Clinical evaluation
The surgeon usually diagnoses an anal fissure by evaluating the patient’s symptoms. Also, a physical examination is one of the best ways to learn if an anal fissure exists. In most cases, the doctor uses a gloved finger to feel inside the anus or an anoscopy. A careful history suggests that an anal fissure is present.
Other diagnostic tools
Generally, a visual examination of the area is highly worthy. In case there is an inflammatory bowel disease the patient 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.
If rectal bleeding is present, an endoscopic evaluation is necessary. By doing this, we can exclude the possibility of a more serious disease. The colon and rectal surgeon might also suggest a test called sigmoidoscopy. This test can see the lower part of the colon. Occasionally, the doctor will ask for a colonoscopy to see the whole large intestine. In patients with a family history of colon cancer or age greater than 50, a colonoscopy is highly recommended.
