Anal fissure: symptoms, causes, treatment, etc. & bull; hello healthy

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Definition

What is an anal fissure?

Anal fissures are small tears or sores found in the mucosal tissue of the anus. The mucosa is the thin, moist tissue that lines the anus. This condition generally occurs when the stool is hard and large enough.

Anal fissures usually cause pain and bleeding, during and after a bowel movement. The muscles at the end of the anus will also feel tight and hard.

This condition can be classified as acute if it lasts less than 6 weeks and you have never experienced it. If symptoms persist for more than 6 weeks or recur frequently, a fissure can be classified as a chronic condition.

In acute conditions, the tear will look like a new wound. However, when the tear is accompanied by two separate lumps on the skin, that is sentinel pile (inner) and hypertrophied papilla (external) the possibility of the condition including chronic.

The appearance of a tear or injury at the tip of the anus generally will not cause serious conditions. In most cases, the wound will go away on its own in 4-6 weeks. However, having a bowel movement can sometimes hinder the recovery of the tear in the anus.

Another case with chronic fissures, which require treatment or even surgery to prevent the condition from recurring. Surgery is also usually performed to prevent damage to the surrounding muscles.

How common are anal fissures?

Anal fissures are a fairly common condition. Although this condition can occur in patients of any age, it occurs in adults aged 20 to 40 years. Many babies suffer from this condition.

Women and men also have the same opportunity to experience this. However, people with certain diseases and health problems are at risk of developing this condition.

Diseases and health problems that are often associated with fissures are anal cancer, leukemia, HIV, or ulcerative colitis.

This condition can be handled and controlled by recognizing the existing risk factors. To find out more information about this disease, consult your doctor immediately.

Signs & symptoms

What are the signs and symptoms of anal fissures?

The signs and symptoms of anal fissures can vary from one patient to another. However, there are signs that are most commonly found in many cases of fissures, namely:

• The anus is bleeding or has a small amount of blood on it
• Fresh red blood from the fissure separates from the stool.
• Mild to severe pain during bowel movements
• Pain after bowel movements that can last up to several hours
• Itching or irritation around the anus
• There are cracks in the skin around the anus
• Small lump or skin tag on the skin around the anal fissure

There may be signs and symptoms not listed above. If you have concerns about a particular symptom, consult your doctor.

When should I see a doctor?

If you have any signs or symptoms above or any other questions, please consult your doctor.

Each person's body shows signs and symptoms that vary widely. To get the most appropriate treatment and according to your health condition, always have any symptoms checked.

Cause

What causes anal fissures?

Anal fissure is a condition that can be caused by trauma to the anus and anal canal. This trauma can result from pushing too hard while having a bowel movement.

This can be aggravated if the stool issued from the anus is large and has a hard texture. Apart from pushing too hard, trauma to the anus can also be caused by the following conditions:

1. Chronic constipation

Constipation makes it difficult for you to pass stool and to push harder than usual, so that a sore can potentially appear at the end of the anus.

2. Prolonged diarrhea

Frequent diarrhea makes you have to defecate several times and push, so that the anus can be injured.

3. Have anal sex

Penetration of the penis into the anus also has the potential to cause trauma to the anal wall and canal.

4. Inserting a foreign object into the anus

The anus has the potential to get injured or torn if a foreign object is inserted.

5. Childbirth

Labor or delivery of a baby can cause trauma to the anal canal, so sores can appear on the anus.

Apart from the conditions above, other causes of anal fissures that are not commonly found are:

• Crohn's disease or other inflammatory digestive disease
• Inflammation of the anorectal area
• Anal cancer
• Decreased blood flow to the anorectal area
• HIV
• Tuberculosis (TB)
• Syphilis

Risk factors

What increases my risk for anal fissures?

Anal fissure is a condition that can occur in anyone of any age group, race, and ethnicity. However, there are several factors that can increase the risk of this condition.

Having one or more risk factors does not mean you will definitely experience the condition. There is also a chance that you could have a sore tear in the anus even though you don't have any of the risk factors.

The following are the risk factors that trigger the appearance of this condition:

1. Age

This condition is most commonly found in adults between the ages of 20 and 40. In addition, the incidence rate in infants is also high.

Therefore, your risk for experiencing this condition is higher if you fall into that age range.

2. Constipation

Straining too hard and passing stool or stool that is hard-textured increases the risk of developing sores in the anus.

