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Anal fissure: Treatment, symptoms, advice and help

About anal fissure

Anal fissure is a tiny tear in the anal canal lining which may cause intense pain and bleeding. They may occur as a result of hard, stony stools. Anal canal is a tubular structure at the end of the gastro-intestinal tract through which stool exits the body.

Anal fissure: Incidence, age and sex

Anal fissures may occur in any age group but it is more frequent in infants. Clinical studies have not shown any distinct gender predominance.

Signs and symptoms of anal fissure: Diagnosis

The clinical picture of an anal fissure comprises of intense, sharp pain or burning sensation during bowel movements. The pain may last for minutes to hours. Sometimes fresh blood is seen on surface of the stool. Some affected individuals may also complain of persistent anal itching. A detailed physical examination of anal region by the surgeon may establish diagnosis of anal fissure.

Causes and prevention of anal fissure

The anal canal may get damaged due to several factors, most common of which is passing of hard or large stools through it. Such consistency of stools may result from persistent constipation. Other causes may include spurious diarrhoea and inflammatory condition of the anal canal. Crohn’s disease and Ulcerative colitis are two such inflammatory conditions which may predispose anal fissure. Rare causes of anal fissure are anal intercourse and vaginal childbirth.

Anal fissure: Complications

Anal fissure is a self-limiting condition, rarely leading to any other serious consequences. It fails to heal in occasional individuals where it may persist for even weeks. No other health problem has been documented.

Anal fissure: Treatment

Anal fissures may heal by themselves or need surgical intervention. Certain dietary modifications like drinking increased quantities of fluids, avoidance of spicy food, maintaining a high fibre diet which includes lots of raw fruit and vegetables may be helpful in preventing persistent constipation. Medications like stool softeners and laxatives may be prescribed. It is advisable not to strain while passing stool. The doctor may advice Sitz bath two to three times daily, wherein the patient is supposed to soak the anal area in plain lukewarm water. This helps in the healing of the anal fissure by increasing blood flow to that area. Surgical correction of fissure may be needed in resistant cases when the above measures fail.