Sounds to me like you have a chronic fissure, which would be completely within the anal canal. The primary symptom of fissures is pain associated with defecation, and spasms of the sphincters that can last for hours after a bowel movement. The spasms prevent healing of the fissure because they reduce the blood supply. Scopes can miss this problem, and only visual inspection of the anus will reveal them. Many doctors will diagnose based on symptoms. The fact that you also had issues with hemorrhoids also would lean toward a diagnosis of fissures.

Call your doctor and tell him you suspect fissures. He might prescribe some nifedipine and lidocaine cream to help the healing process. If they are persistent, Botox injections can work. In the meantime, hot soaks in the bathtub 2-3 times a day are the primary treatment.

Jan

I was thinking the same will try to arrange a appointment which is a hard task in the UK.

P.S Thank you Jan for all you contributions on this forum, I have been following your posts for such a long time now and they have helped me ssoo sooo much..

Do you think it could possibly be IPS. Irritable Pouch Syndrome? I was diagnosed with this along with my cuffitis. I'll look for the paper written by the doctors at the Cleveland Clinic featuring Dr. Bo Shen about it and post the link.

Here's the link discussing Pouchitis, Cuffitis and IPS:

http://www.lerner.ccf.org/path...hen2002AmJGastro.pdf

IPS usually has the same symptoms as pouchitis, but without inflammation. The symptoms are not acutely associated with bowel movements. Fissures have pain localized in the anus/sphincters that is associated with bowel movements.

You can have more than one thing going on.

Jan

Sounds like it could be muscular. Your doctor can write you a prescription for physical therapy and you can go to a pelvic floor physical therapist. They will examine you and work on the issue. It could change your life. You can find a pelvic floor physical therapist near you by searching on the APTA (american physical therapy association) website under FIND A PT.