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Anal fissures usually result from constipation and the passage of hard stools, but can also occur from the frequent passage of liquid stools or from wiping too harshly. The relatively minor operation you had all those years ago is not likely to have caused a change in your stools. Soft stools (not hard or loose) make passage easier and adopting gentle cleansing methods (toilet paper is too abrasive, so wash/pat dry) and using special creams can help heal a fissure. If necessary and all else fails, chronic fissures can be removed, but a surgeon would be cautious in any situation where there is a diagnosis of IBD, and particularly so if there is any presence of peri-anal disease or signs of deep, wide fissures that may be more consistent with Crohn’s disease. The problem should be discussed with your gastroenterologist who can then determine whether you should be referred to a colorectal surgeon.
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