I've spent many hours trawling the net to try to find out what the source of my anal/rectal discomfort is. My main problems are a feeling of tightness/pressure in the anus/rectum, a feeling of incomplete evacuation (often though not always), a feeling of prolapse, and very rarely minor, fresh bleeding. My rectum gets a very strange feeling of being bruised all round if my bowel movement is hard at all.

I've been diagnosed and treated for a pilonidal sinus (standard excision, repeated a couple of times over the last two years with limited success) and internal hemorrhoids (banding, about 3 weeks ago - recovery has been straightforward). I've also had a first appointment with a physiotherapist to look into various muscle-related pelvic problems (levator ani syndrome, chronic pelvic pain syndrome, pudendal neuralgia, mucosal prolapse, etc).

However, I recently read online that fissures can be often misdiagnosed as hemorrhoids. Is this correct? I've had digital rectal exams, a sigmoidoscopy, and a rectal exam under anasthesia. A fissure was never mentioned, however I'm wondering if I could have a chronic fissure that has been missed? Although my bowel movements rarely sting, I often notice a stinging sensatation around the anus if I pull my cheeks apart to clean my pilonidal wound, and sometimes randomly when just walking about. Could this be a chronic fissure? I am convined that due to stress and OCD etc, I have chronically tight and spasmis rectal muscles and I know high sphincter resting pressure is related to fissures. Such a symptom does not seem to fit with what I have already been diagnosed with.

Is it possible I should look into exploring the fissure line of thought?

I have had hemos many times and i have never heard a doctor or anyone else mention fissures as a cause of anal pain. But for me fissure pain and feeling is different from hemorroids. So you should mention the doctor to look for fissure. That is my humble opinion.

Johnno,

How are you feeling? Did you ever have any problems with urination such as frequency, urgency, constant feeling of needing to go?