by momof7 » 09 Apr 2013, 05:24
Warning...graphic descriptions...
There are no hard and fast rules for what is what, but....
Since my fissure doesn't hurt when actually having a BW, though I can sense it's presence, I believe most of my pain comes from spasms of the sphincter. Before the nifedipine I also had levator spams (though not confimed by the doc because I didn't discuss all the varying symptoms). My spasms also create internal hemorrhoid pain. But I think I have decided which is which.
The spasms begin as prickling sensations or quick knife jabs, and quickly turn into a tightness in the anus that resembles a strong need to have a BM. But there is nothing to move. (Applying the nifedipine confirms the anal tightness and the absence of stool.) This tightness can actually feel like contractions in the anus, or it can become a burning sensation. (match size, cigarette size, cigar or even golf ball sized area of heat from nagging warmth to burning hellish heat)
My fissure in at the posterior midline, where most are located, and I have no discernible pain there during spasms. When the spasms are really bad, it gives the sensation that if I could place something in the anus to give it something other than itself to "squeeze" it would feel better. (Doesn't work.)
I also have a particular area to my left side which hurts especially bad during spasm episodes; it originates with my largest hemorrhoid that spans the spectrum from internal, through the anal opening, to external. The hemmie tissues in the opening get squeezed so that it produces sharp , deep pain in a very pinpoint location.
When I had the levator spasms I also had a full time sensation of heaviness or fullness in the rectum, the vagina, and the perineum. I realized once those spasms stopped that I had been having trouble relaxing to urinate. But after 7 live births, there are all sorts of misshapen pathways in the pelvic floor.
Also, another type of pain is the feeling of something "rolling around" in the rectum, like raw flesh on raw flesh. It also feels like sitting on about 18 toothpicks at times. I have learned for me that this means there is stool in the rectum, not enough to pass, but enough to cause discomfort. If the stool is hard and dry it causes more stabbing pains, when it is soft and unformed it causes a duller prickly or rolling sensation. I believe these to be because of my internal hemmies more than spasms, but this pain will trigger the spasms.
Hope that was helpful for some.