Mamafizz - that's great news! I'm sure the hems are part of your problem now. Do you find that the sphincter is actually still very tight, or do you just feel a general tight feeling in the area? Meaning, if you tried to put some cream up inside a little, does the space seem very very small, maybe hard to the touch? Just wondering if perhaps you have tightness elsewhere that's causing you discomfort.

BrittanyB - thanks! Sorry to hear that you're going through this - it's so tough. Just wondering, did you have a particularly large bm or other instigating event that caused the retear? If not, the tone of the sphincter muscle may be tight...it seems as though this is common among those who have trouble getting or staying healed.

I have not had Botox or LIS. I had an excruciating chronic fissure for 3 months and finally had LIS booked when I began to experience some improvement. The fissure area healed over enough to stop the excruciating pain, so LIS was postponed. I am trying physiotherapy in the meantime, but will be speaking to my surgeon again before April in case there is no improvement - I still have a level of pain where I cannot stand or sit for more than 10-15 minutes.

LIS has a higher success rate than Botox, but if you're planning on getting pregnant again soon it may not be a good option.

Keep us updated on your progress!

Hi BrittanyB, Yes I had Botox a month ago and in two weeks the fissure was healed which was 2 weeks ago! However the underlying tissue is still sore and it seems that this is the culprit. It heals on the surface but not all the way through and so the skin is very weak and more prone to further tear. I have had 6 babies so an operation was not recommended. Botox is suppose to be a chemical version of LIS . Botox has worked for me but I still have ongoing pain and muscle tightness. although not as painful as the original issue. My issue now is the remaining tight sphincter that has not yet relaxed back to normal yet, it was just enough to heal the fissure so I am trying to relax and give it more time. Yours sounds like on the surface not through to the muscle so it will most likely heal back up faster. Hang in there. Did you ever have the spasms? Or muscle tightness? Also Internal hems could feel similar I found out I have those as well. Can produce similar symptoms.

Thank you both so much for your replies!!

GilmoreGirl -- This sounds very much like my experience! The pain was agonizing for 3 months, and then it subsided and started to heal. I did some pelvic floor PT, which taught some some good tools about relaxation, ongoing pelvic health, how to have an ergonomic BM, etc. Since it heals often, sometimes for months at a time, I was also discouraged from having the surgery. My CRS said I could try Botox as the next step if I grew too frustrated with this cycle. I'm not sure what my resting anal pressure is exactly. I can remember the moment I sustained a fissure -- I was really dehydrated and had a very difficult to pass/extremely hard bowel movement. But my PT said I am very tight in my pelvic floor, which is probably why I'm struggling to heal all the way.

mamafizz -- Thanks for sharing your experience too! I'm so glad to know that Botox has helped you with healing. I'm not sure if mine is on the surface or deeper. I had it check several time by a CRS and it's definitely a fissure, but I don't think I've had the muscle spasms. How would I know if I did? I do think I'm generally tight back there, according to my physical therapist, but generally my pain is only during a BM, with some achiness and stinging for about an hour or two afterward. Nothing that impairs my activity, though -- I can walk, work out, sit for long periods of time, etc. Did you get your fissure after you were done having babies or before?

BrittB, I am sure I had one or two after babies but nothing that did not quickly resolve shortly after. This came after I went through menopause, (No estrogen) and harder to heal, and spasms are debilitating, really cannot sit or stand, I typically have to lay on my side very difficult to manage. Puts your life on hold. As long as you don't have the internal muscle spasms which is what causes the fissures not to heal. Otherwise you typically would have enough normal blood flow to heal on its own. Your MB has to be the right consistency which is very hard to do all of the time so diet is extremely important. Mine occurred after I learned I could no longer tolerate lactose, The dreaded chocolate milkshake triggered mine.. UGH.. (Loose bowels can create the same problem) No more evil milkshakes for me ever again. ;;lol

Yes!! A milkshake was the source of my first fissure too! I drank a giant milkshake, hardly had any water, and woke up with stool from hell! It doesn't sound like I have the spasms, but I wonder why it seems impossible to heal still -- it's been more than a year. I guess I do have the blood flow to heal on my own, but like you said, one wrong move and my stool is just enough the wrong consistency and the whole thing reopens. Do I just need to get used to it/accept that this is what happens every few months? The Miralax helps me a lot with stool consistency, but I also don't want to be on that forever, so I know I need to focus on my diet a bit more. (Though it's already pretty high-fiber, no dairy, few carbs, etc.)

