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Anal Fissure

Symptoms, Causes and Treatment
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An anal fissure is an anal tear or crack, in the lining of the anal canal, a cut or tear in the anus that extends into the anal canal.

What is Anal Fissure?

An anal fissure is a cut or tear occurring in the anus (the opening through which stool passes out of the body) that extends upwards into the anal canal. Fissures are a common condition of the anus and anal canal and are responsible for 6% to 15% of the visits to a colon and rectal (colorectal) surgeon. They affect men and women equally and both the young and the old. Fissures usually cause pain during bowel movements that often is severe. Anal fissure is the most common cause of rectal bleeding in infancy.

Facts on anal fissures

Here are some key facts about anal fissures.
  • damage to the lining of the anus is a common cause
  • in some cases they are idiopathic (no known cause)
  • approximately 10 percent of people are affected in their lifetime
  • staying hydrated may help prevent anal fissures

Symptoms

The primary symptom of anal fissures is pain during and following bowel movements. The main signs and symptoms of an anal fissure include:
  • Pain - especially when passing stools. During the passing of a stool the pain is sharp, and then afterward there may be a longer deep burning sensation. Fear of pain may put some patients off going to the toilet, increasing their risk of constipation. 

    If the person delays using the bathroom, this can make the pain and the tear worse, because the stools will be harder and larger. Some people may experience a sharp pain when they clean themselves with toilet paper.
  • Blood - because the blood is fresh, it will be bright red and may be noticed on the stools or the toilet paper. Anal fissures in infants commonly bleed.
  • Itching - in the anal area. The sensation may be intermittent or persistent
  • Dysuria - discomfort when urinating (less common). Some patients may urinate more frequently.

Causes

Anal Fissure caused by increased pressure in the lower rectum. The blood vessels around the anus and in the rectum will stretch under pressure and may swell or bulge, forming piles. This may be due to:

Chronic constipation

Chronic diarrhea

Muscle spasms

Pregnancy

Sexually-transmitted infections

Inflammatory Bowel Diseases

Crohn's disease

Anal sex

Treatments

In most cases, an anal fissure will resolve itself within a few weeks. The doctor may recommend some medications to relieve symptoms of pain, burning, or discomfort.

Lifestyle changes

We will initially recommend some lifestyle changes to manage anal fissure.

Diet

A change in diet can help keep the stools regular and soft. This involves eating more fiber, such as fruit and vegetables, or primarily eating bran-based breakfast cereals.

Body weight

Losing weight may help reduce the incidence and severity of piles. Exercising is one of the main therapies for piles.

Medications

Several medicinal options are available to make symptoms more manageable for an individual with anal fissure.
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OTC medications

These are available, including painkillers, ointments, creams, and pads, and can help soothe redness and swelling around the anus. Do not use them for more than 7 days in a row

Laxatives

The doctor may prescribe laxatives if a person suffers from constipation. These can help the person pass stools more easily and reduce pressure on the lower colon.

Surgical options

Advanced anal fissure require surgical treatment. 

Internal sphincterotomy

A portion of the anal sphincter muscle is surgically removed, resulting in fewer and less severe spasms

Fissurectomy

The surgical removal of the fissure - this procedure is rare and may be used in children.

Consult doctor before going for any treatment

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