Joey
No colonoscopy is required to diagnose Anal fistula and anal fissures. For anal fistula, surgery named "fistulotomy" is required as the chances of healing by its own is almost zero. Pls see a qualified colorectal surgeon to perform the surgery. As for anal fissures, at least 50 percent of fissures heal by themselves without need for an operation. Application of special medicated cream, use of stool softeners, avoidance of constipation, and the use of sitz baths (soaking the anal area in plain warm water for 20 minutes, several times a day) help to relieve the symptoms and allow healing to occur. A fissure that does not heal should be reexamined to determine if an underlying problem that prevents healing exists. This could be due to scarring or muscle spasm of the internal anal sphincter muscle. Those which continue to cause pain and/or bleeding can be corrected by surgery.