After my first BM of the day (usually have at least 3) my stools are very narrow and I can feel the muscle pulling up before I am done is this the internal sphincter in spasm? It's driving me crazy as I can't empty and then have to keep going throughout the day. Or worse, it pokes at me the rest of the day and while I try to sleep. Arg. Does anyone else experience this?

I believe this is known as the cigar cutter effect. I got this on the odd occasion before I started taking Laxido and eating low residue/ low fibre diet.
I used to find exercise helped to move things out when you had that feeling that you'd cut the poop off half way through the job. Nothing too strenuous, just a vigorous walk would do it. I did get prescribed senna for a while to try to get one complete bm instead of the multiples I was having. This worked well but you don't wAnt to become dependent on it. Once I changed over to the Laxido I didn't need it anymore.

Now I usually have just the 1 bm and it slides out like a paste.

Is this effect specific to fissures? I have not had this before. I have IBS also so one BM/day is impossible for me.

msimon wrote:After my first BM of the day (usually have at least 3) my stools are very narrow and I can feel the muscle pulling up before I am done is this the internal sphincter in spasm? It's driving me crazy as I can't empty and then have to keep going throughout the day. Or worse, it pokes at me the rest of the day and while I try to sleep. Arg. Does anyone else experience this?

I also experience this... I try to push the remainder of it but since I am in pain I try not to... I just wait until I get the urge to go again so I don't have to push much. I had this issue before I had a fissure though... but it was not an every day thing and I did not have narrow stool.

Right now I really couldn't push it if I wanted to as it feels kind of dead from the botox. Kind of like a balloon fills up higher and doesn't even come down to where I could push. This last round of botox really screwed me up. If it does come to the point where I could push it would so hurt my fissure.

These days I feel like my skin down there is like tissue paper. My Mom suggested to me that there may be a hormonal reason for this. I once had a Doc prescribe me estrogen cream for my vaginal area as she thought it was thinning from being on oral contraceptives for so many years. I asked my new Doc and she said it all looked fine. But I did have a CRS describe my skin around my anus as 'friable' that is, that it gets microtears very easily. I completely blame this on the tight muscles. The only explanation he had was that he sees that when people are consistently moist down there and to use some gauze to absorb moisture. For me, I know this is not the issue. Back when I could get something up there (pre-fissure) I used to use Penaten cream (a zinc-based diaper cream) that I think really helped with the painful skin. Wish I could still use it but it's way too tight and would make the fissure flare up worse I am sure. Have you tried anything like that?

"But I did have a CRS describe my skin around my anus as 'friable' that is, that it gets microtears very easily."

I feel as though that is my problem too... I had a baby 6 months ago and that is when all this started! The doctor said that the reason I get these microtears is because my pelvic muscles are tight. These tears have not been visible upon examination. My area is not moist unless I put something there...I have used a whole list of ointments back there and nothing seems to help prevent these little tears. BM do feel better if I lubricate before I go but I cant keep doing that for the rest of my life!

Have you tried some of the AF creams like nifedipine or nitro?

I'm still not sure about how this is helping me because I just started but my mom is a nurse for many years and one of her friends (who has our issues) suggested using an ointment called, triad. My CRS didn't know what that was but my mom was saying that sometimes doctors don't know as much about certain things. Not the way nurses do. Anyway, this ointment is used for open wounds so her friend tried it and it stopped the burning right away. She gave me some and it has been helping. The other thing I thought was helpful is that when I did have a BM I noticed a strip of white along the stool. (that was the ointment) I figured that's a good thing because it is protecting the fissure from the stool. I was not able to get a prescription for this. I believe that it is really just zinc, like what you put on babies for a diaper rash. Don't quote me on that though. If anyone is interested, I'll ask my mom for more info. I have been applying it several times a day and it helps with the burning and, like I said, protects the fissure.

Msimon,

Yes I have used nifedipine off and on... I felt as though I was getting an allergic reaction to it so I stopped and was using other things on my bum. So now I use it off and on because if that..

Jlm1,

Yes let us know about that ointment! Does she know of an ointment to use for the anal irritation?

Yes Jlm1, the Penaten cream I was referring to is a Zinc diaper rash cream and it really worked for me, when I could get anything up there.

Alyssa, that is so interesting that you have tight pelvic muscles after having a baby. I thought that process would make the muscles weak? Have you been to a physio for this? Who diagnosed you with the tight muscles? What background and experience does the Doctor have that is going to treat you with botox?