Anal Fissure: causes and symptoms
An anal fissure is a condition defined by a small tear present in the thin, wet tissue lining the anus, which is the muscle aperture at the end of the digestive system responsible for stool expulsion. Straining or large stools during bowel movements and constipation are among the most common causes of anal fissures.
Anal fissures can affect people of all ages.. Fortunately, most anal fissures can be easily treated through simple interventions such as increasing fiber intake or warm-water baths. However, in some cases, medication or surgery may be necessary to treat anal fissures.
Symptoms of Anal Fissures
The most common anal fissure symptoms include:
- Pain during defecation: Anal fissures often cause sharp pain during bowel movements.
- Pain after bowel movements: This discomfort can persist for several hours.
- Visible skin crack: A noticeable tear around the anus, sometimes with a visible crack.
- Presence of bright red blood: Blood may appear on toilet paper or Bleeding While Passing Stool
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Get A Second OpinionWhen to see a doctor?
Consult the doctor if you have pain during bowel movements or notice blood on the stools or toilet paper after a bowel movement.
Causes of Anal Fissures
Anal fissures are commonly caused by the following factors:
- Passing large or hard stools
- Long-lasting diarrhea
- Constipation and straining during bowel movements
The following are less common anal fissure causes include :
- Syphilis
- HIV
- Crohn's disease or another inflammatory bowel disease
- Tuberculosis
- Anal cancer
- Anal intercourse
Risk Factors for Anal Fissures
The following factors may increase the chances of having an anal fissure:
- Constipation: Constipation of tearing is increased by straining during bowel motions and passing hard stools.
- Childbirth: Women are more likely to develop anal fissures after giving birth.
- Crohn's disease: Chronic intestinal inflammation is caused by this inflammatory bowel disease. This could make the anal canal lining more prone to tears.
- Age: Anal fissures can develop at any age but are more frequent in infants and middle-aged adults.
Complications of Anal Fissures
Anal fissure complications may include:
- Failure to heal: An anal fissure that does not heal after eight weeks is considered chronic and may require additional treatment.
- Recurrence: After you've had an anal fissure, you're more prone to have another one.
- Extended tears: In some cases, fissures may extend to the muscles around the anus, making healing more difficult and causing prolonged pain.
Diagnosis of Anal Fissures
The doctor will most likely ask about the medical history and perform a physical exam, which will include a gentle digital examination of the anal region. The tear is frequently noticeable. This exam is usually all that is required to identify an anal fissure.
- Anoscopy: A tool inserted into the anus to examine the area.
- Flexible sigmoidoscopy: A Flexible sigmoidoscopy procedure to examine the sigmoid colon with a camera.
- Colonoscopy: A deeper examination of the colon, particularly for those over 45 or with symptoms like abdominal pain or diarrhea.
Treatments for Anal Fissures
In most cases, anal fissure treatment heals within a few weeks with proper home care. Here’s how you can manage it:
- Increase fiber intake: A high-fiber diet helps soften stools and prevents straining.
- Sitz baths: Soaking the warm water for 10 to 20 minutes, especially after bowel movements, can relax the sphincter and promote healing.
- Topical treatments: Over-the-counter creams like Xylocaine (lidocaine) can relieve pain.
If home care doesn’t provide relief, medical treatments may include:
Nonsurgical treatments
Nitroglycerin (Rectiv): This medication can improve blood flow to the fissure and relax the anal sphincter, aiding healing.
Onabotulinumtoxin A: Injecting botox can paralyze the anal sphincter temporarily, reducing pain and spasms.
Surgical treatments
Anal Fissure Surgery: For chronic fissures that don’t heal with other treatments, surgery may be needed. The most common procedure is lateral internal sphincterotomy (LIS), where part of the internal anal sphincter muscle is cut to relieve pressure and promote healing. Although effective, surgery carries a small risk of incontinence.
