Hi everyone, i’m new here and i was wondering if anyone is able to give me some advice. I had surgery in may to get a skin tag removed, and ever since i’ve been struggeling with anal pain. After the surgery the pain was extreme. Over the months it has gotten better but i still have constant mild to moderate pain and occasional bleeding (down to about twice a month now). I’ve seen a gastroenterologist who prescribed me antrolin cream, which helped somewhat. He’s now suggesting my next option is lis surgery but he doesn’t seem to be that sure that i even have a fissure :s isn’t that something he should be able to see when he examines me? When i apply the cream i can feel some hard bits inside at different places. Bowel movements are uncomfortable (i use stool softeners and fibre supplements), but there is no longer the intense pain i had after the surgery.
Is anyone able to give an opinion on this? Could it be hems? Surgery scars not healing? Or fissure? I live in a developing country so botox is not an option and medical advice is not always 100% up to date i would really appreciate any input

I can't help you with a diagnosis, but can tell you that it's very possible for a CRS not to be able to see a fissure, even after digital rectal exams and flexible sigmoidoscopies. My CRS never saw my fissure until he did the LIS surgery, but was pretty sure that I had one because I had both a papilla inside my anus and a sentinel pile outside it. Also, when he pressed on the area that a fissure is most commonly found at, I almost went through the roof because of the pain that it caused! Mine was not visible to him though, because I have massive internal hemorrhoids, that blocked it from physical view, until he went inside and could do a full-on examination of the area.

Thank you so much for your reply :) i got worried that i would need to change doctors but what you’re saying makes sense. I’m actually having a bad day today which is why i decided to post on here. I’m really afraid of the surgery since having a skin tag removed was so extremely painful, and this seems a lot worse Then there’s the added risk of being in this country where i do not really trust the level of care. Does anyone know if there is a chance of getting better using cream if it hasn’t worked after 6 weeks? Is there a big risk of developing too much scar tissue? Or can i try and keep going with the cream for some time? :/

I don't know where you're from, or where you're currently living, but I wouldn't want to have surgery in such a delicate area if the level of care and/or expertise were not as good as it could be. Can you travel back to your home country to treat this issue? Or go somewhere else nearby that you feel is a safer bet? A skin tag removal can be even more painful than LIS surgery, or it can be much less, it depends on the size of the tag and the skill of the surgeon. I wouldn't necessarily equate the two, so avoiding LIS because your tag removal was painful isn't really a logical conclusion to have drawn. Your fear about undergoing surgery in a developing country though, is bang on. I hope that others will come along to answer your other questions soon. Good luck.