Tear or crack in the lining of the anus is known as anal fissure. These fissures can cause severe pain accompanied with bleeding during and after bowel movements. Sometimes these fissures can be deep enough to expose the underlying muscle tissues.
Symptoms of an anal fissure
A few symptoms associated with anal fissures include visible cracks and tear around the anus, small lump of skin next to these cracks and pain accompanied with blood during bowel movement. They also cause itching around the anus.
What causes an anal fissure and who is at risk for an anal fissure?
These fissures usually occur by passing hard or large stools, during constipation and diarrhea. A few other reasons include:
- Straining during bowel movement particularly in the case of acute constipation. It is mostly observed in infants and kids, among whom the constipation issue is very common.
- Straining during delivery can also lead to anal fissure among women.
- People with inflammatory bowel disease are also at high risk of developing anal fissure. The intestinal, inflammation makes the tissue around the anus more susceptible to tearing.
- Elderly are also prone to anal fissure, due to decreased blood flow in their anorectal area.
Diagnosis of anal fissure
To diagnose anal fissure, doctor examines the anal area. In a few cases, for a more confirmed diagnosis, he may also conduct rectal exam, during which an endoscope is inserted into the rectum. Anoscope is a thin tube that allows the doctor to examine the tear in the rectum and find out if there exists any the other reason for the fissure. In acute cases endoscopy might also be performed.
Treatment of anal fissures
Though it is not a very serious condition and in most of the cases, it heals on its own within four to six weeks, yet if it extends beyond that, it is considered chronic. A few treatments include:
- Certain treatments such as use of stool softeners and applying topical pain relievers, such as lidocaine, can ease the discomfort and promote healing. Eating fiber rich food, taking fiber supplements and drinking more fluids also helps in easing the symptoms.
- Sitz bath (a shallow bath that helps to clean the space between rectum and vulva or scrotum) helps to relax the anal muscles, relieves irritation and allows more blood flow to the anorectal area.
- Application of Hydrocortisone cream or nitroglycerin based ointment, also help to increase the blood flow to the affected area and thus help in healing.
If the above treatments do not help to cure the symptoms, doctors perform other treatments such as:
- Use of ointments such as calcium Channel blockers to relax the sphincter muscles.
- Botox injections can be administered into the anal sphincters. They temporarily paralyze the anal muscles and allow the fissures to heal and prevent the formation of new fissures.
- If the above treatments also fail, doctor may recommend anal sphincterotomy. During this surgery small incision is made in the anal sphincter to relax them and thus allowing them to heal.
Prevention of anal fissures
Risk of getting anal fissures can be reduced by following a few simple preventive measures such as by keeping the anal area clean with help of lukewarm water and mild soap. One should keep the anal area dry. Drink lot of fluids, eat fiber rich food and exercise regularly.Infants diapers should be changed frequently.