So I have been doing some reading on anal fissure and I found something that caught my attention.

When your fissure turns into a chronic fissure, you could likely have the classic triad. The triad being the fissure itself, the sentinel pile(or skin tag), and a hypertrophied anal papillae(or anal papilla). I know about the skin tag and the fissure but the anal papilla was new to me. It's like the sentinel pile but it's in the opposite direction. When I first noticed I had a problem in my anus I thought it was hemorrhoids,but then I went to a doctor and he said it was a fissure. So I had to rethink what I had and I think I might have a anal papilla. Some time later I felt a sharp pain near the outer edge of my anus and I think that is the skin tag.
At this point I already have had this fissure for 3 years now. So I'm pretty sure I got the classic triad already.

Has anyone else heard of this before?

Yes I have, my colorectal surgeon told me about it. Sometimes it rears it’s ugly head and causes so much bother and it’s hard to tell which of the 3 are playing up. There’s a 4th dimension too which is the scar tissue which never stretches or fully repairs itself back to what it was

I knew I had the fissure and tag, and when I had a flexible sigmoidoscopy, my surgeon showed me the papilla on the screen. I think that most people have all three and also know that they do. FF has a good point to add the scar tissue issue, because that also causes some people a lot of grief.

Yes I had all three of these things. The sentinel pile was what got me to keep going to doctors since I just had this weird lumpy thing on the outside that worried me. I ended up getting LIS and the surgeon removed the tag and informed me that I also had the papillae thing once he got inside. He said he did something for it but I can't remember.