I also had the 'sphincter is not tight I can get my finger in' conversation. And I had been told that there was a fissure about a week before and he said that he could not find one. Felt like saying, well what is ALL THE PAIN ABOUT THEN!!!!! But I didn't, I was too busy crying with the pain of the anoscope that he inserted with nothing to numb it.

Hi Savaici,
That's exactly what he said to me! He said if you had a fissure, I would not be able to insert my finger in.
Ok maybe it's not that tight.
But what explains the not being able to pass wind silently? This clearly means there is tightness.
How were you diagnosed, if he couldn't find anything? Was it another CRS who diagnosed it?

Also, will a colonoscopy definitely find a fissure?

I would think so, reckless - but I would think that, just for the purposes of finding an AF, a colonoscopy would be a bit drastic of a step.
However, if you're of the age where a routine colonoscopy is recommended, then it wouldn't hurt to have one.

I wonder how a colonoscopy, or any scopy, could find a fissure? Isn't a fissure usually outside the anal canal?

Is it possible for a fissure to be missed using an anoscope?

Andy - do you mean so that an AF would be visible? - because I can't see mine.

I mean why would a doctor need a scope inside the anal canal to spot an AF? I thought they are always located on the outside.

Well, I'm not quite sure about the anatomy down there - but I've never been able to see my AF, even though it's probably not too far from the bottom end.
Plus, if there are hemorrhoids involved, that might make the AF harder to see.
As far as the scope goes, I think the crs uses that, just as part of the exam down there, to take a thorough look.
Really, the whole process fills me with anxiety. I've got to face it tomorrow again, too . . .

Well he used an anoscope on me and didn't find anything suspect according to him.