Ever since I was had with this posterior fissure of mine, I would get this tightening of the anus midway through a bowel movement that prevents me from emptying my bowels completely. It is also excruciatingly painful at the same.

There's rarely any blood in my fissure, but the pain is like nothing I have ever felt before, absolutely disabling and leaves me in tears.

It is staggering how something so small and superficial can cause so much torture.

Anyone know why this tightening comes about midway through a bowel movement?

I have this problem too - sorry you're suffering also!

It's a natural reaction to pain for the anus to spasm like that mid bm. It's trying to protect you from pain - but in doing so actually has the opposite effect and makes it harder and more painful to go.

Have you been to see a colorectal surgeon or family doctor yet? They may prescribe you a topical ointment like nifedipine that will help the muscle to relax. LIS surgery and Botox do the same thing if the topical doesn't work.

Oh and just to note - the spasm mid bm or pre bm can occur even without a fissure. It is a pelvic floor dysfunction called obstructed defecation - the muscles that are supposed to relax don't work in synch with the other muscles during a bm, making it feel like you're "pushing against a brick wall" when trying to go. The first line treatment for this is biofeedback training with a pelvic floor physiotherapist.

-GG

I have the same problem too. GG explains it brilliantly above. Go see a doctor if you haven't already.

On the account of other people, I thought spasms were supposed to happen after a BM. In my case, the spasms and tightening happens during a BM and actually prevents me from emptying my bowel completely.

Unbelievable how small, superficial wound is causing all this mess and pain. Even though the fissure does not bleed, it is inflicting the worst pain I have ever felt in my life. I was diagnosed after an examination under anesthetic because, according to my CRS, the fissure was not visible during normal examination.

I have been living with this for a full year. So far, I have tried every conservative treatment available, from nitroglycerin to Botox just a few weeks ago. The treatment that managed to ease the pain just slightly is the Botox.

My CRS said if the Botox didn't really do anything, then a repeat injection would be useless. He said the next step is an LIS, and even though I have Crohn's that's very well managed, my surgeon has advised me to go through with the LIS because as it stands, it is currently my last option with the best success rate.

Hi I have not so well managed crohns and IBS because of this I was turned down by 2 CRS's who decided that LIS wasn't appropriate for me....well I found one who would and I had the op, it was blooming hard as I had a bad flare for about ten days, 2 weeks after the op so recovery was delayed. But it is now 6 months since I had my op and as long as I don't have multiple BMs a day then I'm pain free. When my other issues act up then yes the scar tissue from the fissure sets off the spasms again but I guess that's only to be expected.
Your lucky to get a CRS to agree to LIS when you have crohns. The Botox could continue to help I felt the best effect from my Botox from about week 7 when I was practically pain free
Good luck

I would have a doctor check for scar tissue which in my case was preventing my fissure from healing. I opted for silver nitrate to burn that tissue out and it burned like hell. That was 22 days ago and things are extremly good. Not perfect . BM tbis morning pain less then 1. No blood stool was soft no lingering burning and stinging. Here is what I am doing. Plenty of water stool softners 2 a day sitz baths 3 a day avoiding fast food proccessed foods refined sugars. I feel I am healed finally after 6 months 12 days post Lis. I am taking no chances because I know I can retear. Thank God I have relief. Not perfect but I will take this compared to that horrible constant burning stinging pain. I have nifedipine and nitro along with lidocaine and rective and I havent had to use it in almost a week. Once in a while I pop a naproxen to take the edge off when I feel a flare which now are brief. Hope this helps

Jim - that's definitely something to ask the surgeon about! It seems like a simple enough thing to do. Certainly better than another op!

How is your pain besides during a bm? Do you get any spasms during activity or sitting? I'm just over a month post op and am still having trouble during the 3-4 hours post bm with burning, soreness and spasms, though at about 50% what they used to be pre-op. I just want to get back to working out and not "feeling" that area all the time!! I'm sure you know what I mean!

Very minor however if I have more then 1 bm in a day it is a bit sore but nothing compared to what it was. This am I had such the case but it calmed down rather quickly. I would say yes very minor spasm. It took over 6 months to get to this point. I went straight tothe bath as well. Anything to get blood flo to the area. Diazepam and xanax help of which I have both. Whatever it takes is what I do. I would have a doctor look into possible scar tissue. That was the case for me. I have very minor discomfort right now but then again I had alot of BM. I am actually pleased its not worse. Tolerable more like it. And yes I was having the same reactions as you are 1 month post my surgery. Your not alone. Been there. Do whatever you have to to calm it down. My 2 cents worth

I wish I could take the occasional Xanax or Diazepam for when things get intolerable, but my doctor won't prescribe it.

Yea my understanding is most doctors wont and especially benzos. I went and saw a neurologist back in 2015 before I had my fissure and he prescribed them for anxiety and panic disorder. All they do is calm me down by taking the edge off.