ColomboSurgeon

Anal Fissures

What is a fissure?

 

An anal fissure is a small tear in the lining of the anus, often causing pain and discomfort during bowel movements. It is a common condition that can affect people of any age but is particularly prevalent in young adults and middle-aged individuals.

 

What causes fissures?

Anal fissures can develop due to:

  • Passing large or hard stools.
  • Chronic constipation or diarrhea.
  • Straining during bowel movements.
  • Trauma to the anal area, such as during childbirth.
  • Underlying conditions like Crohn's disease or infections.

Symptoms

The main symptoms of an anal fissure include:

  • Severe, sharp pain during and after bowel movements.
  • Bright red blood on the toilet paper or in the stool.
  • Itching or irritation around the anus.
  • A visible crack or sore near the anal opening.
  • A small lump or skin tag near the fissure.

 

Diagnosis

Doctors can diagnose an anal fissure through a simple physical examination. In some cases, further tests may be done to rule out other conditions, particularly if the fissure is chronic or associated with other symptoms.

Treatment

Most anal fissures heal with conservative measures, including:

  • Dietary changes: Eating high-fiber foods and drinking plenty of water to soften stools.
  • Hygiene: Keeping the anal area clean and dry.
  • Sitz baths: Soaking the area in warm water to promote healing and relieve discomfort.
  • Medications: Topical ointments (e.g., nitroglycerin or calcium channel blockers) to reduce pain and improve blood flow.
  • Pain relief: Over-the-counter pain relievers and anesthetic creams.

 

For chronic fissures or those that don’t respond to initial treatments, options may include Botox injections or a minor surgical procedure called lateral internal sphincterotomy.

 

Prevention

Preventing anal fissures involves maintaining soft, regular bowel movements. You can achieve this by:

  • Eating a diet rich in fiber (e.g., fruits, vegetables, whole grains).
  • Staying hydrated by drinking plenty of water.
  • Avoiding straining during bowel movements.
  • Managing conditions like constipation or diarrhea promptly

 

When to See a Doctor

You should consult a healthcare provider if:

  • The pain is severe or persistent.
  • You notice significant bleeding with bowel movements.
  • Symptoms do not improve with home treatments after a few weeks.

 

Outlook

With proper care and treatment, most anal fissures heal within a few weeks. Chronic or recurrent fissures may require medical intervention, but these treatments are typically effective in resolving the issue and preventing further complications.

If you have any concerns about your symptoms or treatment options, don't hesitate to speak with your healthcare provider.