Pressure Down Below - Cuffitis or Fissure?

I have this issue often and have the same question. I also have chronic cuffitis and have not been diagnosed with a fissure, but my GI has prescribed fissure ointments when I am having real issues and sometimes bleed. When I have checked myself, I also feel raised tissue (like a bulge in the wall) and when I empty the pouch I can often feel this area getting irritated when passing stool (feels to me like an anal ulcer mass when passing stool).

I also had issues with straining due to a stricture and I think this has caused some of these problems for me. From everything I have read, fissures present as
small tears/cuts in the skin, usually at the very end of the anal canal, but I have read they can turn into ulcerations which could probably present more like raised tissue as you are describing.

I bet Jan can best answer this question.

jeane,
definitely feels like a stricture too. The area is really tight. Doesn't seem to want to loosen up enough to heal.

Could very well be...when mine acts up all the other symptoms you are describing seem to go hand in hand. Hope you get resolution soon.

I have had about 5 dilations since my original surgery in 2011, with the last one being about 6 months ago. This one has helped the most.
I know, however, that my anastomosis opening is smaller than the average of others who have a jpouch. My GI also seems to think the lack of blood flow due to possible ischemia also causes some of the anal issues I have.

On another note, the inflammation (if you have it in the cuff or at your connection) can aggravate a stricture or actually contribute to the narrowing of the anastomosis and some of the symptoms you may be experiencing. If you are experiencing cuffitis, rectal suppositories can help cut the inflammation and relieve some of your symptoms. Not sure these do anything for fissures as the treatment for these is usually prescription nifedipine, numbing creams and/or rectiv cream (can causes severe headaches).

Never did any dilations. The thought of them scares me Seems like aside from these, the only treatments are numbing creams, sitz baths, time, and nifedipine creams.