The classic triad of chronic anal fissure

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The classic triad of chronic anal fissure

Postby bottice » 27 Aug 2019, 06:23

So I have been doing some reading on anal fissure and I found something that caught my attention.

When your fissure turns into a chronic fissure, you could likely have the classic triad. The triad being the fissure itself, the sentinel pile(or skin tag), and a hypertrophied anal papillae(or anal papilla). I know about the skin tag and the fissure but the anal papilla was new to me. It's like the sentinel pile but it's in the opposite direction. When I first noticed I had a problem in my anus I thought it was hemorrhoids,but then I went to a doctor and he said it was a fissure. So I had to rethink what I had and I think I might have a anal papilla. Some time later I felt a sharp pain near the outer edge of my anus and I think that is the skin tag.
At this point I already have had this fissure for 3 years now. So I'm pretty sure I got the classic triad already.

Has anyone else heard of this before?
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Re: The classic triad of chronic anal fissure

Postby Fissurefrustration » 27 Aug 2019, 15:21

Yes I have, my colorectal surgeon told me about it. Sometimes it rears it’s ugly head and causes so much bother and it’s hard to tell which of the 3 are playing up. There’s a 4th dimension too which is the scar tissue which never stretches or fully repairs itself back to what it was
Suffering since June 2013 :(

Methods tried:
Sitz Baths
GTN cream - awful migraines!
Manuka Honey / Coconut oil / Aloe
Vitamin E suppositories
Tablets (Fiber, Cod liver oil with vit A+D, Multi vits)my + tag excision X 2
Dilatiazem - so far so good.
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Re: The classic triad of chronic anal fissure

Postby chachacha » 27 Aug 2019, 19:12

I knew I had the fissure and tag, and when I had a flexible sigmoidoscopy, my surgeon showed me the papilla on the screen. I think that most people have all three and also know that they do. FF has a good point to add the scar tissue issue, because that also causes some people a lot of grief.
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
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Re: The classic triad of chronic anal fissure

Postby TomatoSoup » 29 Aug 2019, 14:03

Yes I had all three of these things. The sentinel pile was what got me to keep going to doctors since I just had this weird lumpy thing on the outside that worried me. I ended up getting LIS and the surgeon removed the tag and informed me that I also had the papillae thing once he got inside. He said he did something for it but I can't remember.
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