I'm beginning to suspect I have a fissure, in addition to internal hemorrhoids, a pilonidal sinus, and pelvic floor dysfunction (although this latter one could really be a fissure I think).
How are fissures normally diagnozed? I've had external examinations, rectal exams and a sigmoidoscopy, which revealed the above problems, but not a fissure. Yet I have found that treatments for my existing problems have not solved my woes, and my symptoms seem to match a lot with what people on here describe.
I wake up, and know that my morning BM will dictate how I feel for the day. It if goes well, I feel OK. It it doesn't, I get a burning, puckered feeling in my anus/rectum all day, sometimes also a feeling of incomplete evacuation. More rarely, I get actual incomplete evacuation because things don't seem to function quite right down there (but this is very rare).
Soft BMs of good volume generally make for a good day, hard BMs or small BMs make for a bad day. My diet totally revolves around controlling this problem, as does my daily routine.
Could it be a fissure?