ANAL FISSURES
Cysts and lumps are abnormal growths that can appear under the skin or within the
body’s tissues.
What Are Anal Fissures?
Anal fissures are small tears or cracks in the lining of the anus, often caused by
passing hard or large stools, straining during bowel movements, or chronic
constipation or diarrhoea. They can be extremely painful, especially during or after a
bowel movement, and may cause bleeding, typically visible as bright red blood on
the stool or toilet paper. Anal fissures can affect individuals of all ages but are
particularly common in infants and middle-aged adults
Types of Anal Fissures
Anal fissures can be classified into two types based on how long they persist and
whether they heal with treatment
1.Acute Anal Fissures
These are fresh tears that appear suddenly and
typically heal within a few weeks with proper care. They are often caused by
temporary factors such as constipation or diarrhoea and respond well to non-
invasive treatments.
2.Chronic Anal Fissures:
If a fissure lasts more than six weeks or fails to heal
despite treatment, it is considered chronic. Chronic fissures may be deeper
and harder to treat, often associated with muscle spasms in the anal
sphincter, which can prevent healing.
How Are Anal Fissures Diagnosed?
Diagnosing anal fissures generally involves a physical examination by a healthcare
professional. The following steps are commonly taken for diagnosis:
Visual Inspection:
During a physical exam, the doctor will inspect the anal
area for any visible tears or cracks. Acute fissures are easier to identify, while
chronic fissures may be harder to detect as they can be deeper or covered by
skin tags.
Digital Rectal Exam:
The doctor may perform a rectal exam by gently
inserting a gloved finger into the anus to feel for any abnormalities, but this is
often avoided in patients with acute fissures to prevent causing additional
pain.
Anoscopy:
In some cases, an anoscope (a small tube with a light) is used to
look inside the anus and rectum, especially if the fissure is not easily visible.
Differential Diagnosis:
The doctor may also check for other conditions that
can cause similar symptoms, such as haemorrhoids, anal infections, or
inflammatory bowel disease, to rule them out.
What Are the Treatment Options for Anal Fissures?
Treatment for anal fissures focuses on relieving symptoms, promoting healing, and
preventing recurrence. Options vary depending on the severity and chronicity of the
fissure:
Conservative and Non-Surgical Treatments:
Dietary Changes:
Increasing fibre intake (e.g., fruits,
vegetables, and whole grains) and drinking plenty of water can soften
stools, reducing the strain during bowel movements.
Stool Softeners or Laxatives:
These medications can help
make stools easier to pass and reduce constipation, one of the main
causes of fissures.
Sitz Baths:
Soaking the anal area in warm water for 10-20
minutes several times a day, especially after bowel movements, can
relieve pain and promote healing.
Topical Medications:
Prescription creams or ointments such as
nitro-glycerine or calcium channel blockers (e.g., diltiazem) can help
relax the anal sphincter and improve blood flow to the area, promoting
healing. Over-the-counter pain-relief creams may also help with
discomfort
Botox Injections:
For chronic fissures, Botox injections can
relax the sphincter muscle, allowing the fissure to heal by reducing
muscle spasms.
Surgical Treatments:
Lateral Internal Sphincterotomy (LIS):
This is the most
common and effective surgical treatment for chronic anal fissures. The
procedure involves making a small cut in the internal anal sphincter to
reduce tension and allow the fissure to heal. It has a high success rate,
though there is a small risk of incontinence
Fistulectomy:
In some cases, especially for chronic fissures
with excessive scar tissue, the doctor may remove the damaged tissue
surrounding the fissure to aid healing.
Anal Dilatation:
This procedure involves stretching the anal
canal to relieve pressure on the fissure. However, it is less commonly
used due to the risk of incontinence.
Conclusion:
Anal fissures are a common condition that can cause significant pain and discomfort.
Fortunately, most acute fissures heal with conservative treatments such as dietary
changes, stool softeners, and topical medications. Chronic fissures may require
more advanced interventions, including Botox injections or surgery. Early diagnosis
and proper treatment can help manage symptoms and promote healing, preventing
long-term complications. If you experience persistent pain or bleeding during bowel
movements, consulting a healthcare professional is crucial for appropriate diagnosis
and care.
For effective diagnosis and treatment of anal fissures, visit Rutvik
Hospitals and receive expert care tailored to your needs.
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