An Anal fissure is a small tear that occurs in mucous lining tissues of the anus. This crack in the skin can cause severe pain and bleeding after bowel movements. The condition may occur when passing hard or large stools during a bowel movement. Anal fissures are very common and can affect people of any age and is usually not a serious condition.
Though anal fissures heal on its own within 4 to 6 weeks or gets better with simple treatments such as increased fiber intake or using stool softeners and topical pain relievers, in some cases anal fissures can be chronic and may need surgery.
- Pain during and after bowel movements, sometimes can be severe.
- Traces of red blood on the stool
- Burning or Itching or irritation around the anus
- A visible tear in the skin surrounding the anus
- A small lump of skin or skin tag on the skin near to the tear.
Common causes of the anal fissure include:
- Passing large or hard stools
- Straining during bowel movements
- Low blood flow to the anal area
- Chronic diarrhea
Other reasons can include HIV, tuberculosis, syphilis, herpes, anal cancer
The doctor examines the area around the anus and performs a digital rectal exam to diagnose an anal fissure. The procedure involves using a short, lighted tube (anoscope) to investigate the anal canal. The location of anal fissure provides information about the cause of the condition. Other tests to diagnose anal fissure include:
- Flexible sigmoidoscopy
Several lifestyle changes and home remedies provide relief from pain and discomfort caused by anal fissures. These include:
- Adding fiber to the diet: Fiber-rich food help keep stools soft and improve fissure healing and these include fruits, vegetables, nuts and whole grains.
- Drink adequate fluids to prevent constipation.
- Regular exercise and physical activity: Engage in moderate physical activity, such as walking for at least 30 minutes for few days of the week. The activity promotes regular bowel movements and increases blood flow to all parts of your body.
- Avoid straining during bowel movements: Straining puts pressure on the mucous lining of the anal area and leads to the reoccurrence of fissures.
- Soaking in warm water for 10 to 20 minutes several times a day help relax the sphincter muscles and promote fissure healing.
- Nitroglycerin: Applying medication containing nitroglycerin externally helps increase the blood flow to the fissure and promote healing.
- Topical anesthetic creams provide pain relief.
- Botox injection paralyzes the anal sphincter muscle and relaxes spasms.
- Blood pressure medications help relax the anal sphincter.
Surgical procedure for anal fissure is known as lateral internal sphincterotomy (LIS). The procedure involves cutting a small portion of the anal sphincter muscle to reduce spasm and pain. This action promotes fissure healing and is an effective medical treatment.