I am sure i have developed an internal anal fissure after 5 years of having one on the outside. How will i know for sure? The stinging is now coming from the inside during a bm, which it never did before but this has been going on for a few weeks now since i got constipated! How is an internal fissure cured? can surgery do it the same way as an external fissure?

Idol,
Only a CRS may be able to see your fissure during an exam.
I never saw my fissure. LIS relaxes the internal muscle and will allow the fissure to heal.

hi idol79, ur symptoms are like mine when i had a fissure and then an internal piles. Pls do let ur CRS do a digital exam to ascertain on this. For internal piles, u cld use prep H / horse chestnut cream. I used the latter and it's good.

Good link for hemorrhoids and fissures at the Cleveland Clinic, and there are many links on the form about LIS (lLateral internal sphincterotomy (LIS).
One from Cleveland Clinic on anal fissures, with links to other problems:
http://my.clevelandclinic.org/disorders/anal_fissures/hic_anal_fissures.aspx
Also one just put up under links, from the American Society of Colon and Rectal Surgeons:
http://www.fascrs.org/physicians/education/core_subjects/2008/hemorrhoids_fissure_in_ano/

Thank you guys... does anyone have any idea why im not healing like i used to anymore? and why the pain is there all the time now? after all theese years its suddenly changed!?!

Idol79 wrote:Thank you guys... does anyone have any idea why im not healing like i used to anymore? and why the pain is there all the time now? after all theese years its suddenly changed!?!

You know, I don't know for sure what causes it to eventually stop healing, but it's exactly what happened to me after five years too. I've seen the same thing over and over from different people on these boards. I think that's just the progression of it. Every time you tear and heal you're building scar tissue and the muscle is working itself tighter and tighter with spasms, making it less likely to heal like it did in the past. Try not to worry, it doesn't mean something sinister that it won't heal--but you may have to resort to drastic measures, i.e. surgery.

I think some thinning of the anal mucosa occurs over time, more so after us fissure and hemmy sufferers bombarding our rectums with creams, ointments and eventually surgery, my idea is that once our rectums have been compromised in such a way that the area will never be the same again and will always be prone to tears, you can be as careful as you like but these things are so unpredictable.