dull pain in anus at 5 o'clock region with coughing only. Next day, constant dull ache, third day pain was so bad I went to emergency and could barely walk. Neg cat scan so was referred to CRS. He did exam and anoscope and said normal. 2 months later went to other CRS who said normal exam. It is now 6 months and went to a 3rd CRS who said normal exam! I'm frustrated, I get an ache before bowel movements at the 5'oclock spot and sharp pain with the bowel movement and then it gets better. Sometimes sitting hurts, sometimes it doesn't. Sometimes it just is a dull ache on its own and other times no pain at all. Im frustrated. Can you have anal fissure without it being seen on examination??? Anyone else with the same symptoms???

Hi dvalen
Someone else just came in here with similar symptons. If even 3 CRS's could not spot a fissure then it may be what the other guy here may have.
Look under the heading Help for Levator Ani
Its the muscle on the pelvic floor that can go into spasm just like the sphincter muscles of the anus. You may want to mention you think you may have Levator Ani (Proctalgia fugax) to your CRS the next time. ( you would think one of them would have suggested it though)
Here are some links here on the topic....
http://anal-fissure.org/t7042-help-for-levator-ani
http://anal-fissure.org/t3127-pelvic-floor-tension?highlight=pelvic+floor
http://anal-fissure.org/t7049-hemorrhoids-anal-fissures-and-proctalgia-fugax
link out to...
http://ehealthforum.com/health/symptoms-of-levator-ani-syndrome-vs-pne-t259832.html
See if this refers to what your going through, if so, they say the best remedy now is pelvic exercising techniques along with the relaxing prescription creams as you'll read.
HTH GL

dvalen, hi there, so sorry about your discomfort with negative results on the exams.
Just like buttastic said, perhaps you need to research in other issues that relate to pain in the anal area, I am new to many of the other reasons why we can have discomfort from no apparent reason, I hope the information that buttastic posted will help you.
Even when my fissure is healed I also experience pain and discomfort once in a while in the area where my fissure used to be located, something I wonder if is other reason why we still get discomfort after healing.
I wish you the best.

I am not having spasms like people and articles describe. I am seeing a urologist this coming Friday. My GP did a DRE after my post this morning and when he palpated the right side of my prostate, OUCH!!! He said if felt a little boggy and is now thinking that I am having this anal pain secondary to inflamed prostate. So, we will see. I'm not sure why it would hurt to touch on the outside of my anus if it was my prostate. Maybe referred pain? And yes, the CRS never mentioned LAS. All he said is sometimes fissures cannot be seen and it was either that or atypical rectal pain. UGGGGG

dvalen, is good news to know that you are seen be a doctor and that soon you will find out what the problem is.
Hopefully is just some inflammation and something easy to take care.
keep us posted on your progress. 

Dvalen,

Any updates on your condition?

Allysa yes it was an anal fissure. CRS said sometimes they are so small you can't see them

Valentine,

How many doctors did you see before giving you these results? I've seen five and none have seen any more fissures since mine was healed. What was your treatment plan?