Fissure: Symptoms, Complications, and Treatment

Contents

In this article, we will take a look at:

• What is a fissure?
• How does a fissure occur?
• Who is prone to a fissure?
• Symptoms of a fissure
• Diagnosis of a fissure
• Complications of a fissure
• Treatment for fissure

You can click on any of the links above to navigate to the section of your interest.

What is a fissure?

A fissure refers to a small tear or cut in the lining of the anus. In some cases, it can be deep enough to expose the underlying muscle tissue. Anal fissures can be very painful and may cause bleeding during bowel movements. However, it is not considered a very serious condition. In most cases, it heals within a month or two. If it persists for longer than that, it may be called a chronic fissure. In rare cases, surgery may be needed.

How does a fissure occur?

Anal fissures usually occur as a result of constipation or frequent diarrhoea. When passing stool that is hard and bulky, the lining of the anal passage may get irritated. This can cause cuts and tears. Similarly, passing stool frequently while suffering from diarrhoea can also irritate the tissue and result in a fissure. Other factors that may cause a fissure include:

• Straining while passing stool.
• Straining during childbirth.
• Inflammatory Bowel Disease (IBD).
• Reduced blood flow to the rectal area.
• Extra tight anal sphincter muscles.
• Anal cancer.

Other less common causes include:

• HIV.
• Tuberculosis.
• STDs such as Herpes and Syphilis.

Who is prone to fissure?

You could be at risk of developing fissure if:

• You suffer from IBD.
• You suffer from Crohn’s disease.
• You are frequently constipated.
• You have just given birth to a child.
• You have anal intercourse.
• You are overweight or obese.
• You have had fissures before.

This is commonly seen amongst infants and young children as they often suffer from constipation.

What are the symptoms of fissure? How is fissure diagnosed?

The symptoms of fissure include:

• Visible cut or tear in the skin around the anus.
• Visible skin tag or lump around the tear.
• Sharp pain while passing stool.
• Bleeding while passing stool.
• Itching or burning around the anus.

Diagnosis

A physical examination of the anal area along with a rectal exam is usually used to confirm a diagnosis of fissures. This may include inserting an anoscope into the rectum to allow the doctor to inspect the anal canal as long as the patient is not in too much pain. In some cases, an endoscopy may be required. If the doctor believes that the fissure is caused by an underlying condition, he may also ask for a colonoscopy and a flexible sigmoidoscopy.

What are the complications of a fissure?

Some of the complications caused by fissures include:

• Recurring anal fissures.
• Tear that extends to the surrounding muscles.
• Extreme pain during bowel movements that makes the person want not to pass stool.

What is the treatment for fissure?

Medication and simple lifestyle remedies are usually all that is needed to treat fissures. Medication is usually prescribed to relieve the pain and itchiness associated with the fissure and to improve blood flow to the rectal area. A high-fibre diet and drinking plenty of fluids are advised to relieve constipation and soften stool. In some cases, stool softeners and laxatives may be temporarily prescribed.

In some cases, Botox injections may be prescribed to temporarily paralyse the rectal muscles to prevent new fissures from developing while the existing fissures heal. In rare cases of chronic fissures, surgery may be needed to relax the sphincter muscles.