Diagnosis of Anal Fissure
Diagnosing an anal fissure is usually straightforward and does not require advanced tests. Diagnosis of anal fissure involves a careful medical history and physical examination which is often enough for a healthcare provider to confirm the condition.
Step 1: Medical History
Your doctor may ask about:
- Recent constipation or diarrhoea
- Pain during or after bowel movements
- Bleeding or visible tears
- Past surgeries, trauma, or anal intercourse
- Other digestive symptoms like cramping or bloating
Step 2: Physical Examination
A visual inspection of the anal area is usually done:
- A fresh fissure appears as a small, red, inflamed tear
- A chronic fissure may look deeper, with scar tissue or a skin tag at the edge (called a sentinel pile)
Doctors typically avoid digital rectal exams or inserting instruments during active fissure pain, as it may cause discomfort and worsen the tear.
Step 3: Rule Out Other Conditions
In some cases, especially when bleeding is present, further testing may be done to exclude:
- Haemorrhoids
- Anal abscess or fistula
- Inflammatory bowel disease (IBD)
- Anal cancer (especially in older patients or those with suspicious findings)
Tests may include:
- Proctoscopy or anoscopy (after pain subsides)
- Colonoscopy, if bleeding is persistent or there’s a family history of bowel disease
In South Africa, anal fissures are managed by general practitioners, surgeons, or gastroenterologists, depending on severity. Early diagnosis helps avoid complications and speeds up healing.
Let’s now explore how fissures are treated — both at home and medically.
👉 [Next: Treatment for Anal Fissure]