GG, I think the internal hems are causing alot of the problem right now, Botox procedure and the anoscope really inflamed everything, so it seems there is tightness and swelling (inflammation,) which causes the burning aching maybe but the muscle higher up feels clamped tight, ( i can still go to the bathroom ok) but it is def in a knot, but once the hems calm down maybe it will begin to smooth out again, I also have a pulling feeling, not sure if that's the swollen veins, but fees like something in there all of the time and feels like need to go after just going, not sure if that's muscle memory or is what hems feel like? I went to the market yesterday, could barely get through it, very painful burning aching and tight all he way to the tailbone, it seems as though it is having a effect on the surrounding pelvic floor as well.

BB, Yes, it sounds as though as long as you can still function it is manageable, these are just a sign we have to take better care of ourselves. It takes a lot of patience. Lucky for you the spasms are not involved. They are killer, I pray every day I am cured of this and for anyone else who is suffering from it as well. (I never even heard of a fissure before and have never had any problems not even with hemorrhoids until now) Sheesh.. Since a lot of people get these I am sure you will recover nicely as well. Just hang in there give it more time... AND NO more treacherous milkshakes, my diet has completely changed, I retained 10 pounds after each baby and lost 60 pounds with this condition, I look great now, and soon I have to feel even better!

Hi Gilmore Girl and BB, has anyone seen a post from Reighleysmama, she had her procedure LIS today, hoping to hear from her soon..

Also Spoke to the specialist today, and with discussing symptoms he was really reassuring, and mentioned that the levator muscles are attached to the internal and anal muscles and these create constant tension and pulling, if there are internal hems that are severely swollen from all of the inflammation for so long and maybe impossible to see, may also cause a feeling of fullness and closed and swollen and pulling spasms. *Which is why there is deep throbbing ache and burning, and I suppose the golf ball feeling also) he has had great results as you mentioned GG with PT , natural muscle relaxers like Cramp Bark, Vit e, Aleve, and a bioflavanoid supplement, also hemp oil, essential oils in soles of the feet, and a supplement diosmen called RhoidAid. which is a holistic approach to help with anal restoration with the cells and veins which aids with the muscles and those feelings that we need to go away. He states there will be success and it will go away without surgery. Must learn emotional balance as well since we store our emotions and stresses in this area. And the fear cycle also. Takes time. But we are on the right path. If you have pelvic floor dysfunction it does effect these levator muscles, some people suffer from this without fissures or hems and strictly from emotions, so it is no wonder we would have these issues coming from an actual intense injury. Heres to less melt downs and more healing.. I cannot wait until I can get in my car and drive away sitting like a normal person... That will be a milestone for sure.... Can't wait...

PS.. he said its like getting out of an abusive relationship lol takes time put your guard down...he recommends stop worrying,,,

I'm going to join in on this convo since I'm in basically the same boat is brittanyb. I've been dealing with this for 14 months. It started after the birth of my daughter. I hope we all find relief soon.

Right now my CRS wants me to try a stronger nifedipine ointment (.3% instead of .2%) and come back in one month. At that point we might try botox. I have also had period of healing, but within 2 weeks of stopping the ointment I always have a relapse. He is wary of doing the LIS due to me wanting more children and the risk of future incotinence. But, I also can't continue to deal with this... so I'm going to do something about it soon one way or another.

I had a general surgeon previously who was willing to cut in right then and there (back in march 2015, when the fissure was just 3 months old). I wanted to wait more at that point in time.

Anyways, now I kinda just wish I had done the surgery. Maybe I'd be done with this all months ago.