Because you are still having **anal pain and lower abdominal/pelvic pain with a pulling or burning sensation 4 months after your recent procedure**, this should not automatically be assumed to be a recurrent fissure. Persistent anal pain can sometimes be related to continued sphincter or pelvic-floor muscle spasm, scar tissue, incomplete healing, nerve-related pain, or another anorectal/pelvic condition. Persistent symptoms after treatment warrant a proper reassessment.
The fact that you have **no bleeding or pus is reassuring**, but it does not by itself identify the cause of the pain. Since you have already undergone several procedures, I would strongly recommend a review by a **colorectal/coloproctology specialist**, preferably with your previous operative reports and examination findings. This does **not mean that you definitely need another surgery**.
Regarding the **slate pencils you ate during college**, that history is unlikely by itself to explain your current anal pain and pelvic burning years later. However, because you have lost around **20 kg and are feeling weak**, it is important to evaluate the weight loss and nutritional status rather than attributing everything to the previous surgeries.
At **Unicare Homeopathy**, we can review your complete history, previous surgery details, current symptoms and available reports and provide supportive individualized care. However, given your history of multiple procedures and significant weight loss, we would recommend appropriate colorectal evaluation alongside any complementary treatment rather than delaying necessary assessment.
Please seek urgent medical attention if you develop **fever, increasing swelling around the anus, pus/discharge, severe or rapidly worsening abdominal pain, persistent vomiting, inability to pass stool/gas, heavy bleeding, fainting, or marked weakness**.
If you have your **operation reports, recent examination/proctoscopy report, MRI/scan reports or photographs of the affected area**, you can share them for review so the history can be understood more accurately.
Next Steps
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Health Tips
Continue keeping stools soft and easy to pass and avoid straining. Warm sitz baths can be continued if they provide relief. Avoid taking strong painkillers such as opioids without medical advice, as they can worsen constipation. Do not undergo another procedure without first establishing what is actually causing the persistent pain.