Sure its fissure?: Not all anal fissures are readily apparent on external exam, nor are internal hemorrhoid(s), proctitis (inflamed rectum), anal abscess or fistula, trauma to the anal canal, subtle skin changes around the anus (benign or malignant). Also, proctalgia (of any cause) can promote distress without inflammation. If anal fissure is confirmed, & is refractory to medical treatment, surgery is an option.
Answered 5/17/2017
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