I haven't been tested for crohns but I think I probably should be. My fissure is in the 5 o'clock position which I know is less common but my CRS said that he still didn't think it was anything more serious (not that he did any tests or anything) Though I do question whether my doctor accurately diagnosed my IBS 5 years ago. I know that IBS can often be a diagnosis when the doctor doesn't really know what you have. I just googled peri anal crohns and I have experienced all the symptoms I read for years.

Pain and/or itching around the anus
Anal bleeding and/or passing pus/muscus
Urgency to pass stools or incontinence

I'm going to ask for a test straight away. My poor butt, you have been a god send. I've spent the last year totally confused and suffering and the NHS has continually failed me. In one day you have given me more insight and advice than everyone else combined.

I hope you are paid for everything you do on this site. Truly, thank you! I

Awww, thank you Nick
The moderators on this amazing site have helped me so much and i was recently asked to be one myself. No one receives any kind of monetary payment, we all do it as we have all struggled with fissures and other issues and want to help others as we too were helped. I think in todays world fellow sufferers often help each other more than the NHS, that often is more focused on saving money so even well meaning caring doctors cant actually help us as much as we need.
To maybe set your mind at rest peri anal crohns is rare and the fissure normally occurs around the 3 or 9 position. On my crohns forum i think only about 30 people out of thousands have it. Hopefully you dont and its just bad luck...and the botox or LIS sorts you out.
Have you had any colonoscopies to test for UC or crohns itself...as yes its very simple for a doctor to say its IBS instead of investigating further. Then often just leaving you to suffer.
Another thought...was amitryptiline ever mentioned to you as it can help the sphincter to relax and can also help IBS, as its tablets if it doesnt work it again has no permanent ramifications.

Hey Nick, did you ever get it resolved? I have been battling for 6 month now with two same fissures and according to three different CRSs I have a normal sphincter tone.

I have done everything possible but still am not healing.