Anal Fissure – Symptoms, Causes, Pictures, Treatment

If there is any split or cutting in the area of anus, it is known as anal fissure. It is the opening or tearing in the mucous lining of the anus causing infection. Very often, infants of less than one year have anal fissure and it would subside as the child grows. Fissures rarely occur on school going children and adults. However in some adults, fissures or opening is caused due to constipation or passing of hard stool. A small crack or opening in the anus which stretches the anal area is the main symptom of anal fissure. It may cause moderate to intense pain while bowel movements. There may be discharge of blood along with stool.

As such anal fissures do not require any treatment and following hygiene habits will prevent you from fissure and pain. Make sure to cleanse the area gently and do not rub the surface with your hands. Apply muscle relaxants like petroleum jelly on the affected area. Eat more fibrous food and drink plenty of water to avoid constipation. Certain stool softeners are available in the market to ease the passage of bowel movements. Only in severe cases, surgery is done for relaxing the anal muscle. Some people take Botox injection for relaxing the muscles in the anus. Follow clean habits and change diapers quickly to keep the anus dry and clean on infants.

What Are Anal Fissures ?

Anus, also known as rectum is that part of the body through which feces (stool) are expelled out. Fecal particles along with water gets collected in the large intestine and when it becomes full, urinary bladder ejects urine and the anus sends out feces. Sometimes when the stool becomes very hard and is not able to come out normally it tears the inner lining of the rectum which is known as anal fissure. Fissure is actually a tear or multiple tears in the region of anus when solid stools are pushed out. People who have constipation are likely to develop anal fissure.

Anal fissure can cause considerable pain while passing bowels. Sometimes it can also bloody discharge in the feces. Very often mild anal fissures heal on their own without any treatment. However for people with chronic constipation anal fissures is also long-term, requiring medical treatment. Anal fissures can occur at any age and it can affect even healthy people also.

What Are Piles (Hemorrhoids)?

  • A hemorrhoid is not the same as anal fissure, but is often confused. In the anal fissure, the skin around the rectum gets tear affecting the soft mucus lining of the rectum.
  • But a hemorrhoid can develop due to swelling of vein in the lower rectal area.
  • Both of these can cause similar symptoms like burning pain in the rectum while passing stool and blood discharge in the feces. Both of these problems can be managed with home remedies.

Causes Of Anal Fissure :

  • Any injury or trauma occurring in the anal canal can lead to anal fissure. Some people are in the habit of passing large (hard) stool which can cause tear in the lining of anal region.
  • People who suffer from long-term constipation would exert constant pressure while passing stool. This can cause considerable damage to the soft lining of the rectum causing anal fissure.
  • Individuals getting diarrhea infection often can get anal fissure. Frequent visits to the toilet can damage the cells of the anus causing anal fissure.
  • Women after childbirth are more likely to develop anal fissure. This is because during pregnancy, uterus would expand significantly to accommodate the growing fetus which would exert pressure in the pelvic region. This can cause anal fissure in many cases.
  • Similarly people who are overweight or obese are likely to develop anal fissure.
  • Extra tension developing in the sphincter muscle of the anus can lead to anal fissure. Normally the outer sphincter functions in your control whereas inner sphincter muscle is involuntary. Continuous pressure in this area can cause spasm which can restrict the blood flow to the anus which gradually becomes an anal fissure.

Anal Fissure Symptoms :

You may feel the burning pain while passing stools. There would be sharp intense pain suddenly during bowel movements. When the hardened stool passes through the tear the sharp edges of the stool would cause more intense pain. For some people anal fissure can cause bleeding occasionally. Bright red streaks of blood can be seen on the toilet paper. This type of cases can take more time for healing. Infants can also develop anal fissure shortly after birth but this would settle down in few months. Never wipe hardly after the baby passes stool. You can use little water for cleaning and gently pat it dry.

Diagnosis :

Your doctor will first complete the physical exam paying attention to the rectal area. He would use lighted instrument to look into the anus by gently inserting his gloved finger inside. He would identify any tear or ulcerous growth inside during anoscopy test. In case of excess of pain he would give you a shot of numbing injection before examining the rectum.

Pictures of Anal Fissure :

Images, Pictures, Pics and Photos of Anal Fissure

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Anal Fissure Treatment :

Mild form of anal fissures would heal automatically within few weeks. You can manage pain with home remedies or OTC medications. Lifestyle changes and home remedies can help in relieving the symptoms of anal fissure.

  • Lifestyle changes

The first point of treating the fissure is to prevent constipation. You need to schedule time for passing stools and never postpone it. Don’t push or strain yourself in the toilet. Constipation can be prevented by eating plenty of vegetables, fruits and whole grains daily. Include fiber rich diet in your schedule. Each adult should take 20-30 gm of fiber daily. Foods like oat bran, whole wheat, grains like brown rice, cereals and breads, vegetables like beans, peas and citrus fruits and prune juice contains plenty of fiber. By adding some of these items you can improve constipation for sure.

Practice some exercise regularly. Fiber supplements like Metamucil after consulting your doctor. Whenever you feel bowel movements in your lower abdomen do not postpone it. In case the stool has become hard you can use some laxatives occasionally. Sitz therapy can be effective for people having anal fissure. You can relax yourself in a big tub filled with lukewarm water for some time. You can repeat this simple therapy many times a day to get the best result. After using toilet, do not wipe harshly which can increase pain in the torn anus. You can try using baby wipes or pads like Tucks or H wipes.

  • Medications

Based on the intensity of cuts or tear on the rectum, your doctor may prescribe ointments like Rectiv or similar ones which facilitates healing and relaxes the anal sphincter muscle. This compound contains nitroglycerin that helps in increasing blood flow to the area to heal it quickly.

He may also recommend anesthetic creams like lidocaine hydrochloride for temporarily numbing the area so that you may not feel pain. Botox injection can be given for relaxing the spasms. Medications like diltiazem or Procardia can also be prescribed for relaxing the anal sphincter. Your doctor will prescribe suitable doses based on the symptoms.

  • Surgery

This is considered as the last option for anal fissure and if the patient has chronic constipation which is not responding to any of the treatments. LIS (lateral Internal Sphincterotomy) is the surgery done for anal fissure in which the surgeon would gently cut and remove small part of the anal sphincter muscle thus increasing the hole of the rectal area. Even chronic constipation cases can get relief by this surgery.

Some Useful Tips To Prevent Constipation :

Men who are above 50 years are likely to develop constipation gradually. If you have anal fissure and burning pain in the anus you can try some of these home remedies to prevent anal fissure. Apply a paste made from few drops of olive oil and honey on the rectum. Leave it for few minutes and gently wash it off with water. Aloe Vera has excellent healing properly and you can apply this gel on the anus to get relief from sharp pain. Sit in the hot water tub for 15-20 minutes for getting soothing effect. You can repeat this simple method several times a day. This would reduce itching and swelling in the rectal area considerably.

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