What is an anal fissure?
What is an acute and chronic anal fissure?
What are the common causes of anal fissures?
These are typically caused due to some kind of trauma to the anus, usually seen with –
- Chronic constipation or straining during bowel movements
- Passing dry, large or hard stools
- Chronic diarrhoea
- Anal intercourse
- Trauma during childbirth
Other less common causes include-
- Inflammatory bowel disease
- Anal cancer
- Sexually transmitted infections (for eg. HIV, syphilis and herpes)
What are the risk factors for anal fissures?
Some conditions that can put you at a greater risk include –
- Crohn’s disease
- Anal intercourse
- Age (infants and middle-aged individuals)
What are some symptoms of anal fissures?
You may experience the following symptoms-
- Severe, sharp pain while passing motion
- Bright red blood in stools
- A crack or breakdown in the lining of the skin around the anus
- A small lump on the skin in the anal area
- Burning or itching in the anal area
How is an anal fissure diagnosed?
Your doctor will ask you about your symptoms and your bowel movements. They will do a gentle examination of the area around the anus. In case of any suspected underlying condition, they may further carry out –
- Anoscopy: A short device is inserted into the anus to visualise the anus and the lower rectum
- Proctoscopy: A short rigid tube is inserted into the anus to inspect the anus and the rectum
- Flexible sigmoidoscopy: A long flexible tube with an attached video camera is inserted to examine the rectum and lower portion of the colon
- Biopsy: A part of the tissue around the area involved is removed and taken for examination
How do you treat an anal fissure?
This condition can be extremely painful. Your doctor will recommend medicines that help relieve the pain and promote healing, such as –
- Simple painkillers such as paracetamol or ibuprofen
- Topical anaesthetic creams that you can apply directly on your anus to counteract the pain
- Laxatives to help you pass motions more easily
- Topical Nitroglycerin ointment that you can directly apply to the affected area. This increases blood flow to the affected area and promotes healing
- Calcium channel blockers (CCBs) usually used to treat high blood pressure, can increase the blood supply to the anal sphincter and help it relax
- Botox injections (botulinum toxin) which paralyse your anal sphincter muscle and prevents it from spasming
- In case of a non-healing or chronic anal fissure, your doctor may recommend surgery. A procedure called lateral sphincterotomy is usually performed. A small incision is made into the muscle surrounding the anal sphincter which can help reduce pain, promote healing and decrease your chances of getting them in the future.
What is the post-op recovery period of fissure surgery?
Are there any side effects post-surgery?
Very rarely, you may experience side effects that usually resolve on their own after a few weeks. These include –
- Minor faecal incontinence, where you may temporarily lose control over your bowel movements
- Flatulence or passing gas involuntarily
What are some complications of anal fissures?
Complications include –
- Persistent pain
- Difficulty passing motions or altered motions
- Decreased quality of life
- Extension of the tear to surrounding muscles
Can an anal fissure go away on its own?
What happens if an anal fissure in untreated?
Can an anal fissure return after healing?
How can I naturally prevent anal fissures?
Preventive measures include –
- Staying well hydrated
- Consume a fibre-rich diet with lots of fresh fruits and vegetables, wholewheat grains such as brown rice, oats, ragi, millets etc.
- Avoid straining while passing motion
- Keep your anal region as clean and dry as possible
- Avoid any over-the-counter creams and ointments unless specifically recommended by your doctor
- Regularly exercise at least 2.5 hours a week