I'm beginning to suspect I have a fissure, in addition to internal hemorrhoids, a pilonidal sinus, and pelvic floor dysfunction (although this latter one could really be a fissure I think).

How are fissures normally diagnozed? I've had external examinations, rectal exams and a sigmoidoscopy, which revealed the above problems, but not a fissure. Yet I have found that treatments for my existing problems have not solved my woes, and my symptoms seem to match a lot with what people on here describe.

I wake up, and know that my morning BM will dictate how I feel for the day. It if goes well, I feel OK. It it doesn't, I get a burning, puckered feeling in my anus/rectum all day, sometimes also a feeling of incomplete evacuation. More rarely, I get actual incomplete evacuation because things don't seem to function quite right down there (but this is very rare).

Soft BMs of good volume generally make for a good day, hard BMs or small BMs make for a bad day. My diet totally revolves around controlling this problem, as does my daily routine.

Could it be a fissure?

Hard to tell. It could be an internal hemmo that makes the pain. Removing the internal ones with some kind of rubber band they put on do not hurt. I think i have removed four using that method, no pain, blood or any other problem.

I had banding done for my internal hemorrhoids last month. I don't get such a prolapse feel anymore, but I have all the other pain/problems.

Have you used any ointment with cortisone? It can make your skin thin and maybe that causes the burning. I have the same issue. Will see what the doctor say on the 22 this month.

Hi Johnno,

The fissure is typically located at the 6 or 12 o'clock position, but they can also be in other areas. Some are outside the anus and visible from the outside and some are inside the anus and others are half in and half out. If you have a fissure and it is not visible from the outside, a scope is needed to check for a fissure. You should contact a CRS to do an exam and let your doctor know that you have a concern of a fissure because of your symptoms. Most fissures are less than a half inch long for something so small, they can make your life hell.

Fissures can be missed as the first CRS that I went to did not see the fissure and wanted to do surgery on my hemorrhoids. I got a second opinion and the second doctor noted a fissure, so I had a LIS and banding. My fissure was located inside the anus and located at the 6 o'clock position, but I felt the pain like it was on the left side of my anus.