I've been diagnosed with an anal fissure 40 days ago, although had two retears during that period.
I'm taking nifedepine 0.2% and fiber diet, and it seems working (I messed up with with retearing because of exercising), I don't know what will happen but it seems the fissure itself is healing, I'll wait few more weeks.
The thing that worries me is that I started to feel (After the 1st retear) a 'thing' on my outside skin and I'm wondering if its a fistula. I do feel a tunnel like 'bump' in my anal area, yet no pain coming from it, pus or anything. It is irritated a little bit after BMs but really nothing serious yet.
Is it a fistule ? Is it an anaomly that will go away ? How can I know ? Are there any caution measurments I can do to make things better?
I became optimistic about the fissure but now I fear I have a fistule which means 100% surgery right ?
Any help will be great.

Don't panic yet! It may be a sentinal pile.
" Chronic fissures often have a small external lump associated with the tear called a sentinel pile or skin tag." Lots of us have them. They feel and look strange but are harmless.
http://www.fascrs.org/patients/conditions/anal_fissure/
This is an outstanding article ( and site) for anyone here, and shows a pic of a sentinal pile.
Of course only your Dr can give you a diagnosis.
But information never hurts!

I had a fissure that healed as a superficial fistula. If you have a fistula, the only way to find out for sure is to have a colorectal surgeon (CRS) take a look at it. Depending on how uncomfortable you feel, a CRS may have to perform an inspection under anesthesia (EUA). If it is a superficial fistula, the surgery is a breeze. All the CRS has to do is "deroof" the fistula. The entire procedure (not including the anesthia) takes only a few minutes. According to my CRS, a fistula will not ever heal on its own.

Hi,
Great to hear you are doing so well with the fissure :)
Having suffered a fistula myself, the lump you describe does not sound like a fistula to me especially in light of the fact you have no accompanying bleeding/ pussing/ pain/ itching etc. Have to agree with AussieMom that it sounds more like a skin tag if it's not bothering you in anyway other than just "being there and in the way of BM's" but as ever, if you are scared about it, just go back to your GP. They should definately be able to confirm a simple skin tag and help put your mind at rest.

Thanks for all the comments, I do hope my fissure improves and won't retear this time.
Can a skin tag be internal but felt externally?
The lump i'm feeling is if like there is something inside the skin when causes it to 'bump', and it's tunnel shaped thats why I fear its a fistula. Can it just be a swelling of the underskin because of the fissure itself ?
Did you feel pain with your superficial fistula? or any other symptom ? How did you know there was still something wrong ? How long the recovery of a superficial fistula take ? From other topics I heard the fistula surgery recovery takes one to three months.
When do you guys think I should go back to my doctor ? Can I wait few more weeks to see what happens with my fissure ?
Thanks in advance once again.

Hiya,
It's really hard to say if you have a fistula or not and I would say push for an appointment sooner than later to get it checked out. Is the new "lump" very close to the fissure site? My fistula developed on the opposite side to the original fissure and initially, it wasn't any trouble. It was when it developed a sort of "hole" in it that started to pus on & off when it became obvious. Even up to then it caused a lot of confusion with GP's diagnosing it a pilonidol sinus/ cyst etc etc. The CRS confirmed it immediately.
It never caused as much pain as the fissure, which to date, has been the most painful thing in my life I think!
It was only troublesome when it was inflamed and once it started pussing, felt OK again.
Classic fistula symptoms tend to be a lump with soreness, itching, pain, pus discharge, sometimes a with foul smell, fever, chills, feeling rubbish but you may not exhibit all those symptoms. If it is a fistula, they are not all that awful to deal with but they do need to be surgically dealt with to get rid of them.
The op is simple, straight forward, lasts about 20 minutes and fistula recovery rates are very good and generally successful. You are right in thinking that the average time is about 3 months, but sometimes & depending on the state of the fistula, it can take a few months for complete healing.
If it is a fistula, there really is nothing to get really worried about as they can be easily treated.
If I were you, I would go back to my GP/ CRS as soon as I could just to get some reassurance on it all. It could be alternatively absolutely nothing to worry about though! But at least if you have it checked, you will know rather than worry and self-diagnose (which I am great at doing!!!)
If the fissure isn't troubling you and feels better - Great! I wouldn't worry too much about it but I would suggest you keep up all the good work you've been doing with your diet and BM's in the meantime so as not to risk a retear. :)

I was diagnosed with a fissure about 2 months back..was feeling better then went for a follow up appointment at the 1 month point and doctor re ripped it during examination and had to start over healing from square 1..now almost a month from the follow up im feeling better again not totally healed but starting to sit down again and walking without a burning sensation and bowel movement are barely hurting.. about a week ago i notice a "welt" on the bottom of my left butt cheek like on the groove of the curve of the bottom of the cheek hope that made sense..ts pretty far from the anus (at least 2 inches) almost closer to the center of my butt cheek but right in the groove curve at the bottom..its like oval shaped running along the curve..its not really too sore to touch but i feel like im starting to feel it a little when i walk..its not red..and its not hard..very weird..could it be a fitsula? or just be coincidence and its a pimple or boil from all the stress and i do outside work ? anyone have any advice or answers would be greatly appreciated..thank you!