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ANAL FISSURE

WHAT IS ANAL FISSURE?

Trauma or injury can lead anal canal to enlarge and a tear in the anus lining. These anal fissures are frequently produced by increasing or hard stools. They may cause pain and bleeding during and after bowel movements.


Anal fissures, unlike piles, can be extremely painful from the start. The minor rip in the moist tissue of the anal area might result in intense itching and spam in the anal sphincter.

WHAT ARE THE TYPES OF FISSURES?

Fissures can be categorized as follows, depending on the severity of the condition:

• Acute Fissures
• Chronic Fissures

WHAT IS ACUTE FISSURES?

Acute fissures are newly formed, they are easily treated. Simple home remedies can help these fissures heal on their own. If left untreated, turn into chronic fissures in the future.

WHAT IS CHRONIC FISSURES?

These are fissures that last longer than 8-12 weeks and require treatment to heal. Chronic fissures include, in additional to the anal break, a swelling known as a skin tag and extra tissue regeneration known as hypertrophied papilla.

WHAT ARE SYMPTOMS OF FISSURES?

Anal fissures are typically accompanied by a burning discomfort at the bottom. Following fissure symptoms are:

• During bowel motions, there is pain that can be severe at times.
• Pain that lasts for several hours after bowel movements
• After bowel movement, there is bright red blood on the stool or toilet paper.
• A visible skin tears around the anus
• A tiny bump or skin mark at the anal fissure.

WHAT ARE CAUSES OF ANAL FISSURES?

Most common reasons of an anal fissure:

• Passing thick or difficult stools
• Constipation and bowel movement strained
• Diarrhea that repeats
• Sexual activity
• Childbirth

WHAT ARE LESS COMMON CAUSES?

Less common causes of anal fissures


• Cohn’s disease or another inflammatory bowel disease
• Anal cancer
• Anti-Retroviral Therapy
• Syphilis
• Tuberculosis

WHAT ARE THE RISKS INVOLVED WITH ANAL FISSURES?

Factors that may increase your risk of developing an anal fissure include:


• Constipation- While pushing during bowel movements and passing hard stools, increases the risk of tearing
• Childbirth- Anal fissures are more common in women after they give birth.
• Crohn's disease- This irritable bowel disease causes chronic intestinal absorption, which may increase the anal canal wall more prone to tearing.
• Anal intercourse.
• Age- While anal fissures can occur at any age, they are more common in newborns and middle-aged adults.

WHAT IS THE TREATMENT FOR ANAL FISSURES?

Anal fissures heal in a few weeks if you take precautions to keep your stool soft, such as increasing your fiber and hydration intake. Bathing in warm water for 10 to 20 minutes many times each day, particularly after bowel motions, might help relax the sphincter and promote healing.


WHAT ARE NONSURGICAL TREATMENTS?

Your doctor may advise you to use nitroglycerin externally to improve blood flow to the fissure, promote healing, and relax the anal sphincter.


When all other conservative treatments fail, nitroglycerin is often considered as recommended medical treatment. Headaches, which can be severe, are one of the possible adverse effects.


• Topical anesthetic creams such as lidocaine hydrochloride (Xylocaine) may be helpful for pain relief.
• Botulinum toxin type A (Botox) injection paralyzes the anal sphincter muscle and relaxes spasms.
• Blood pressure medications, Oral nifedipine (Procardia) or diltiazem (Cardizem) could use to relax the anal sphincter. These medicines, which can be taken orally or applied directly, are used when nitroglycerin is ineffective or causes significant side effects.

WHAT IS SURGICAL TREATMENT?

If you have a chronic anal fissure that is resistant to other treatments, and if your symptoms are severe, your doctor may consider surgery. Doctors often perform a procedure known as lateral internal sphincterotomy (LIS), which involves cutting a small section of the anal sphincter muscle to ease tightness and discomfort and promote healing. According to studies, surgery is far more beneficial than any medical treatment for chronic fissures.

HOW TO PREVENT ANAL FISSURES?

• Stay hydrated. Throughout the day, drink lots of caffeine-free fluids. (Excessive alcohol and caffeine use might cause dehydration.).
• Eat a fibre-rich diet. To avoid constipation, aim to consume 20 to 35 grammes of fibre each day. You may gradually increase your fibre intake.
• Try fibre supplements if you can’t get enough fibre from food. They can lighten stools and help you become more regular.
• Don't ignore or Hold off bowel movements can lead to constipation, stools become more difficult to pass, causing discomfort and tearing.
• Do not push or sit on the toilet for a longer duration. This might cause an increase in pressure in the anal canal.
• After each bowel movement, gently wipe and dry your anal area.
• Avoid skin irritants like scented soaps and bubble baths.
• Get treatment for chronic constipation or ongoing diarrhea.


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