After a year, I know I've had at least 3 fissures. A couple inside healed and left me tight and now a new one opened outside the rectum (I can see it with a mirror). My question is why does gas hurt so bad? Not all the time mind you, sometimes it comes out nicely, but most of the time it feels like it is struggling to get out and pushing on every sore muscle and nerve. I sometimes eat up to 10 gas-x a day. I had 20 units botox that helped with the gas pain some. I realize bread and bran are my enemy. ANyone else have this? When will the gas pain just be nice gas again? I am not sure yet if I will do more botox, cream, or try surgery. THanks

When my fissure was fresh passing gas was very painful, no so anymore.
You are taking 10 gas x a day, you already know that bread and bran are not good for you, probably you are sensitive to gluten, perhaps you should stop the dairy also to see if the gas ease off more, that means anything with milk in it or made from milk.
The sensation of struggling to pass gas could be that your anal muscle is very tense so perhaps doing some pelvic exercises will help relax the area.
I am so sorry you are struggling so much even with the botox and cream.

i agree with marg you have something called anal stenosis, its a unusual spasm caused by prolong sitting or some type of exercises. some time sitting posture could cause spasm to a point that we do not normally feel. we feel spasm when it pain there. walking 30 minutes a day could relieve those spasm by circulating the blood supply and sitting in hot water or use a heating pad. develope timing for the eating and not to eat anything after you finish eating or in the middle of digestion of food. do not eat in the middle of meals use only liquid stuff. water it self is a good antioxident.

marg6043, wouldn't doing pelvic floor excerices make the muscle more tense? I do use electric pad and take hot baths. I seem to have more trouble when I am sitting. Some days, it comes out just fine. It makes sense of anal stenosis. I read up on this. The surgical procedure of LIS would fix it. I am going to CRs tomorrow again for this new fissure so I will see if he has me wait a while more to see if the botox will need more time or if he would suggest LIS soon. THanks I just was wondering if I was the only one with painful gas.

Pelvic floor exercises works in two ways one you can tense and strengthen the muscle the other is you relax the muscle and feels like you open up the sphincter, it takes practice to differentiate the two it helps control the anal muscle spams.
Now LIS while is available and pretty much a safe procedure, comes with consequences, should always be use as the last resource when nothing else works, or pain is unbearable, works fantastic for some but not for others.
I have been suffering for a while, have a sentinel pile to show for it, but I after 4 months of suffering like you know of it feels, I learn with trial and error to control the fissure.
It is healing, but very so slowly, I have a great experienced colorectal doctor that I trust very much, but even him is letting me take my time and see if this heals on its own, surgery will always be there but as the last solution.

thanks marg. Went to CRs again today. He said my 20 units of botox is normal and should help. He said can give 30 or up to 50. I have nitro too now and have to wait 2 months to give it time. I have been thinking about trying to make my stool larger but still soft. maybe it will help stretch the muscle a little? Maybe even biofeedback or yoga would help to relax that dang sphincter.

hopefulbutt, you can try some exercises to relax the muscle but for some reason the anal sphincter is a very interesting muscle, that we don't give it much attention unless something goes wrong with that area, it has a mind of its own, the way it works is involuntarily specially when is injured.
Just relax and let go, that is how I do my exercises I just let the muscle go like I am ready to have a BM. whenever I feel the muscle getting contracted again I let go again gently.