Your doctor will review your medical history and conduct a physical examination of the anal region. Most anal fissures can be diagnosed by viewing the anal region on separating the buttocks. If the tear is visible, diagnosis becomes easy and treatment can be started immediately. If not, a sample of the rectal tissue may be removed for examination.
Anal fissures can be diagnosed by digital rectal examination or using an instrument called an anoscope. Digital rectal examination involves inserting a gloved finger into the anal canal. The anoscopeis a short instrument with a lighted tube which can help your doctor view and examine the fissure. If these procedures cause extreme pain, your doctor may wait till the fissure heals or use a topical anaesthetic to reduce the discomfort.
Your doctor will have to rule out other problems that can cause fissures. Anal fissures are characteristically located either on the back or front surfaces of the anus. If your condition is characterised by several fissures, or the fissures are located on the sides of the anus, then you may be suffering from a different condition (inflammatory bowel disease, anal cancer, syphilis or HIV infection). Your doctor will conduct further tests to confirm these conditions.
Thank you for doing my operation for me. It is much appreciated. 
-MR