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Book an AppointmentAnal Fissures Dos and Don’ts
Follow its do’s and don’ts to manage or minimize its symptoms.
|
Do’s |
Don’ts |
|
Add fiber to your diet |
Have foods such as popcorn, nuts or tortilla chips. |
|
Drink adequate fluids |
Take alcohol |
|
Take a sitz bath |
Consume constipating foods |
|
Exercise regularly |
Use hemorrhoid suppositories |
Anal Fissures Care at Medicover
At Medicover, patients with anal fissures can receive comprehensive and individualized care to manage their condition effectively. Depending on the severity of the fissure and the patient's overall health, the treatment plan will typically include a combination of medicines and surgical procedures.
The team of general surgeons at Medicover hospitals will work closely with patients to build an effective treatment plan personalized to their specific needs and preferences. The purpose is to give compassionate treatment and support to patients to assist them in achieving the best possible results and quality of life.
Frequently Asked Questions
What are anal fissures?
Anal fissures are tiny holes or cuts in the anus lining., causing discomfort, pain, and sometimes bleeding during bowel movements.
What are the common symptoms of anal fissures?
Common symptoms include sharp pain during bowel movements, blood on the toilet paper or in the stools, itching, burning, and discomfort in the anal area.
What causes anal fissures?
Anal fissures can be caused by factors such as constipation, straining during bowel movements, hard stools, prolonged diarrhea, and childbirth. These factors can lead to trauma and tearing of the anal lining.
How are anal fissures diagnosed?
An examination of the anal region by a healthcare professional is typically required for diagnosis. Sometimes, additional tests such as a digital rectal exam or anoscopy may be performed to confirm the diagnosis.
What is the best treatment for anal fissures?
Treatment options for anal fissures depend on their severity. Conservative approaches include dietary changes, increased water intake, fiber supplements, and topical creams. In more severe cases, medical procedures or surgery may be recommended.
What is the medical procedure for treating anal fissures?
Medical procedures for anal fissures include methods like lateral internal sphincterotomy and Botox injections. These procedures aim to relax the anal sphincter muscle and promote healing.
When is surgery necessary for anal fissures?
When non-surgical treatments are unsuccessful, surgery may be considered. Anal fissure surgery involves removing a small portion of the anal sphincter muscle to reduce pressure on the fissure and promote healing.
What are the symptoms of chronic anal fissures?
Chronic anal fissures can cause ongoing pain, bleeding, and discomfort. Some individuals might experience spasms of the anal sphincter muscle, which can exacerbate the pain.
How is an anal fissure surgery performed?
Anal fissure surgery typically involves a procedure called lateral internal sphincterotomy. During this surgery, a small portion of the internal anal sphincter muscle is cut to reduce pressure and promote healing.
Can anal fissures be treated without surgery?
Yes, many cases of anal fissures can be treated without surgery. Conservative approaches, dietary changes, and topical treatments can often help in healing fissures.
Can anal fissures heal on their own?
In some cases, small anal fissures might heal on their own with proper hygiene, dietary adjustments, and self-care measures. However, chronic or severe fissures may require medical intervention.
What should I do if I notice blood after a bowel movement?
If you notice blood on toilet paper or in the stool, it's important to consult a healthcare provider. While it might be due to something minor like anal fissures, it's essential to rule out more serious conditions.
Is there any way to prevent anal fissures?
Maintaining a healthy diet rich in fiber, drinking plenty of water, avoiding straining during bowel movements, and practicing good anal hygiene can help reduce the risk of developing anal fissures.
Can anal fissures be mistaken for other conditions?
Yes, anal fissures can sometimes be mistaken for conditions like hemorrhoids or inflammatory bowel disease due to similar symptoms. A proper medical evaluation is necessary for an accurate diagnosis.
Is a "cut on the anus" the same as an anal fissure?
Yes, a "cut on the anus" is another way to describe an anal fissure. It refers to a tear or small cut in the lining of the anus.
