deep belly breath and push the breath down the abdomen, while relaxing the pelvic floor.

While doing the breathing and relaxing, she wants me gently massage the perineal area near the anus (this is where all my tightness is - it feels like a ROCK) for 2-3 min, using some oil (I use a blend for fissures, you could probably just use olive oil - it just is to help with skin elasticity). The massage is very light and very small movements. She then wants me to just hold some pressure on the area for the remaining 2-3 min, while continuing to breathe.

I believe the idea is to help train the muscle to relax when being touched/stimulated - so that the nerves can stay calm during/after a bm etc. Her plan is to also increase this gradually, to help in blood flow, decrease scar tissue etc.

I also find lying down with a heating pad on the entire pelvic floor to help. Also, this morning I had to "go" and the area felt quite painful - it was actually better after without the irritation of the stool present - so it seems as if it something that may just take time

yes i think mine is higher up near the tailbone..? maybe the inner scphincter?? I have had for soo long the memory muscle seems stuck...its always tight as a rock and pulls and aches even if not in total spasm...thanks i may try pt as well but may ger botox very soon
i read it retrains the muscle to relax may be quicker,,, God willing...

Yes I'm doing some reading on botox now for the use of pelvic floor spasm unrelated to fissures. It has been used with moderate success from what I've read - I can update you with a review of the scientific literature when I'm done researching.

Botox blocks signals being sent from nerves to muscles. Those signals would normally cause the muscle to contract - Botox is a toxin that blocks the signals and thus can reduce muscle contraction. Theoretically a hypertonic (too contracted) muscle should relax in response, but it may return to contracting as the toxin is processed by your body and wears off (around 3 months I think from what I've read).

I have read some places that Botox can actually cause some over active nerve endings to die, so that they may be replaced by less sensitive ones that are not always stimulating the muscle to contract - but I'll have to do more reading on this!

Yes I have read good things, and the surgeon says some relief should happen soon.. Is yours higher up mine seems inner schincter closer to tailbone? I guess the area is short and spasm and tightness can affect the whole area. Hard to tell where it's coming from... so painful... soon it will be better!!!

Yes I get a feeling like a goofball up in there! I also get burning when standing or sitting too long. When I feel the muscles around the anal area, the front and left side are rock hard...others are relaxed. But I have read of people with tightness at the posterior side like yours. Where was your fissure, front or back?

ouch...lol they still have not seen it... but it seems like it is in the posterior and that is where the tightness is golf ball is located... yes can't stand long can't sit at all, since it;s sore to the tailbone.... Mine must be pretty severe, mine seems better in the morning not gone but not as tense or spastic, but after going to the bathroom in the morning it starts all over again and gets worse at night. What a cycle... I never heard of this before... Prayers we are healed as our Christmas Present...