Hello I am new here but not new to anal fissures!! I've had them for years but was only diagnosed with one 7 years ago. Anyway (what a lovely topic!) they come and go and I use creams, try to keep my stools soft, lean forward when having a BM and have sitz baths when I need. However, my jobs requires me to sit for long periods of the day and I sit on a cushon with a hole in the middle as my legs and bottom become painful and I try to walk at lunchtime to relieve the pain and also increase the blood flow to any fissure I might have. To get to the point, I may be painfree(ish) with a BM and it may be soft and I feel no pain afterwards but after sitting at my desk for a couple of hours I feel pain in my bottom. I am a bit anal (pardon the pun) about it in that I check when I get home to see if I have a fissure or tear and most of the time I don't have one. I think they could possibly be further inside where it is too difficult to see but I have noticed and I don't know if this is normal or not but if laying on your back, at 6 o'clock inside the anus what looks like a red line going all the way back. It isn't bleeding and I rarely have any blood when passing a stool. Is this normal? If not what is it? Could it be causing the pain when sitting for so long? I went to the doctors in September 2011 and she could see nothing (although I didn't mention the red line because it is very obvious it is there and so thought it must be normal because she said she couldn't see anything). I don't know how long it has been there at least 7 months but could be for much much longer. So I was thinking if it's that obvious surely it would bleed or I'd have more pain when I pass a stool, unless it is perfectly normal. It feels a bit more comfortable when standing. When I get up in the morning it's great, no pain, feels fine it's as if the ache of sitting all day has gone so I just want to put my mind at rest really.
Thank you.

I have been diagnosed with a fissure, but I never have any blood with a bowel movement. In fact, I don't even have any pain during a bowel movement unless the bowel movement is unusually hard. My pain starts following a bowel movement when the spasms start and lasts several hours. The pain you are feeling may be the spasm caused by the fissure.
My recommendation would be to go to a colorectal surgeon (CRS), NOT a family doctor. You want to go to someone that deals with anal issues all day, every day.
A fissure can be hard to see, even for a trained doctor. But if you do have a fissure, there are medications that your doctor can prescribe to help it heal. I am currently on Nifedipine. I also take Miralax daily to keep my stool soft, get lots of fiber (including fiber supplements) and drink lots and lots of water.
Good luck!

The spasms from a fissure can start hours after a bm. In my experience the worse the fissure is the sooner the painful spasms start. When the fissure is almost healed the spasm starts way later. Mine do start by just sitting around while I didn't notice it when I was up and about.

I'd have to agree with both of the above comments. I've had the spasms start anywhere from immediately after a bowel movement to an hour afterward. Generally, they could go on for three to five or more hours, during which time, there was no comfortable position in which to stand, sit or lie down.
This last time, because the pain got so bad that I held myself for four days, I went to an immediate care facility (kind of like a mini ER). The doctor there diagnosed me as having internal hemmies and prescribed Hydrocortisone suppositories and Norco for the pain. With things as bad as ever after the pain killers ran out, I went to my primary care physician. He said that I had a fissure, but ended up giving me too high a strength of Nitro ointment. Finally, I went to the CRS. He took one look, said "Oh my," and we scheduled an LIS (Lateral Internal Sphinctorotomy). That was almost three weeks ago and I am feeling so much better.
If you suspect a fissure, don't trust it to anyone but a CRS.
Rob

miss uk,
I've had 3 doctors 'not see' my fissure. All GPs. I thought it was a hemorrhoid, and so did they.
Took going to a CRS to get the kinda help I needed.
The only time I had the courage to look at it, I saw a thin red line.
Anyways, I agree that seeing a CRS would be a good idea.
Feel better soon!
-Tanya