Glad to hear it mynamehere. I love sudocrem! It just feels more soothing than my other creams and my surrounding skin doesn't react to it like my wheatgrass or aloe Vera. The rashes those cause can sometimes be more of a pain than the fissure!

MyNameHere wrote:Interesting. Levator ani syndrome does tick a lot of the boxes but I don't see anything about bleeding. As I mentioned I had some blood on 3 different occasions....

I am convinced there is significant overlap between these conditions - it is possible to have anal fissure, levator ani, or both. These anatomical structures are connected and intertwined, and pain from an AF can activate the LA, causing spasms, referred pain to the tailbone, etc. Straining from constipation can "pull" the AL muscles at the same time that it tears the anus to create a fissure. And the pulled muscle then knots up, leading to a cycle of cramping and spasms.

I believe that many AFs are relatively mild, and that the combo of AF + LA is far more likely to cause severe pain and motivate a person to go to the doctor. The doctor does a rudimentary exam, sees the tear, and pronounces it an AF. Which it is - but there may be more to it, and a dual diagnosis presents more information about the cause, and more options for treatment.