Anal Fissure

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.

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