All you need to know about Anal fissures and their Symptoms, Causes, Diagnosis & Treatments.

What is an anal fissure?

An anal fissure is a very small tear in the layer of tissue that lines the anus. The cause is usually passing a large or hard stool. An anal fissure may also occur as a result of chronic diarrhea, Crohn’s disease, or another condition that causes inflammation in the anal area. You may feel pain when moving your bowels or while they are passing, and you may see blood on their surface.

However, if the fissure doesn’t heal on its own and you continue to experience painful symptoms, you may need surgery. Always consult your doctor if you have any questions or concerns about what prevention and treatments are right for you.

Self-care is often successful in healing fissures without having to resort to surgery. However, if self-care fails, surgery can be considered.

Symptoms of anal fissure

Symptoms of anal fissures include bright red blood in the toilet or on toilet paper after a bowel movement and pain during bowel movements that last for several hours. Some people also experience discomfort when they pass gas.

You’re less likely to have pain when resting or at night, in comparison with hemorrhoids.

* Health pain when you have a bowel motion

* painful, bright red blood on the surface of your stool

* blood on your inner bottom or on the toilet paper

* watery brown stools or diarrhea.

Causes of anal fissure

An anal fissure is a tear or open sore (ulcer) that develops in the lining of the large intestine, near the anus. Some of the causes include:

  • chronic constipation
  • passing a dry, hard stool
  • rough or excessive wiping of the anus after passing a motion
  • diarrhea
  • inflammation of the anus and rectum
  • Crohn’s disease
  • scratching (as a reaction to pinworm infection, for example)
  • anal injury
  • pregnancy
  • childbirth
  • cancer of the rectum.

Diagnosis of anal fissure

Anal fissures are diagnosed during an examination of the anus, rectum, and lower part of the colon. The doctor will use a gloved finger to feel for abnormalities and may insert a short, flexible tube (anoscope) with a light at the end to examine your anal canal.

Detailed Notes on fissure diagnosis, including anoscopy and rectoscope.

Treatment for anal fissure

If you have a minor fissure, home remedies may help relieve your symptoms and help promote healing. However, see a doctor if the pain doesn’t get better or if you notice blood when you wipe after having a bowel movement.

Your doctor may provide pain-relieving medication or recommend topical creams to help ease spasms and relieve pain. Laxatives may also be used to soften stools. If a muscle spasm is behind your fissure, you may need to use nitroglycerin cream or Botox injections for several weeks. In extreme cases, surgery will be considered

Surgery for anal fissures

Severe fissures have to be surgically repaired. The wound is cleaned and packed, and an incision is made in the skin near the bottom of the fissure to allow more room for healing. Sometimes, a small section of the sphincter muscle is removed, as this helps prevent a recurrence in that area.

The operation, called a lateral internal sphincterotomy, is performed under local anesthetic and heals quickly.

Self-help for anal fissures

  • Apply petroleum jelly to the anus.
  • Use baby wipes instead of toilet paper.
  • Shower or bathe after every bowel motion.
  • Make sure to do regular exercise
  • Stay hydrated (Drink six to eight glasses of water every day)
  • Avoid wearing tight pants
  • Eat foods rich in fiber and drink a lot of water.
  • Stop worrying so much!
  • Try cutting down on caffeine.

Take regular sitz (salt bath) baths, which involve sitting in a shallow bath of warm water for around 20 minutes.

You can use a warm compress on the area to help provide some pain relief and allow you to go comfortably if you need to.

Some people find peppermint oil helpful for pain management and prevention.

Prevention of anal fissures

It’s important to reduce the risk of developing anal fissures by keeping your stools soft.

A low fiber diet and not drinking enough water can increase the risk of constipation, leading to anal fissures.

Eat a well-balanced diet with lots of foods that contain natural fiber — especially fruits, vegetables, and cereals — to keep stools soft. Also, drink 6-8 glasses of water each day to help soften stools. 

Things to remember

  • Feces is temporarily stored in the rectum and expelled from the body via the anus.
  • An anal fissure is a tear or split in the lining of the anus (anal mucosa).
  • The symptoms include pain and bright red blood from the anus.
  • Treatment options include laxatives and surgery.
  • Self-help suggestions include switching to a high-fiber diet and drinking plenty of water.
  • Cancer of the anus may mimic an anal fissure.

Reference

  • Anal fissure, American Society of Colon and Rectal Surgeons, USA  See more here
  • Anal Fissure, Colorectal Surgical Society of Australia and New Zealand. See more here
  • Anal Fissure, Colorectal Surgery – Patient Information. See more here
  • https://www.betterhealth.vic.gov.au/
  • https://www.healthline.com/

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