Hello all! Thanks for taking the time to read my post!

I am a 25-year-old grad student and I have had recurring, chronic anal fissures and (internal & external) hemorrhoids since I was 18 (when I was diagnosed with irritable bowel syndrome).

I had surgery to correct the anal fissure, but here I am again! I have done everything right: gotten my IBS and (I think) ovarian cysts under control. Currently, my only symptoms along with my current, chronic anal fissure is bleeding and pain with bowl movements, intercourse, and long periods of sitting. Not to get too graphic, but my partner also raised a concern of feeling like there was some sort of mass in my vagina, and I find inserting tampons to be nearly impossible (could this be related to my internal hemorrhoids at all?).

Questions:
1. Is it normal for vaginal intercourse to bother an anal fissure/hemorrhoids?
Any ideas on how to avoid this?
2. What should I tell which specialist?
(I see a gynecologist and anal surgeon, but they are both very busy and don't want to hear my life story).
3. What can my recurring anal fissures mean?
I am scared to death, but my anal surgeon said I will likely need a colonoscopy to rule out IBD and colon/rectal cancer. Are these real possibilities, given my case? Is there anything that's more likely?

Hi collegelady2015 and welcome;

You know, you raise some interesting ?'s and we will try to answer them
best we can. I'll focus on your 3rd ? whats causing your recurring fissures.
Some people may assume that their fissure can become cancerous if it keeps
comimg back.

If that were the case I would have probably been long dead about now as I went
through years of recurring fissures. Now In your case with IBS experts say that it
also does not increase risk of developing colorectal cancer. The recurrences may
simply be due to your IBS and once you get that under control you may beat the
recurs.

My recurrences were due to diet and possibly some IBS type symptoms (never tested)
but I beat my recurs through diet alone going on three years now fissure free.

Yes, with IBD the two "monsters" of Ulcerative Colitis and Crohn's may indeed increase
your chances of getting colon cancer. But your IBS is totally different and will not lead
to cancer as you'll see from just one of many sources I found.......

click here.
http://www.netdoctor.co.uk/ate/digestiv ... 01997.html
and here
http://www.ibsgroup.org/forums/topic/42 ... or-crohns/

So I would not be too concerned if I were you, besides, your just giving your
digestion a little more trouble with the stress of worrying. Good luck on your
Colonoscopy. I'll let others answer your other ?'ns.

P.S. Keep your stools soft....

Hi Collegelady,
Sorry to read you have so much going on right now. It's not easy to deal with a fissure at the best of times, but when compounded with other issues, it must be a real headache for you, and more so, when they continue to recur.
Whilst both anal fissures & ovarian cysts are different issues, there may be a slight cross-over with these. I'm speaking with some experience having suffered a fissure with endometriosis & ovarian cysts and whilst the fissure has healed, I'm now facing treatment again for the gyno stuff!
Vaginal intercourse can certainly be painful if you have a developed cyst and it may cause some discomfort to an acute fissure too but it doesn't directly affect it if your positioning is "anal" friendly (that is, the pressure is not on your bottom at all - so woman on top is best at such times!)......In the height of my fissure pain, intercourse was never directly incredibly painful from the fissure itself - it was more a case of finding a position comfortable enough to avoid any pressure to the fissure area and to be honest, I rarely felt up to it! - because the stress of the situation did not actually do anything for my sex drive at such times. Intercourse has never bothered my hems in the slightest though!....
Here, I would definitely approach your gynecologist because vaginal pain, in my opinion, is far more likely to be related to the gyno issues and not the fissure (although sometimes it is possible to feel some generalised pain/ discomfort from the fissure in other areas because it's all so close together down there!)
Inserting tampons has become increasingly more difficult for me recently and I think this is due to the resurfacing of old gyno problems. I also feel like I have some "mass" within my womb area and going to the toilet sometimes, I feel like I have pressure within my abdomen in terms of both peeing & pooping! This will be true in my case if an undetected cyst or endometriosis is found again (looking highly likely after recent blood test results) so I guess, I really would urge you to have your initial chat with your gynecologist regarding your mass sensation & painful intercourse and just give yourself the complete all clear that everything has cleared up with that side of things.
Most of the other things you describe, such as the pain & bleeding with the BMs, uncomfortable sitting etc. sounds far more than likely to be related to your fissure - but it really would be a good idea to just mention all issues to them both.
There's no harm in focusing on the things you feel are really important to the gynecologist but then just to pop in a "By-the-way"...........& mention some of the other things briefly........Likewise, the other way round too with the CRS - Just mention you have had gynecological issues and whether the fissure would have any effect on them at all.......
Unfortunately fissures can recur and for some people it might be a trigger of underlying issues (such as Chrons or other inflammatory issues) but for others, it's a case of slipping back into old bad toilet habits/ dehydration/ poor diets or it could be that previous trauma and history to that area could make you more susceptible to a re-tear.
Try not to scare yourself too much - A colonoscopy will help rule out some of the others issues & it's quite possible you have none of them anyway.....Colon/ rectal cancer is very rare and I've never come across anyone on this site that has been diagnosed, so I really would try to put that out of your mind.
I would recommend however you strongly have a good chat with both your medics for each of the different issues in turn because you definitely need some more reassurance for your fears in both areas. Once you are able to rule out certain things, you will feel a lot better just being able to focus on the issue(s) at heart, deal with them & move on.
Take care and wishing you all the very best in getting yourself well & eliminating all that horrible fear......

