Anal Fissure
Overview
An anal fissure is a tear in the delicate lining of the anus. This leaves the anal sphincter exposed and can cause pain and bleeding. Anal fissures usually occur due to passing hard stools.
It is a small split or cut in the skin at the anal opening. Fissures typically cause pain and often bleed. Fissures are quite common but are often confused with other causes of pain and bleeding, such as hemorrhoids. Most fissures occur along the mid-line - the top or bottom - of the anus.
The symptoms of anal fissure are following:
- Painful bowel movement
- Bleeding
- Constipation
There could be many reasons for Anal fissure including:
- Anal fissures are pretty much common in young infants but may occur at any age
- Diarrhea for a longer period of time
- Too much tension in the sphincter muscles that control the anus
- Passing of large, hard stools
Conservative Management
At least 50% of anal fissures are healed by medical management, which includes topical ointments, sitz baths, dietary modifications (i.e. incorporating a high fibre diet and avoiding foods that are not well digested like maida, popcorn, chips), drinking plenty of fluids, and using stool softeners/ laxatives.
Fissure Surgery
Anal Fissure Surgery is used for treatment when fissures do not respond to other treatments. The two options available for anal fissure surgery are:
- Chemical Internal Sphincterotomy: A minimally invasive approach to relax the anal muscle by injecting chemicals into the anal sphincter muscle and partially paralyzing it.
- Lateral Internal Sphincterotomy: In this fissure surgery, a portion of the anal sphincter muscle is divided which helps the fissure to heal and decrease the pain and spasm. If a sentinel pile is present, it is removed to promote healing. It is a quick surgical process and can also be performed as a short outpatient procedure. The chances of recurrence are almost nil. It is the most effective treatment option for non-healing fissures.
Most anal fissures heal their own and do not need any specific treatment. However, following fissure surgery treatment options are used to treat anal fissures:
- Drinking more fluids
- Eating a high-fiber diet to avoid constipation
- Using stool softeners
- Allowing enough time for a bowel movement
- Sitz baths (soaking anal area in plain warm water)
- Avoid foods that may not be well-digested (i.e., nuts, popcorn, tortilla chips)
- Topical ointments
Other Conditions & Treatments
- Anal Fistula
- Gangrene
- Gastroesophageal Reflux Disease
- Hemorrhoid
- Piles (Hemorrhoids)
- Rectal Prolapse
- Varicose Veins