I too had/have this type of delayed spasm described by you. Botox helped, but sometimes I feel I could use another shot. My doctor also recommended Bristol 4, but what I found was working best on a raw fissure was no.5. No.6 was burning me like hell.
But now that the fissure is scarring, I find that 6 is the best as it passes easily and it doesn't burn anymore.
Unfortunately they always come in pairs, so I would get 4-5 or 5-6

I read somewhere, that nerves on the bottom of fissure are still being aggravated, and cause spasm.
Spasm cause more pain as pulls wound together and makes feces to contact wound more. So it is like you take dirty stuff, put on wound and press on it for 4-5 hours.

So true B and I..Ugh its never a happy medium for us..mm. A 4 to a 5 is perfect but of course it some times changes, its hard to get it just wright. 
Trial and error, we keep trying, the days when I' m not in pain I'm a happy camper  
Going for my walkies..lol.
take care every one.  

I'm finally healing, I want to thank every one for your invaluable advice, sometimes better then my Doctors,
With all that I have been doing, and still (a lifetime) doing, I will never go back down that road again,,Please every one heal fast.
I guess I was never one for patients, was like that as a kid..lol.

Please go away: i read your other posts about the placement diet where you eat soluble fiber first. I tried it yesterday and was able to go better this morning. Im not in any pain right now..., hope i dont get that delayed type pain today. I backed off on adding ground flax seed to my oatmeal... I checked the nutrition package and it said 3 gr insoluble fiber, 1 gr soluble. So im thinking its not a good source of soluble fiber, maybe causing me some pain. Anyway, i was fine without it this morning.

Even if it's more insoluble, it's OK , because your only adding a 1/2 a teaspoon (ground) to your Oatmeal(working over time). My Pharmacist recommended flax over Metamucil.
But either way, do what you feel comfortable with.:) I'm so glad you tried that approach, and I hope it keeps working for you until your healed, then you don"t have to be as strict with it.
I still got delayed pains but with time and patients, I feel no delayed pain at all now. All my best
Sorry I forgot too add, I questioned the Pharmacist about the fibre in flax, as long as you add 1/2 teaspoon to your oatmeal as your making it, will balance itself out, ( she just didn't want me using Metamucil, too much bloating , insoluble gas).
I just went over to my Pharmacist today and she printed this up for me, I call her my angel:
One tablespoon of ground flax seed provides 1.8 grams of insoluble fibre and 0.9 grams of soluble fibre.When added to your Oatmeal, the fibre's will balance them self out because of the higher soluble in Oatmeal.
soluble fibre ~Helps make bowel elimination easier by reducing irritation on the gut + gently bulking up stools with gelatinous mucilage so insoluble fibre exercises the bowel muscles as it helps broom out debris from the colon and provides a smoother passing formation of feces.I hope this extra helps.

Please go-away! I was just wondering, do you think it would be possibly to tell us what you eat during the day? I am trying to figure out what to pair together to balance the insoluble and soluble. If you eat soluble before insoluble, how long do you wait until you eat the insoluble food? Does it have to be awhile after, or can you eat it right after?
Thanks :)

Hi Smiles, love the name, I usually wait about a 1/2 an hour after I eat a soluble food.
Also because I also have Divert, and IBS, the soluble food then has the time to collect all the water from my colon (my system is slow).
It also depends on your issues, you probably Don't have to wait that long. Sometimes I don't take that long and it's OK.
It can also depend on what I have eaten the night before or if it's still in me.  Lately I can only have a BM in the morning,after breakfast, sometimes I go once or twice.
When I see my Gastrologist,at my next appointment, I will discuss it with her.
Of course it has Been a while since this post and unfortunately there has been a Little setback, will figure it out when my doctor look's at me down there..:roll:,Oh well.
1.Morning, Oatmeal with ground flax (regular kind) with chopped/diced apple (about 1/4), few raisins and or prunes.
2.Lunch;it could be a combination or one, sweet potato, turnip and parsnip mash.Then I follow with steamed/sauteed Kale or mashed/cooked kidney beans.  Since fish is more digestible, I usually eat together or combine it.(I can eat chicken too)
3. Dinner can be similar, or depends on how I feel. My dinner is early if I can or my lunch mite be later. This also depends on how much I eat for lunch.
Even I have problem's sometimes, a few day's ago I had a Dinner of Turnips with carrots, cooked well, then followed with Quinoa, I added black eyed peas.
Unfortunately, I either added to much, bean's to the quinoa, didn"t mash them or even the quinoa could of bulked me up or slowed me down.
I think it is all out of me, through trial and error, we learn to find what works for each of us, Please do read every ones post's, this forum has been a g-d send.
Take care and heal fast..:)

Thanks Please go-away! This was very helpful :)
Sorry about your setback, I really hope you heal fully and completely!!