Anal Fissure
An anal fissure is a small cut or tear in the skin lining the anus.
Childbirth,
straining during bowel movements, or
bouts of constipation or diarrhea
can all tear the anal lining.
Anal fissures are usually not a cause for concern and most heal without any medical treatment. However, those resistant to treatment may require surgery.
Symptoms
# A visual tear on the anus
# A skin tag (small lump of skin) next to the anal fissure
# Extreme pain in the anal area during bowel movements
# Streaks of blood on stools or on tissue paper after wiping
# Burning or itching in the anal area
Causes
The skin around the anus can be torn when passing large or hard stools.
Chronic constipation or frequent diarrhea can also tear the skin.
Other causes:
# Crohn’s disease or another irritable bowel disease.
# Straining during childbirth # Decreased blood flow in the anorectal area due to old age
# Overly tight or spastic anal sphincter muscles
Diagnosis & Treatment
Usually diagnosis is made by just a visual exam. However there may be a need to insert an endoscope or anoscope into the rectum to make it easier to see the tear.
Most anal fissures heal with just home care treatments like adding fiber supplements to the diet or use of stool softeners.
Warm baths can relax the anal muscles, relieve irritation, and increase blood flow to the area.
Ointments:
Topical pain relievers, such as Lidocaine, applied to the anus can help relieve the pain.
Calcium channel blocker ointment that can relax the sphincter muscles and allow the anal fissure to heal.
A topical nitroglycerin ointment applied to the anus widens the blood vessels in the anus, encouraging blood flow to the area, will also promote healing.
Another treatment is Botox injections into the anal sphincter. This will prevent spasms in the anus by temporarily paralyzing the muscle. The purpose is to allow the anal fissure to heal while preventing new fissures from forming.
Surgery:
If anal fissure fails to respond to other treatments then anal sphincterotomy is recommended.
This is a surgical procedure where a small incision is made in the anal sphincter to relax the muscle, which allows the anal fissure to heal.
Risk Factors
# For unknown reasons, anal fissures are common during infancy. They occur in approximately 80 percent of babies during the first year of life.
# Older adults are also prone to anal fissures due to decreased blood flow in the anorectal area.
# During and after childbirth, women are at risk because of the straining during delivery.
# Inflammatory bowel disease, such as Crohn’s disease, This is because the inflammation in the intestinal lining makes the tissue more prone to tearing.
# Frequent constipation.
Prevention
Although anal fissures cannot always be prevented, you can reduce your risk of getting one with the following guidelines:
to prevent anal fissures in infants, change diapers frequently
# keep the anal area dry
# Cleanse the anal area gently
# Avoid constipation by drinking plenty of fluids, eating plenty of fiber, and exercising regularly
# Treat diarrhea immediately
An anal fissure is a small cut or tear in the skin lining the anus.
Childbirth,
straining during bowel movements, or
bouts of constipation or diarrhea
can all tear the anal lining.
Anal fissures are usually not a cause for concern and most heal without any medical treatment. However, those resistant to treatment may require surgery.
Symptoms
# A visual tear on the anus
# A skin tag (small lump of skin) next to the anal fissure
# Extreme pain in the anal area during bowel movements
# Streaks of blood on stools or on tissue paper after wiping
# Burning or itching in the anal area
Causes
The skin around the anus can be torn when passing large or hard stools.
Chronic constipation or frequent diarrhea can also tear the skin.
Other causes:
# Crohn’s disease or another irritable bowel disease.
# Straining during childbirth # Decreased blood flow in the anorectal area due to old age
# Overly tight or spastic anal sphincter muscles
Diagnosis & Treatment
Usually diagnosis is made by just a visual exam. However there may be a need to insert an endoscope or anoscope into the rectum to make it easier to see the tear.
Most anal fissures heal with just home care treatments like adding fiber supplements to the diet or use of stool softeners.
Warm baths can relax the anal muscles, relieve irritation, and increase blood flow to the area.
Ointments:
Topical pain relievers, such as Lidocaine, applied to the anus can help relieve the pain.
Calcium channel blocker ointment that can relax the sphincter muscles and allow the anal fissure to heal.
A topical nitroglycerin ointment applied to the anus widens the blood vessels in the anus, encouraging blood flow to the area, will also promote healing.
Another treatment is Botox injections into the anal sphincter. This will prevent spasms in the anus by temporarily paralyzing the muscle. The purpose is to allow the anal fissure to heal while preventing new fissures from forming.
Surgery:
If anal fissure fails to respond to other treatments then anal sphincterotomy is recommended.
This is a surgical procedure where a small incision is made in the anal sphincter to relax the muscle, which allows the anal fissure to heal.
Risk Factors
# For unknown reasons, anal fissures are common during infancy. They occur in approximately 80 percent of babies during the first year of life.
# Older adults are also prone to anal fissures due to decreased blood flow in the anorectal area.
# During and after childbirth, women are at risk because of the straining during delivery.
# Inflammatory bowel disease, such as Crohn’s disease, This is because the inflammation in the intestinal lining makes the tissue more prone to tearing.
# Frequent constipation.
Prevention
Although anal fissures cannot always be prevented, you can reduce your risk of getting one with the following guidelines:
to prevent anal fissures in infants, change diapers frequently
# keep the anal area dry
# Cleanse the anal area gently
# Avoid constipation by drinking plenty of fluids, eating plenty of fiber, and exercising regularly
# Treat diarrhea immediately
