Diagnosis of Fissure in Ano
The diagnosis of fissure-in-ano is easy to make clinically and usually, no complicated procedures are required to diagnose this condition. The physician will usually try to avoid putting any instrument in the anus, as the area is extremely sensitive and such examination can be very painful. In the majority of cases, with careful evaluation of the symptoms and a close look at the anus, a diagnosis of fissure can be confirmed by your doctor.
On examination, the doctor may observe following:
- Spasm of the anus
- A split or cut in the posterior midline of the anal mucosa.
- Lateral fissures: If fissure is observed laterally, instead of posterior midline location of the fissure, it may give hint to underlying diseases such as Crohn’s disease, ulcerative colitis, or sexually transmitted diseases. In such cases, fissures are usually multiple and may have an atypical appearance.
- Acute fissures (usually present for 6 weeks or less) are superficial with sharply demarcated edges.
- Chronic fissures (present for more than 6 weeks) are usually deeper and may have secondary features, including hardening of the edge of the fissure, a sentinel pile which looks like a small skin tag, and hypertrophied anal papillae, etc.