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How Anal Fissures are Diagnosed

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An anal fissure is a tear in the lining of your anus or anal canal. They are very common and can be caused by any trauma or injury that stretches and tears the anus.

Symptoms of an anal fissure include:

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  • a visible tear in your anus
  • pain during, and even after, bowel movements
  • small amounts of blood on the surface of stools and toilet paper
  • burning and itching around the anus
  • smelly discharge

These symptoms can easily be mistaken as signs of other conditions, such as hemorrhoids.

Many people may not be comfortable telling these problems to a doctor. But it is important to let your doctor know about your symptoms, so that she can rule out more serious conditions.

Preparing for Your Doctor's Visit

In most cases, discussing your symptoms can give your doctor enough information to diagnose anal fissure. If you've experienced any of the symptoms, be sure to tell her:

  • when you have pain, burning, or itching
  • how bad your discomfort is
  • how long the pain and discomfort usually lasts
  • what type of bleeding you've seen
  • what, if anything, improves your symptoms

Your doctor may ask you about your diet, bowel habits, and if you have any other medical conditions or intestinal problems.

Physical Exam for Anal Fissures

Your doctor can usually diagnose anal fissure from the symptoms you tell her. But the best way to learn whether or not you have an anal fissure 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) although they are sometimes necessary.

Additional Testing for Anal Fissures

Generally, a visual exam of the area is all it takes. But if your doctor thinks an inflammatory bowel disease has led to the development of anal fissures, 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 may also suggest 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 are used to look for abnormal growths or inflammatory conditions.

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