Multiple Anal Fissues

[nar43]

Dear friends,
I am a 33 year old female. I have no history of Chrone's in my family, and i dont smoke.

For the last 2 years i have been having chronic anal fissures and hemorrhoids. My fissures are multiple but they are not all the way around the anus-predominantly between 3 and 9 o"clock anterior (hemorrhoids are located there also). I went to see my general practitioner this week and next week i am seeing GI. The general practitioner said that it is unlikely to be Chron'e because "the story is not right". I do have, although regular, quite hard BM. Also the blood test came back completely normal.
I do have a bit of irritation in my stomach (possibly beginning of an ulcer) which flares up when I am pervious-so far in 2 years it happened only twice and went away on its own. Also i have rumbling in my stomach, a bit of gas and a it of bloating sometimes--but my diet is very high in vegetables etc.
I am just very confused about anal fissures because everywhere on the internet it says that if they are a result of physical damage, the appear on 12 and 6 o"clock line, and if they are lateral, there are underlying causes such as Chron's, HIV, herpes etc. I dont have any of the other deseases and early IBD could be the only thing. Should i be worried?
If you have any info on the above matter, I would be very grateful to hear it.
Thank you in advance.

[DR_RTewari]

Dear Nar..
Just avoid constipation in future.. take more of green leafy vegetables and fibres and less of fat/ meats. Whenever you have constipation or abnormal bowel habits (ESPICIALLY DURING ANTIBIOTCS/ TRAVEL ETC.) these symptoms (piles and fissure) reccur.

[nar43]

Hello all,
So I went to see my GI and did a colonoscopy to exclude IBD (Chrone's).  Nothing has ben found--thank GOD! GI said to me that multiple fissures can occur and often doctor's  simply dont know why it happens.
I will keep making posts to update you with the progress of my investigation. But the point is: even if you have multiple anal fissures, it does NOT automatically mean that you have cancer, Chrone's , TB or any of those terrible desease that they say on the net are the cause of it. So don't panic like I did.  

[Enoch Choi, MD]

Anal fissures and hemorrhoids that recur and become chronic require a proctologist / general surgeon to evaluate it.  A GI can evaluate for Chron's disease with a colonoscopy or cat scan with enterography.  Excess acid from anxiety can lead to ulcers.

IBD can be evaluated by colonoscopy.  The GI can advise if this is a reasonable test to pursue.

Enoch Choi, MD