What comes first spasms or fissures?

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What comes first spasms or fissures?

Postby Badd825 » 03 Jun 2012, 18:52

I've had constant rectal pain since removing clots from thrombosed hemorrhoids back in December. After nitro and Botox from the first crs dr I saw I'm not much better. He diagnosed spasms. I always told him I had a burning stinging sensation like a paper cut but he didn't see anything. The second crs I saw diagnosed a fissure and told me to give Botox 3 months. I'm 2 months post Botox. I'm wondering will healing spasms heal the fissure or will healing fissures stop the spasms? Basically what came first the chicken or the egg? Also ice which helped me so much was contraindicated by the 2nd crs. The first crs said it was ok. Any experience with this? I'm desperate for an ice pack as that was the only time I wasn't in total pain. The dr said it causes spasms and prevents blood flow. Stopped 3 weeks now and still having spasms. Any advice would be appreciated and a great comfort
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Re: What comes first spasms or fissures?

Postby sailorgal » 03 Jun 2012, 20:32

Hey Badd,
Again, was in very similar boat as you. My understanding is that, there are people that may have increased sphincter tone that can predispose them to a fissure, but that terrible spasming-shards of glass pain is due to the spasm-fissure combo. a nasty cycle to get out of. and everyone heals differently, but for me - knocking out the muscle (and it's spasms) is enabling the fissure to heal. when there is no fissure, there is no reason for the muscle to acutely spasm - that's assuming there is not another underlying source to the spasms. if you are still in that much pain that far out, you definitely need to get another procedure (be it a 2nd botox from different CRS, LIS, SAD, etc). and regarding the ice-heat thing. if you are desperate for an ice pack, i don't see any reason not to try it if there's a chance it will give you relief. I actually was doing hot bath-ice cold bath contrasts (10 min of each for a 40 min rotation) to help with healing. spasmed muscles can sometimes respond by spasming more with ice, or less by numbing it, so it depends. but, i don't see you have anything to lose by trying it, the blood flow is already restricted by the spasms, so I don't see how trying cold can make that any worse. how is your pain controlled? vicodin and hot baths is what enabled me to survive 3+months of pain after my 1st -failed-botox.
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Re: What comes first spasms or fissures?

Postby jr2 » 03 Jun 2012, 20:44

Just wanted to agree with the great advice by Sailorgal. Ice can be very very soothing and for me doesnt make the sphincter tightness any greater at all. Besides, there is a resulting surge of blood flow to any area after it has been iced, so in a way it gives the area a circulatory boost when the ice is removed.
Last edited by jr2 on 03 Jun 2012, 21:19, edited 1 time in total.
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Re: What comes first spasms or fissures?

Postby Badd825 » 03 Jun 2012, 20:59

Wow, I'm happy to hear that. I can't take anything other than advil for pain. I had an allergic reaction to codeine way back. Basically the advil feel I've taken a tic tac but I'm desperate so I keep taking it. I feel a constant ache with burning that's pretty deep. Does this sound like spasm? I kept thinking it was a super large fissure. I'm off to put on some ice! The 2 doctors I've seen combined haven't been as helpful as the people on this forum!
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Re: What comes first spasms or fissures?

Postby jr2 » 03 Jun 2012, 21:24

It could definitely be spasms. Different people describe spasms in different ways but aching and burning fit into the descriptions I've heard.
My CRS was so funny one day... She told me I know more about fissures than she will ever know! I told her that's what this kind of suffering does to you. You'll research to the ends of the earth to try anything if it has even a slight chance of relieving the pain!
I hope the ice brings you relief! Image
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Re: What comes first spasms or fissures?

Postby 3 years now » 04 Jun 2012, 08:01

Hello - ice works, I do it all the time. it relieves the pain. Why the doc would say it inhibits blood flow is beyond me. The ice reduces the inflammation.
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Re: What comes first spasms or fissures?

Postby Badd825 » 04 Jun 2012, 08:39

That was the 2nd crs I saw. I stopped 3 weeks ago and I've been even more miserable. No improvement at all. She was basically useless. She had my medical records when she saw me and knew my first crs. She was gushing about him and completely deferred to him. She's attended his lectures and said he is renown in the field. My second opinion basically used the notes from the first crs to tell me to give the Botox 3 months. If I thought he was so wonderful why would I be in her office? I'm crying in her office and she said see you in July. All she managed to do was make me afraid of using ice claiming that it causes spasms and prevents blood flow. So frustrating! I'm grateful to have the advice and experience of people who feel my pain!!!!!!
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Re: What comes first spasms or fissures?

Postby Emm123 » 04 Jun 2012, 12:10

Be careful with ice. I remember when I did biology in high school that coldness causes contraction in the vessels thus limiting the flow of blood in the area.
That's why for healing fissures you do sitz baths with warm water as it allows the blood vessels in the area to expand and allow for blood to flow freely.
Alternating with ice and followed with warmth such as with warm baths is noted by some users to cause relief. Good luck OP
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