I am in a bit of a panic. I have had an anal fissure on and off since 1998, following a long period of IBS. I've had the current bout for a long time now, about four months, and am growing concerned. On one day, there may be no blood, on the next there is blood on the tissue paper or in the bowl. Whereas before the fissure has been accompanied by pain, this time it is painless. Plus, it has taken less time to heal.

I've take anusol and proctosedyl suppositories, but they didn't work because I think they never got near the fissure. The doctor has given me rectogesic ointment, which gives me a permanent hang-over feeling and I end up being unable to function well on it. After a few days, I've given up.

The painlessness and the lack of progress in healing make me think it could be cancer. I've not worried about cancer before but a friend is currently terminally ill with cancer (he had successful treatment for oesophigal cancer, but a year later they found untreatable secondaries on the brain) and it's on my mind. The GP did a digital examination and found nothing and said it wouldn't be cancer, although I'm concerned he's saying this just to ensure I don't get anxious. He has said he'll refer me for some colonoscopy should the rectogesic ointment fail. That in itself is worrying me as I've heard all sorts of issues about it - one woman I know got a perforated colon and got very sick after a colonoscopy.

Has anyone else had an experience like mine? Are anal fissures identical in symptoms to colon cancer?

Information about me: Male, 39, 164cm height, 57kg weight, relatively fit (I do martial arts and seem to have more stamina than most others) and no other symptoms, although sometimes I have a hard stool (which aggravates symptoms - when it happens, I take Fybogel, but I don't like it much - gives me wind).

Hello Danno,

About three years ago I was having a lot of anal bleeding, small stools and some other symptoms of colon cancer and my GP doctor insisted that I do a colonoscopy. My bleeding issues were from internal hems and a fissure, but doing the colonoscopy did give me peace of mind that I did not have colon cancer. Internal hems can bleed and cause no pain.

Make an appointment with a CRS and get checked out. The risks of doing a colonoscopy are small compared to the upside.