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Fissure in ano  Diagnosis
The diagnosis of fissure-in-ano is easy to make clinically and usually no complicated procedures are required to diagnose this condition. 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 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 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 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 sentinal pile which looks like small skin tag, and hypertrophied anal papillae, etc.
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