Thank you all for the insight! You are all so helpful and comforting! I'll keep you updated after I visit the CRS this Thursday!

So I'm going for my first colonoscopy Nov 4. The CRS said his office would call me beforehand and explain everything, so at this point, I know nothing.

What can I expect? Does it hurt afterwards for those with fissures?

Hey Collegelady! I am close to your age, so you aren't alone! I was really disappointed to have my first colonoscopy 25 years before most of my friends, but it wasn't all that bad.

Usually, the day before, you'll have to do a bowel prep. I recommend taking the day off, as you'll need to be on a clear liquid diet all of that day (jellos, water, Sprite, see-through Gatorades, broth, etc.). Then, usually in the late afternoon/early evening, you'll start the bowel prep. For some folks this is a drink (Colyte, for example).
The worst part, to be honest, is the prep. I am very sensitive, gag reflex-wise, to taking in liquids at a fast pace, so I was nervous about doing the Colyte so many times an hour, but I had no problems. In fact, I finished ahead of time! :-)
Then, you use the bathroom for many, many times for a long time that evening. Just camp out in the bathroom with some good reads or a laptop with a movie or something. Don't stray away from a bathroom. Basically, you'll clean your bowels out before the procedure.

The next morning, you go in and wait to go into a room. For me, they brought me into a room to do all my basics - weight, blood pressure, etc. I was the youngest person in the room by at least 40 years... :-) But, I was probably the healthiest getting the procedure done, which made me feel a bit more comfortable.

After they do all this, they then rolled me into a special procedure room. I had my GI doctor, an anesthesiologist and a nurse. The last thing I remember is them all introducing themselves, and then I was out. I woke up in a completely different room and the nurse gave me some juice and crackers. The doctor came in to follow up with me, and I went home about 15 minutes after waking up.

I ate some food when I got home, no pain, and took a nap to sleep off the anesthesia. They recommend you don't resume any other activities that day. I had some minor discomfort the following day, but nothing terribly bad, and they had removed a polyp during the colonoscopy for some testing (it came back fine). Also, the pain wasn't near the fissure site - it was higher up. I don't remember the fissure being any worse after that than it already was.

It's really not that bad, so I wouldn't fret it too much. Good luck!

I didn't have any pain from my colonoscopy - not during the cleanse nor during or after the procedure.
I was really worried because they said don't take any ibuprofen for three days before, and at that time I was living on ibuprofen for my fissure pain. So the days before the cleanse were bad, but the cleanse itself was fine because all my BMs were liquid.
I wish you all the best!

Don't have much to add..... But good luck for the 4th.
Keep asking those questions and getting support in the mean time.... That's what we're here for.

OMB x

Hi all! Thanks again for all your help! The colonoscopy went well. It was not fun, but I survived, and everything is NORMAL (except the obvious)!

My stomach is still a bit tender when I move around, pass gas, and defecate. Is that normal?

The doctor dilated and scraped the fissure, but I don't think that did anything. Has anyone gotten that done? I'm a bit confused as to what to expect here..



Thanks again!!

PS. Links to the appropriate forums are welcome!

Hi Collegelady,
Glad to read you have your colonoscopy out the way and even more so, that everything came back as normal. That must be really reassuring to know.
I'm guessing those effects you describe are normal but I couldn't say for sure.
It sounds like the doc "cleaned up" the area a bit for you but again, I'm also not sure what effect this will have - but in the meantime, just continue to do all the good stuff you've been doing to give your fissure every fighting chance of healing.
Did you manage to get any further information on what effect your ovarian issues might affect anything down there? :)