I went to see my CRS (actually he is a general surgeon who does colorectal surgery) today and it was probably a mistake. As usual he was very rough and probably did more harm than good. He told me that he can always see fissures by just spreading the cheaks apart because fissures are always just on the inside of the rectum. He did his exam and saw nothing and then proceeded to do the finger exam and then use an anoscope. He said that everything looked fine, but I absoultely do not feel fine. I feel the sharp pain of a fissure and I have been told my old CRS that my fissure is further in the rectum. What are your experiences with diagnosing fissures? Are they usually visible without the need for an internal exam?

My fissure was just barely inside the rectum. I never saw it but my CRS had to barely open things up to see it. It was inside but didn't require a full finger exam.
Was it painful when you had the exam? I was told by a CRS that they usually are pretty sure there's a fissure when the patients can't tolerate the exam. I guess I could have if I would have had too, but just her barley looking inside had me in tears....

Hi MM92599,
My CRS never did an internal exam because he said I wouldn't be able to tolerate it. He said he only saw scar tissue on the outside, and noted that I had two healed fissures, one anterior. So, yes, he was able to tell that there were fissures without an internal exam.

My CRS initially diagnosed me with an AF by simply pulling the butt cheeks apart which was uncomfortable, but nothing like the pain from an anuscope is (especially with an active fissure). I think if the tear is close to the opening, it is much easier to see (obviously). If it is further upwards, an internal exam might be necessary.