Hello!

My fissures have been 'dormant' for a while, but there still is scar tissue. I've been using Nifedipine (.2%) two times daily for several months, recently trying to taper off.

The problem is, I can't seem to get off it without the hypertonicity returning. I tried to pass a stool, but it got 'stuck' for a little while. Found a small amount of blood on the TP and the area feels inflamed.

The whole point of taking it for this long, I was told, was to develop consistency so that it stays wide and open. Now I just feel dependent on it. What do I do?

I was given Nitro a long time ago. I'm not sure how to evaluate its effectiveness back then...I was not instructed how to apply it properly, and I was also using hydrocortisone suppositories at the time. The general consensus, though, seems to be that Nitro is more effective, but it can cause headaches. Has anyone had difficulty coming of Nifedipine too? Have those coming off Nitro retained better sphincter relaxation?

I wish I had started using this forum earlier. I spent so long as a 'read only' visitor. It feels nice to have people give specific thoughts and attention to my inquiries! (*cough, cough -- doctors)

This is EXACTLY what happened to me... Have you been evaluated for pelvic floor hypertonicity? If not this could be the root, this caused me so many problems with spasm despite recieving a round of botox to my internal sphincter. I strongly urge you to see a urologist or pelvic floor physiotherapist who can evaluate you for such. I did and ive never been so glad, i thought i was out of my mind for a while having anal spasms while on botox!!!! Feel free to pm me for more info. Best of luck :)

what are your spasms like? are they noticeable 'charlie horses' or are your spasms just general tightness?

I don't think I fit the bill for pelvic floor hypertonicity, thought I could use some loosening up of everything. I am rather high anxiety.

I DO have to pee frequently, often urgently, but I also drink a lot of water. I've never had difficulty urinating once I'm in the act of it. Interestingly, I feel my sphincter tighten mildly when I urinate--but I THINK that is normal. I have never been constipated in the sense of going multiple days without pooping. I poop twice a day, once when I wake up, once after breakfast. No pain during orgasm, and no noticeable spasms throughout the day.

My sphincter 'spasms' aren't noticeable. I am not aware of my sphincter unless I am passing gas (which can be an indicator of tightness). The anal canal just seems tight when I defecate. It does respond to use of nifedipine, and it also responds to removal of it.

I will keep this in mind, though, and bring it up the next time I seek treatment. Do you do any exercises the release tension or is it only work the physical therapists can do?

Keep in mind that the pelvic floor can be tight in certain areas which will affect certain people differently. Frequency to urinate is one. Do you ever feel like when you defocate that you feel sharp stings other than where the fissure is? I defocate three times daily and have found that without stool softners and treatment that my anus sort of hugs the stool. Everyone is different for sure, just thought i would bring it up because nifedipene did not work so well for me and neither did botox. Usually what is involved in therapy is internal work as a male its done through the rectum. Triggerpoints and myofascial release are a part of it plus giving you proper proprioception of your pelvic floor. It couldnt hurt to find out and my crs told me a lot of people who suffer from chronic fissures lasting months yrs etc usually have some form of it which goes undiagnosed because most docs dont know how to deal with it. One evaluation with a specialized pelvic floor physiotherapist would be able to tell you. It saved my life.

that is very interesting. I used to feel 'pinpricks'--or sharp stings--when defecating, but I have not recently. There was almost never any blood. Then again, I am not exactly sure where my fissures are...only that they are there.

Internal myofascial release, huh? I went and got a digital exam recently, and despite the immediate discomfort, I felt pretty good the following few days (this was also likely due to the fact that he told me he couldn't find any active fissures, just a bunch of scar tissue, which made me happy). A few days later I had some hypertonicity and the poop had trouble coming out, plus a very small amount of blood. I wonder how his poking-around-in-there affected the musculature...

I am going in for an evaluation and an anoscopy in a few days, and I will ask about the pelvic floor at that time. They are naturopathic doctors (Dr Hubbard and Gardner of the Oregon Hemorrhoid Clinic--mentioned on the forum a few times), and Gardner was a chiropractor before a naturopathic doctor, so perhaps he will have some insight into that.

That will be the next avenue I explore if this doesn't work out. Thank you for your reaching out to me with your experience, havefaith. I am grateful that you reached out to me with your experience.

Omg man i had the same experience. I thought when i defocated that i had multiple fissures lol when in fact i only had 1!!!! Please do yourself a favour and get examined for it, even when u described immediate discomfort of a digital rectal exam then it felt better...... Its all what ive been through. Thing is though it has to be a trained physical therapist otherwise if u have active trigger points in the floor they will cause more spasm and more tightness and lack of ability to defocate.

Pelvic floor dysfunction is a functional problem not a structural one so it involves reprogramming ur brain to give you proper proprioception of your pelvic floor again so you can properly defocate. Any other questions dont hesitate pm me.

"I thought when i defocated that i had multiple fissures lol when in fact i only had 1!!!"

I am experiencing the same thing! I have been told that am I healed but I continue to have pain during and after I go to the bathroom; the only relieve I get is when I am in the sitz bath, laying on my side, or when I am sleeping. I have been referred to a pelvic floor physical therapist; I just want this pain to be over! I stopped using nifedipine about a week ago because I developed a rash and had burning...but I continue to use Vaseline and a & d to lubricate the area.

Alyssa i believe this to be a massive problem as when it hurts to goto the bathroom, youre pelvic floor almost goes into shock! Especially with chronic fissures i find. See a pelvic fooor physio asap and get on some valium!! I guarantee if it works then youre dealing with skeletal muscle problems and not smooth like a sphincter

havefaith,

can you tell me what you have done to fix the pelvic floor problem?

Currently i use 5 mg diazepam morning and night, i take a stool softener and i go for pelvic floor physiotherapy :)