Suffering with Anal Fissure for 2 years - Help!

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Suffering with Anal Fissure for 2 years - Help!

Postby rearfire » 17 May 2012, 08:24

Hi..
Male, 36 years of age here. Two years ago, I had little bleeding and pain in my anus. When my gastroentrologist took Colonoscopy, he diagnosed me with anal fissure. The laxatives and ointments din't help much.
Exactly after 3 months after I was diagnosed with anal fissure, I started getting pain in left leg, and somewhere between left inguinal (groin region), the place where leg joins with the pelvis. I checked with several specialists thinking it is something else - urologists ruled out any STDs after several tests. I also went to Spine specialists, Pelvic pain chiropractors, and the neurologists ruled out nerve impingement, etc after different MRIs.
Since the pain in left leg and groin region started only after I was diagnosed for anal fissure, I visited my gastroentrologist recently to tell him about all these strange pains in my leg and groin. He examined me again with finger insertion this time, telling I have some cut in the anal opening, and he can feel a small gutter little inside. He told me, this is causing the constant radiating pain in my leg and groin. He continued telling me that I need to under go a surgery for the anal fissure, so that all these strange pains will stop.
My questions -
1. Can this 2 years of anal fissure is really causing the constant radiating pain in leg and somewhere around groin region?
2. Can the gastroentrologist feel the wound with finger insertion in the anus? Or do I need one more colonoscopy?
3. Will a surgery for anal fissure help me?
I'm very much frustrated and baffled. Please share your suggestions and thoughts.
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Re: Suffering with Anal Fissure for 2 years - Help!

Postby jr2 » 17 May 2012, 10:35

You really want to be seen by a colorectal surgeon who can give you a much better idea of what is going on with you. Pain is a complex thing and it is entirely possible your fissure pain is causing nerves to fire and send radiating pain signals into your groin and leg. Of course, it could also have nothing to do with your fissure. Fissures generally cannot be felt with a finger unless they are very large ulcerations and if you had one big enough to feel with a finger it is highly suspect that this exam wouldn't have caused you excruciating pain. There isn't any way to know if surgery will help you until you've been seen by a surgeon. Another colonoscopy really isn't needed. If the surgeon needs to see your fissure better he or she can use an anoscope that looks just at the anal canal only. Most fissures can be diagnosed by visual inspection alone, but if need be the surgeon can use an anoscope, and if need be can perform this exam under anesthesia to make it more comfortable for you.
Good luck! I hope you find some answers soon!
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Re: Suffering with Anal Fissure for 2 years - Help!

Postby rearfire » 17 May 2012, 20:22

jr2, Thanks for your reply.
I understand your answer is both yes and no?
As you said fissures can't be felt with hand, but what the doctor said was he can feel some gutter on the side of the wall which is making me worried a bit.
Though the pain in left leg and left groin are the symptoms of classic CPPS/Prostatitis, my urologists said I don't have it, saying I don't have the main symptoms of frequency in urination, etc which are very normal.
I searched for "anal fissure and groin pain" in google, and found several links. Here is one such link which says anal fissure is one of the cause which can trigger CPP/Prostatitis.
It is not letting me paste the link.. you can search for "chronic-pelvic-pain-in-men-discharge-care.html".
Should I take a second opinion with a different gastroentrologist to see if surgery is really need, and will it cure my chronic pain?
Will a surgery relax the levator and sphincter muscles?
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Re: Suffering with Anal Fissure for 2 years - Help!

Postby jr2 » 17 May 2012, 21:58

Tough to know what exactly your doctor is feeling when he uses the term gutter. Could be any number of things, could just be the way your normal anal physiology is set up, could be a hemorrhoid, etc. I looked up the link you wanted to paste, and since you've been checked out by a urologist already I still think your best next check is with a colorectal surgeon. It is a bit odd that your leg and groin pain did not begin until 3 months after your diagnosis of anal fissure, but it is possible that as your fissure became chronic it caused muscle spasms and as a consequence led to some pelvic floor problems which may include the levator ani and/or PC muscle. Your best bet is to get a check by a CRS so that you can get some more definitive information about your fissure situation and what this "gutter" might be. Surgery for a fissure will not do anything about any problems with the levator ani or the PC muscle, but it is possible that if you have a spasming internal anal sphincter that is causing a sort of cascade spasming effect with other muscles in your pelvic floor that surgery could be of some help. Generally speaking, however, levator syndrome is considered something separate from the internal anal sphincter spasms that accompany a fissure. If it were me, I would start with a colorectal surgeon and take things from there depending on what he or she says.
Hope that helps a little. These things can be really tough to get figured out and sometimes requires multiple trips to multiple specialists to get it all sorted through.
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Re: Suffering with Anal Fissure for 2 years - Help!

Postby rearfire » 18 May 2012, 02:46

Right jr2. Even I'm bit confused with the term "gutter" he used. He showed some charts hanging in the wall of his office, pointing to some places in the anus, saying, he has seen several cases of people with weird pains in different parts of the body mainly after diagnosed with anal fissure.
Though I said I have groin pain and leg pain after 3 months, they must have must started before, but was not manifested, and I was primarily focused on the anal fissure pain. Once the anal fissure reduced, I started to feel the groin and leg pain.
I lost proper sleep in these 2 years, continuously thinking why none of these specialists are able to diagnose my pains and give a concrete solution. I have become like a "throw" ball between various specialists, wasting my time and energy, which makes me physically and mentally weak.
I will go for a different colon specialist to take his opinion. I will keep posted on what he says.
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Re: Suffering with Anal Fissure for 2 years - Help!

Postby rearfire » 18 May 2012, 08:38

I'm just back after visiting the other gastroentrology (who is also a colorectal surgeon) doctor for his opinion.
This doctor again did a finger insertion in the rear, and said he couldn't feel any fissure, and don't see any "gutter" as mentioned by the previous doctor.
The new doctor is also telling me that surgery may not be required, and they cause various post surgery side effects.
He continued saying "chronic" anal fissure cause groin pain, however asking me to go for another colonoscopy/anoscopy for a new diagnosis of my anus/rectum.
He is thinking about the pain could be any one of these -
Chronic anal fissure
Proctalgia Fugax
He has asked me to come for a colonscopy in the next few days. However, as I'm taking Stelbid and Oxerute ointment, I'm not having anal pain for the last few days.
Do we need to take colonscopy/anoscopy only when there is pain in the anus? I'm having doubt whether it will show up the fissure when I'm pain free and on medication?
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Re: Suffering with Anal Fissure for 2 years - Help!

Postby jr2 » 18 May 2012, 14:14

Of course, im not a doctor, but if you aren't having anal pain, it doesn't seem very likely that your leg and groin pain are due to a fissure or even proctalgia fugax, both of which cause anorectal pain as first symptoms. It is sounding more like some kind of pelvic floor dysfunction.
If it were me, I would probably agree to anoscopy to check out the fissure situation because if the doctor does not find an active fissure he can't just keep telling you that your pain is due to a fissure. It's up to you to decide how comfortable you are with doing a full bowel cleanse for a colonoscopy as this could put your fissure at risk for further tearing and irritation.
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