I developed fissures in September 09. I went to a gastro who said it was hemorrhoids. I asked for a referral to a surgeon because if hemorrhoids hurt that badly, I was getting rid of them immediately. The surgeon told me I had 3 fissures. He gave me nifed pills and diltiazem gel.
One month later and the fissures had healed, but the pain was still intense. I opted for surgery. In surgery I had 3 skin tags removed and dilation. Immediately following surgery (with all the pain meds) I was thrilled. The next morning though I found a new level of pain. It seems that the internal sphincter has gone into spasm.
For five days after surgery the pain was still beyond belief and no movement was happening. I was unable to have a BM and the surgeon ended up prescribing me "MoviPass" which is what you take for a colonoscopy (very nasty stuff).
Since then I have had to stay on softeners and forgot any type of bulk.
Has anyone else had this problem? My surgeon says if we can't get the muscle to settle down then I am in for an LIS. Please help if anyone has suggestions! I am scared to death of creating more of this pain. My life has come to a halt and it revolves around my bathroom time, my limited diet and my pain.

When my fissure first started kicking my ass, I'd get really bad spasms too. It got to the point where I ended up getting wheeled in to the ER because it was too painful to walk. They gave me some Percocet and Valium to break the spasm cycle. I also used nitroglycerin ointment to loosen the sphincter before bowel movements and Miralax (probably the same thing as MoviPass) to soften stool. That combination of approaches didn't heal the fissure (I still have it) but it did take care of the spasms and has kept the fissure at a manageable level.
I stopped the Percocet within a day or two of leaving the ER but still take Valium, nitroglycerin, and Miralax.
I don't know if the same would work for you but it's worth a try if the spasms are bad enough. When my spasms were at their peak I didn't care, I would've tried anything. I should note that I haven't had any kind of surgery though so I can't speak for any contributing effect those may have.

Chrishell,
Just back on my computer as it had a virus and was in for repairs.. Also wanted to mention that my older son went to NIU, and my younger son lives in Rockford. I live in Central Illinois. It's a small world sometimes, isn't it? I hope you feel better very soon!!
Cheryl

Hi Chris!
Sorry to hear about all the pain. Do you still have to hemmies? I believe they are a precurser to fissures and only make fissures worse in the long run (in my expirience). Are they small enough to get rubber band ligation done? I had it done and my fissure problems improved drastically after that.
Miralax is great as is Benefiber - Both worked well for me. Even taking some milk of mag is ok if your in alot of pain - Whatever it takes to get you comfortable.
Don't fear LIS. I had it done and I healed after it. It is a very common surgery. Just find a doctor that has expirience. I went to 2 CRSs and the first said I may end up incontinent and the second said no way - he has never made anyone incontinent and only a couple times did the procedure not work and he had to redo the surgery. Yes, incontinence is a rare risk, but it made me feel good to have a surgeon that was 100% confident that it would not happen to me.
Welcome again! There is so much great info on the boards! Let me know if you have any questions.
Cheryl - Hi old buddy! I hope all is well with you and your family! Since you live close to Chris, maybe you can give him the name of your former CRS! just a thought.

Jen,
What's up? I e-mailed you, and rec'd no response back from you! I would recommend going to Mayos; I don't think my local CRS is any different from most others although I like him. I have my psychiatrist prescribe diliatzem for me now!
Cheryl

The CRS said that I do not have any hemorrhoids. Just the fissure and an engorged (what an ugly word) sphincter muscle that will not relax. At this point I am wondering if the pain is from the af or from the muscle

It could be from the muscle, Chris. The analrectal manometry test can check that. That is how my pelvic floor dysfunction was diagnosed at Mayos. Good luck! I sent you a PM.

If the pain is constant and dull it is most probably from a muscle spasms ! They are the worst since they are relentless and could be present 24/7.
Fissure pain is localized and extremely sharp during BM. After BM it manifests as strong burning, itching, irritation and such.
It is hard to distinguish between "what is hurting" in such a small place : ((, sometimes even positioning of the fissure is hard to locate just by patients observation. Nerves in that area are so intertwined, it is crazy, really.
Muscle super-tonicity is not a problem only because of debilitating pain but also because it prevents fissure from closing. : ((
I think that your butt got into the "shock" mode after the surgery and is in permanent spasm now . I was told that it sometimes happen after extensive surgery there and it happened to me after my second LIS and 5 other cuts done.
The only thing that helped were warm sitz-baths and Valium for muscle relaxation !!!! It was over in 2 weeks I think :roll: .
Hope this info helps
PS: do not be afraid of the LIS - it is really the best long-term solution , at least it was for me ACTUALLY LOL, I needed TWO of them to relax my stupid sphincter !!!