Your doctor may ask you about your diet, bowel habits, and if you have any other medical conditions or intestinal problems.
Even though your doctor can usually diagnose an anal fissure from the symptoms you tell her, the best way to learn whether or not you have one is through a physical exam. Your doctor may look at the area for a fissure.
You probably won't need a rectal exam (when the doctor uses a gloved finger to feel inside the anus) or an anoscopy (when the doctor puts a lighted scope into the anal canal). Sometimes they're necessary, though.
Generally, a visual exam of the area is all it takes. But if your doctor thinks an inflammatory bowel disease has led to the anal fissure, you might need more tests. Often, the number and location of anal fissures can point to other conditions, like Crohn’s disease. The presence of a skin tag at one end of a fissure may also point to chronic anal fissures.
Your doctor might also suggest a test called a sigmoidoscopy to see the lower part of the colon, or the sigmoid colon. Or, you may need a colonoscopy to look at the whole large intestine. Both tests involve inserting a long, thin, flexible, lighted tube into your anus to view the colon. They're used to look for abnormal growths or inflammatory conditions.