Hello AF community,

Once again I seek your insight, advice, perspectives, personal stories....

In the last year or so I've had two fissures (or it could be the same one that re-opened a year later because both are in the same area, posterior region). When I had the second fissure late January of this year I scheduled my first GI consultation and CRS appointment to try to get some help figuring out whether I seem to be susceptible to them.

At my consult the GI's only solid suggestion was to ask the CRS to test to see if I have a high resting pressure or tight sphincter. Later in the day she wrote, "After thinking more about your case, I think you should have a colonoscopy to check for Crohns. Fissures can be an early sign of Crohns."

Later in the day I went to see the CRS who gave me a digital and scope exam and said my fissure is healed and all the tissues look nice and healthy. Her advice seemed to be to see a pelvic floor therapist to learn biofeedback, take Miralax regularly to keep my stools soft, wean off the Colace, and go from there.

I found the GI's rec to get a colonoscopy bewildering since I don't have any symptoms of Crohns. So I asked teh CRS what she though, and she seemed ambivalent writing "It is uncommon to have fissures as the first presentation for Crohn's but she [the GI] would certainly be more familiar with this sort of early presentation. You have had 2 fissures so you could either go ahead with the colonoscopy or give it more time to see if this turns out to be more of a chronic problem."

Just wondering if anyone out there has any advice, insight, perspectives to consider on this choice I'm facing. Perhaps needless to say I'm not enthusiastic about getting a colonoscopy. They do have risks, and I feel like it isn't clear it's worth the risk given my current situation. Thoughts?

Thank you and wishing you all healing.

I have had crohns diagnosed for over 20 years and only had a fissure 3 years ago. I personally have never heard of fissures being the first sign of intestinal crohns. Normally it’s increased bowel movements blood in the stools, then exceptionally numerous BMs (mine in a flare can be 30 a day) lots of blood and clots, feeling weak and feverish.
I do know that fissures are the first sign of peri anal crohns but then those fissures do not heal and are often accompanied by fistulas and abscesses. In the U.K. a CRS would know as much as a GI about crohns.
A colonoscopy is not a terrible procedure, they are quite painless. There are risks but they are minimal.
If you feel that it would put your mind at rest then by all means have the colonoscopy it will certainly show what’s going on.
Good luck

If you have fissures but no other signs of chron’s, I would not get a colonoscopy. It can make your fissures worse. In fact my CRS said he would never perform a colonoscopy on someone with active/unhealed fissures unless you exhibitied signs of colon cancer. I know someone with chron’s and she was very sick for years before she was diagnosed. If you had chron’s I think you’d know it.