Anal fissures are not a serious medical condition and can affect people of any age group. Since constipation is a common problem in infants and young children, most cases of anal fissures are known to occur in these age groups.
In most cases, anal fissures resolve on their own in around four to six weeks. It is considered severe only if anal fissures persist beyond eight weeks and Smiles Gastroenterology has the best treatment for fissures, which include laser treatment for fissure.
An anal fissure is a small tear or cut in the thin tissue that lines the anus. The tear can cause severe pain and bleeding during bowel movements and in some cases, patients may even experience spasms in the anal sphincter (a small muscle ring at the end of the anus). Smiles Gastroenterology has highly skilled doctors that recommend the most effective piles and fissure treatments.
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What Causes Anal Fissures?
Common causes of anal fissures include:
- ● Anal intercourse
- ● Straining during childbirth
- ● Bowel movements
- ● Inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis
- ● Overly tight anal sphincter muscles
- ● A decrease in the blood flow to the anorectal area
In rare cases, anal fissures may also develop due to:
- ● HIV
- ● Anal cancer
- ● Syphilis
- ● Herpes
- ● Tuberculosis
What are the Symptoms of Anal Fissures?
- ● Severe pain during bowel movements
- ● Pain after bowel movements that lasts for hours
- ● A tiny lump of skin next to the tear
- ● A visible tear in the skin around the anus
- ● Bright red blood in the stool or on the toilet paper after wiping
- ● Itching or a burning sensation in the anal area
If you or your child experience these symptoms, seek medical assistance immediately.
How are Anal Fissures Diagnosed?
An acute anal fissure may look like a tiny cut in the skin resembling a fresh papercut. A chronic anal fissure may be a deeper cut and have a fleshy growth, either internal or external or both. The location of your anal fissure may help determine its cause as well. For instance, an anal fissure that develops on the side of the anal opening could be due to inflammatory bowel disease, such as Crohn’s disease.
Your doctor may recommend the following tests to confirm the diagnosis of anal fissures:
- ● Anoscopy The doctor will insert a tiny tube-like device called an anoscope into your anal region to examine the anus and rectum. It will help the doctor determine the location and severity of the fissure.
- ● Flexible sigmoidoscopy The doctor will insert a small tube equipped with a camera at the bottom of your colon. It will help the doctor determine the location of the anal fissures. This test may be performed only if you are younger than 50 years and have no possible risk factors for intestinal cancer or colon cancer.
- ● Colonoscopy This test may be done to inspect the entire colon. The doctor will insert a tubular device into your rectum to look for fissures. Your doctor may perform this test if you are older than 50 years, have risk factors for colon cancer, or show signs of other underlying medical conditions.
How are Anal Fissures Treated?
- ● Increasing your intake of fluids and high-fiber foods
- ● Soaking your anal region in warm water for 10 to 15 minutes a day
If your symptoms continue to worsen, your doctor may recommend alternative treatment options for anal fissures which include:
Non-surgical treatment options
- ● Blood pressure medications : To help relax the anal sphincter, your doctor may recommend medications such as Diltiazem or Nifedipine. These medications can either be taken orally as pills or applied externally to the affected region.
- ● Nitroglycerin : This may help increase the blood flow to the anal region and promote healing of the anal sphincter. Nitroglycerin is considered to be an effective treatment option when other options fail to work. You may experience some side-effects of taking nitroglycerin which in some cases, can be severe.
- ● Anesthetic creams : Your doctor may recommend topical creams that contain lidocaine hydrochloride to help provide relief from pain and discomfort.
- ● Injections : An injection of botulinum toxin type A may be given to paralyze the anal sphincter and help relax spasms.
Surgical treatment options
Your doctor may recommend surgery if your anal fissures are chronic and if your symptoms continue to worsen over time.
The surgeon may perform a procedure known as lateral internal sphincterotomy to treat anal fissures. It involves removing a small piece of the anal sphincter muscle to provide relief from pain and spasms and promote healing.
Result The outcome of anal fissure surgery is usually positive. Studies have shown that in severe cases of anal fissures, surgery is proven to be most effective.
What are the Risks associated with Anal Fissures Surgery?
