Hello there-
I went to see a general surgeon I was referred to by my primary care doctor to get a better diagnosis (he only saw hemorrhoids and couldn't see under my tag, unfortunately his anoscope probably helped the surgeon see because I came away from there bleeding).
She bent me over this strange table where my butt was in the air after asking me a few questions. She looked around a bit and she said she wasn't even going to use the anoscope (THANK GOD!) because she could see I had a fissure and a lot of irritation.
First, she scared the crap out of me because she said that she needed to remove the tag (eeek!) and that while she was there she would cut my sphincter so that it would help the fissure heal.... at this point I was seriously freaking out because there was no way I was going to go for surgery before trying other methods.
She said that she really needed to biopsy the tag because it was a bit hard and irregular but it could be from the length of time I have had problems. While this particular fissure episode has been going on for about 2 months, I know now that some of the issues I have had over the past few years were fissures and not hemorrhoids.
I told her to go ahead with the biopsy, but no way to surgery. She agreed to prescribe nitroglycerin ointment and see how it works. I am just waiting for the pharmacy to call me when they have it ready, because they have to make it.
While I am glad for the biopsy just to know for sure that all I am dealing with is fissures, I am now scared about my tag.... are everyone's tags soft?

Hello butthurt,
I'm sorry you're going through this... I'm in a similar situation with a fissure and I also have a tag, but mine isn't that hard. I'd call it soft, but it isn't like loose skin, it's more like a softish wart. My CRS told me that since the tag isn't large and isn't bothering me, it's not a good idea to remove it. The tag generally means that your fissure is chronic but could be healing. I never used Nitro, but headaches can be a side effect... Maybe the doctor could instead prescribe Diltiazem/Nifedipine instead?

If you will drink at least 8 oz. of water before you apply the nitroglycerin, it will really help you from getting a headache. I had a fissure and it was healing itself with the nitroglycerin, fiber diet, LOTS of water (at least 64 oz. a day), metamucil, miralax, and sitting in a tub of warm (not hot) water. Try it before surgery, and give it weeks!
Sadly, I had an abscess emerge that burst which caused a fistula. So, I ended up having surgery after all. But now I'm 2 weeks post surgery, doing great, and glad I had it done.
Good luck and keep us posted!!!

Thanks for the nitro tips. I will definitely try the water beforehand. I already have the prescription filled so I will go ahead and try it.
Looking back I know that I have had many fissures over the years. They have always healed on their own but seeing my tag it has left behind damage.
My regimen is to take a lot of baths, avoid hot spicy foods (I love hot stuff and just recently realized this makes me hurt more), avoid hard foods like chips and nuts, chew everything extra so that everything is smooth coming out, I don't take any laxatives because my stool is normally like soft serve ice cream with random bouts of constipation due to IBS (which is what causes the fissures unfortunately).
I wish I would have known that she wasn't going to scope my butt, because those enemas irritated me :(