I agree with momof7. My GP did a few internal exams (finger & with a small telescope) which luckily at the time did not cause me pain. But once I was referred to see a specialist, my condition deteriorated massively within the "4 month" wait and I was rushed to see the CRS (I was willing to get a private appointment just to move things along as the NHS lists in my area were humongous and I hadn't even had a 1st appointment letter or an apology letter for such a long wait 4 MONTHS!).
Once in to see him, I explained how chronic the pain was and he did a quick visual exam (he explained his thinking out loud with a Jr Doctor there too) and said there was a skin tag - which is indicative of anal fissures and did not want to do an internal exam. I was then scheduled for an EUA (exam under anaesthetic) where he would have a proper look and decide at the time what to do, which ultimately came down to a Sigmoidoscopy, double fissurectomy, skin tag removal and Botox.
So in my advice as momof7 suggests, be honest with your CRS, I'm sure they'll see the pain in your eyes if you tell them. They're there to help, not to cause you pain. They're specialists in this area and see this day in and day out. GPs on the other hand need to see exactly what's going on in order to diagnose as best they can (Jack of all trades, master of none).
Hope this helps
Welsh x

Finally, I got to see a CRS in a hospital in Reading today. The doctor is a 'registrar', not a consultant - does it mean that she is still training to be a specialist? Actually, on her tag it says 'general surgeon' so maybe she is not specialised in colorectal surgery!
So anyways, it wasn't a good experience. She was very kind and patient when talking to me, but unfortunately her handling wasn't so gentle. First she did a digital examination, which was okay.. but when she used the protoscope, she was kind of forcing it in the wrong angle, so it was quite painful, and I bled
Since my original post in June, even though I have been having pain, it was gradually getting better, and I had not bled for months now, until TODAY! :(
Anyway, she only said that I have a small hem and a fissure. she will also arrange a colonoscopy for me, since I also have persistent abdominal pain, but I am worried that it will make the fissure worse (esp. after her rough handling today)!
I also wonder why I bleed so easily! and why can't I relax..
I just hope that the damage done today won't be worse than my original fissure.
She gave me another course of Rectogesic for that...
I should have read this post thread again before I went for my appointment today!!!!
I haven't been here for ages!!!