Hello there!
I've been browsing around this board for a while and found that it is pretty likely I might have an anal fissure. I'm writing this mainly to vent, but maybe someone recognizes my story and symptoms and can lead me into the proper direction. Thanks a lot if you're reading and reacting.
About 6 months ago, out of the blue, I woke up with a rectal pain, that appeared/seemed to be caused by a hemorrhoid. I had never had them before, or maybe I had them, but not that prominent. The hemorrhoid subsided but the pain, although not as intense, remained.
From this day onwards I have been in the medical mill to find out what caused my problems. I would always have pain sitting and also lying down, no matter in what position. A dull ache; sometimes it would feel like having been on a 15-hour flight. There would be a feeling of constant pressure, some days it would feel like I had to go to the toilet all the time.
I have even visited a physiotherapist but to no avail. A few times the hemorrhoid came back and if they would the first few days would be a living hell.
On one occasion my doctor found a fissure, but I didn't think much about it because I was also having a painful hemorrhoid. I thought I knew how my fissures would feel: that sharp pain during and after having BM, and that'd be the end of it. It would always subside.
I never had much problems with obstipation. My stool is usually pretty normal.
I had an rectosigmoid-scopy this december and they found nothing interesting - an old hemorrhoid and some veins that were likely to swell up.
Lately, since my problems seem to never go fully away (although I have better days), I've been starting to suspect my trouble has always been an anal fissure. Doctors have all failed to spot it though but I doubt they have ever taken a good look since they were so distracted with the hemorrhoid-theory.
These days the pain seems 'on the surface' more than on the inside, I can touch the skin around my anus and it feels painful. I've taken a look in the mirror (which is pretty hard) and I think I can see a very small tear. There's never blood. The pain is managable and dull, but always there and very annoying. It's always on 1 side so there really must be something there causing it.
I've been taking cold sitbaths that seem helpful for a short while.
I know I should go back to the doctor, and I will; but does anybody recognize this pattern of symptoms? Can it be that hard to spot a fissure?
I'm now trying to just live with it and don't let it spoil my life any further, but it's difficult.
Well if you came this far, thanks for reading and maybe I can get some guidance.
And if you're still fighting your AF, best of luck with it.
Andy.

Hi, Andy -
It does sound like you have an AF - and I guess that different people can have different experiences.
I'm fighting an AF recurrence - and I've never had blood with mine, nor the first time I had it (it healed up quickly, only to re-tear this past Oct.). I can't even see my fissure. But I have had MAJOR, AGONIZING pain - both times. My pain level is down - but I know I'm still not healed. --- And like you, my pain is more on one side.
Oh, doctors! One crs (who found my AF the first time) said it was fine this past Oct. -- but my other crs found it in Oct. So, go figure. How can one doctor see it, but the other doctor didn't?
Watch your diet - make sure it's the best it can be. I'm doing that, plus taking supplements and stool softeners. Still, I'm in discomfort. So, these things can be absolute devils to deal with.
Hang in there - that's what we're all trying to do!

Thanks a lot for your reply. I think I'm going back to my doctor and really ask him to take a good look for any AF's.
I've used some isosorbide dinitrate-cream a few months ago and it seemed to help a little, especially because it seemed to cool the place down a bit.
I'm watching my diet although it could definitely be better. I like going out with friends and drink and I enjoy spicy food. Once again it doesn't seem to influence my stools; they're usually more on the soft side than hard.

YW, Andy - We're all in this misery together here.
IMO, diet/fiber/supplements/stool softeners are so important. --- Boy, I don't know about spicy foods . . . my bottom would never let me get away with that.
I'm really watching what I eat, because I've wanted the area to heal (hasn't yet - but I see my crs in two days) - plus, the good thing is that I've cut all the junk out of my diet. At least that's better, even if I'm still suffering.
So, think about your diet -- a person's diet is usually one of the culprits when there's an AF.

Hey Andy sorry your having troubles. It definately sounds like you are fissure problems. Spasms can make you feel exactly how you are feeling. Not seeing any blood is common as well. Mine didn't bleed for months. I don't know if you are seeing a CRS, but that's the way you want to go. GP's miss fissures all the time and chalk them up to hemorrhoids, which a lot of the time go hand in hand. I would start some Miralax for sure, drink lots of water and incorporate lots of high fiber foods to your diet. Watch the spicy food, and nothing sharp or hard to poop like chips, peanuts. Hope you feel better soon. Oh yeah, stay out of the cold water!!! take a warm bath for like 20 minutes and just soak. Ice packs are ok but don't apply it directly to the skin, wrap it in a towel.

Thanks for the advice. I'm going to get myself a CRS.
I'll stay away from the cold water and try some warm water next times. The cold always felt nice, probably for its painkilling/surpressing effects.
I doubt I'll need a laxative though. Like I said, I'm seldomly constipated and I don't want to make things too thin if you know what I mean..

Maybe I should add that I have NEVER had any pain while having a BM. This is one of the reasons I myself, and doctors too, were telling me it's unlikely I have a fissure.

I had no pain either, not while going. In the very beginning I felt like I was pooping razors but then that went away and the spasms started. I would not have any pain from the BM, but 1/2 hour to 45 minutes later the spasms would kick in. It was horrible they would last most of the day and working all day was rough, but I did it for a few years. Could not deal with it, I was tired of it consuming my life and I had LIS and I can tell you I would do it again in a second. It totally gave me my life back!!!

By spasms do you mean this dull, aching, pressure-like feeling? I've never had a sharp pain during the day.

andy - I'm pretty sure I have spasms, and it causes my anal area to burn. I also feel the dull, aching, pressure stuff.