| General
Illness Information |
Common Name: |
ANAL FISSURE |
|
Medical
Term:
|
Fissure-in-Ano
|
| Description: |
A tear or ulcer in the lining of the anus, causing pain on defecation.
|
| Causes: |
Causes include stretching of the anal wall by large hard stool or tightening
of the anal canal due to tension or the laceration by foreign body.
|
| Prevention: |
Avoid constipation by: Drinking at least 8 glasses of water daily;
Eating a diet high in fiber; Using stool softeners if needed; Don't strain at stool; Avoid anal intercourse.
|
| Signs
& Symptoms |
 |
Painful bowel movement associated with bright red bleeding.
|
|
Pain then subsides and recurs with the next bowel movement.
|
|
Streaks of blood on toilet paper, underwear or diaper.
|
|
May become chronic, with periods of exacerbation or remission
|
|
Fissure causes the sphincter to go into a spasm, which may prevent healing.
|
|
| Risk
Factors |
|
Constipation
|
|
Multiple pregnancies
|
|
Leukemia
|
|
Crohn's disease
|
|
Immunodeficiency disorders
|
|
Chronic use of laxatives
|
|
| Diagnosis
& Treatment |
| General
Measures: |
|
Examination of the anus and rectum with an anoscope or sigmoidoscope
to rule out other causes of anal or rectal bleeding.
|
|
Gently clean the anal area with soap and water after each bowl movement
|
|
To relieve muscle spasms and pain around the anus, apply a warm towel to the area
|
|
Sitz baths also relieve pain. Use 8 inches of warm water in the bathtub, 2 or 3
times a day for 10 to 20 minutes.
|
|
Surgery may be necessary, if conservative treatment is not successful, to remove
the fissure or to alter the muscle that contracts and prevents normal healing
|
|
| Medications: |
|
For minor pain, use non-prescription drugs, such as acetaminophen or topical anesthetics.
|
|
Zinc oxide ointment or petroleum jelly applied to the anal opening may help to prevent the burning sensation.
|
|
Bulk stool softeners will help to avoid the pain occurring with bowel movements.
|
|
Lidocaine ointment may be recommended.
|
|
| Activity: |
|
No restrictions. Physical activity reduces the likelihood of constipation.
|
|
| Diet: |
|
A high-fiber diet and extra fluids (ie. 8 glasses of water a day)
to prevent constipation are recommended.
|
|
| Possible
Complications : |
|
Permanent scarring that prevents normal bowel movements.
|
|
| Prognosis |
|
Most adults recover in 4 to 6 weeks with treatment, making surgery
unnecessary. Most infants and young children recover after the stool is softened.
|
|