3. Childbirth

Fissures are also more common in women who have recently given birth.

4. Suffering from Crohn's disease

This inflammatory disease of the digestive tract can cause chronic inflammation of the intestine. This can affect the thickness of the anal canal wall, making it easier for sores to appear.

Complications

What are the complications that can result from anal fissures?

While anal fissures generally heal on their own without special treatment, there are rare cases where complications can occur.

Here are some of the complications that can develop from the appearance of a tear in the anus:

1. Chronic fissures

If the tear does not heal after 6 or 8 weeks, the condition can be classified as chronic and requires further medical attention.

2. The possibility of relapse at a later time

If you have had a fissure once, you are more prone to developing this condition the next time.

3. The tear spreads to the anal muscle

The fissure can spread into the sphincter muscle. This muscle functions to close the openings of your anus. If the tear spreads to the muscle, it will be more difficult to heal.

4. Anal cancer

In very rare cases, untreated tears can lead to anal cancer.

Diagnosis & treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

How are anal fissures diagnosed?

If you feel the signs and symptoms mentioned above, immediately consult a doctor or the nearest medical service center.

During a physical exam, your doctor will ask you what symptoms you are experiencing. In addition, the doctor will also ask for a history of the disease that you have or are currently suffering from.

After that, the doctor will perform a physical examination by looking directly at your anus. In diagnosing a fissure, your doctor will perform several types of tests, such as:

1. Anoscopy

In this test, your doctor will insert a small tube equipped with a light to view your anal canal. This small tube can help the doctor see more clearly the part of your anus that is torn.

During the exam, your doctor can also find out if other conditions are affecting the tear, such as Crohn's disease or other inflammatory bowel disease. The doctor will recommend further tests to detect these conditions.

2. Flexible sigmoidoscopy

This test can be done if you are under 50 and have no risk factors for bowel disease or colon cancer.

3. Colonoscopy

This test can be done if you are over 50 years of age or have risk factors for colon cancer, signs of other conditions or other symptoms such as stomach pain or diarrhea.

How are anal fissures treated?

Anal fissures generally go away within a few weeks if you change your diet. An improved diet, such as increasing fiber and fluid intake, can help soften your stool or stool.

You can also soak in warm water for 10 or 20 minutes several times a day, especially after having a bowel movement. This can help speed wound healing and relax the anal sphincter muscles.

However, if the symptoms do not improve, you will need further treatment, either nonsurgical or surgical.

1. Non-surgical

The doctor will recommend several types of non-surgical treatment, such as:

Nitroglycerin (Rectiv)

This topical medication helps increase blood flow to the anal tear, so that the wound closes faster and the anal muscles relax more. This therapy is chosen if conservative therapy is unsuccessful. One of the side effects that may be felt is a headache.

Topical anesthetic cream

Your doctor may also prescribe a cream to relieve pain, such as lidocaine hydrochloride (Xylocaine).

Botox injections

Botulinum toxin type A or botox injections are useful for relaxing the sphincter muscles in the anus and relieving anal spasms.

Blood pressure medication

Medications such as nifedipine (Procardia) and diltiazem (Cardizem) can help relax the sphincter muscles. These medications can be taken or used if nitroglycerin is ineffective or has side effects.

2. Surgery

If the condition you are suffering from is chronic and does not improve after undergoing the above treatments, your doctor will recommend a surgical procedure.

The surgeon will perform a procedure calledlateral internal sphincteroctomy(LIS). In this procedure, the surgeon will cut a small part of your anal sphincter muscle to reduce pain and promote healing.

Home remedies

What are some lifestyle changes or home remedies that can be done to treat anal fissures?

Here are the lifestyle and home remedies that can help you deal with anal fissures:

• Add fiber to your diet. Eat fiber-rich foods in your diet every day, such as fruits, vegetables, nuts and whole grains.
• Drink lots of fluids. Fluids can help prevent constipation.
• Exercise regularly. Exercising helps with bowel movements and increases blood flow throughout the body, which can speed up recovery of anal fissures.
• Avoid straining too hard during bowel movements. Straining causes pressure, which can open a tear that is currently healing or cause a new tear. Set a schedule for bowel movements every day.

If you have any questions, consult your doctor for the best solution to your problem.

Hello Health Group does not provide medical advice, diagnosis or treatment.