- ● Fecal incontinence
- ● Infection
- ● Unexpected bleeding
- ● Perianal abscess
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Pregnancy & Fissure
What Is Pregnancy & Fissure?
Why Do Anal Fissures Appear During Pregnancy?
Anal fissures are small cuts or tears that appear in the inner lining of the anus. Because the anus is sensitive, even a small cut may cause sharp pain, bleeding, or itching in the area.
During pregnancy, the hormonal shifts along with the increased strain on the pelvic region may develop fissures. However, there are several treatment options available to combat the symptoms.
What Causes Pregnancy & Fissure?
- ● Constipation: The pregnancy hormones may change your bowel movements and cause constipation. Passing stools while constipated may strain your anal region and lead to cuts or tears due to the hard stools.
- ● Straining during childbirth: Another common reason for anal fissures in pregnant women is childbirth. During childbirth, you may put a strain on your anal region and cause tearing.
- ● Inflammatory intestinal diseases: Various inflammatory intestinal conditions such as inflammatory bowel disease, ulcerative colitis, or Crohn’s disease may also cause anal polyps.
- ● Sexually transmitted diseases: Sexually transmitted diseases (STDs) like HIV, syphilis, or herpes may also lead to anal fissures.
- ● Other medical conditions: Other medical conditions like high blood pressure or anal cancer may also make you more susceptible to developing fissures.
What are the Symptoms of Pregnancy & Fissure?
- ● Bleeding from the anus
- ● Change in the stool color
- ● Change in bowel habits
- ● Severe Abdominal pain
- ● Burning or itching in the anal region
- ● A small lump on the skin near the tear
How are Anal Fissures Diagnosed in Pregnant Women?
- ● Physical exam: Your doctor will first visually check the site of your anus and ask for your medical history.
- ● Colonoscopy: In this procedure, your doctor inserts a thin, flexible tube with a camera attached to your anus. The camera transmits images of the rectum and helps detect any tears or bleeding in the skin.
- ● Sigmoidoscopy: In this procedure, your doctor will insert a more flexible and thin tube inside your anus. The camera attached to this tube helps check for cuts in the upper part of the rectum.
- ● Stool tests: The stool tests help your doctor check for blood in the stool and assess the presence of abnormal cells in the body.
How Is Pregnancy & Fissure Treated?
- ● Topical anesthetic creams: Topical anesthetic creams like lidocaine hydrochloride can be applied to relieve pain in the area.
- ● Externally applied nitroglycerin: Nitroglycerin is generally applied when other treatments do not work. It helps promote blood flow in the anal region and relax the sphincter muscle.
- ● Botox injection: A botox injection may help in relaxing the muscles and reduce spasms.
- ● Surgery: If other treatments do not work, your doctor may recommend surgery. Doctors generally perform lateral sphincterotomy (LIS), a surgery in which the surgeon will cut a small portion of the sphincter muscle to relieve spasms and pain.
What are the Results associated with Pregnancy & Fissure Surgery?
What are the Risks associated with Pregnancy & Fissure Surgery?
- ● Itching in the anus
- ● Perforation in the rectum
- ● Bleeding from the anus
- ● Severe pain
- ● Fever and chills if the area is infected
How do can I know it is an Anal Fissure and not a Hemorrhoid?
What Happens if Anal Fissures are left Untreated?
Can Ointments and Creams Heal Anal Fissures?
What type of Food Items should be Consumed during Anal Fissures?
How Long does it take to Recover from Aanal Fissure Surgery?
What Happens if Anal Fissures are Left Untreated?
- ● Increased swelling in the anal area
- ● Bowel obstruction
- ● Increased pain while passing stools
- ● Bleeding from the anus
- ● Difficulty in walking or sitting
- ● Increased risk of infection
What are Some Foods to Avoid if you have Anal Fissure?
- ● Processed foods like bread, biscuits, cakes, etc.
- ● Coffee, tea, or other caffeinated drinks
- ● Spicy foods or any frozen pre-prepared foods
How Can Anal Polyps be Prevented?
- ● Limiting your intake of caffeine
- ● Maintaining good hygiene and cleanliness
- ● Drinking plenty of water
- ● Consuming fruits and vegetables that are high in fiber