Anal fissure is a tear in the anal canal, the lowest part of your intestinal tract. Due to this the bowel movements are painful and can cause pain that may last for hours after you have gone to bathroom.

Anal fissure is common in young infants but can effect at any age group. Most of the anal fissures can be simply managed with increased intake of fiber diet or sitz bath. Some need medications and occasionally surgery is indicated.

 

Symptoms:

  • A visible tear in the anus
  • Pain during bowel movements
  • Blood on used toilet paper or wipes
  • Blood on the surface of stools
  • Bleeding that discolors toilet water
  • Bad-smelling discharge

Causes:

  • Passing large or hard stools
  • Constipation
  • Chronic diarrhea
  • Crohn’s disease

 

Diagnosis:

Doctor will take detailed history and will perform digital rectal examination i.e the gloved finger is inserted into your anal canal. The doctor may use anoscope to examine the anal canal. These tests are deferred until after the pain has subsided, with the application of a local anaesthetic gel, to minimize the pain and discomfort. Doctor may suggest further testing if he or she thinks that you have an underlying condition causing anal fissure.

Further testing can include

  • Flexible sigmoidoscopy
  • Colonoscopy

Treatment:

  • Stay hydrated
  • Eat fiber rich food
  • Avoid straining during the bowel movement
  • Get treated for long standing constipation and diarrhea
  • Sitz bath for relief of discomfort
  • Topical anaesthetic cream like Lidocaine Hydrochloride can help in applied to the area pain relief.
  • Surgery: surgery called lateral internal sphincterotomy involves a small cut in anal sphincter muscle. It reduces pain and pressure allowing fissure to heal.

 

By,

Dr.Chandrashekar

 

Reference:

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2141661/

https://www.mayoclinic.org/diseases-conditions/anal-fissure/diagnosis-treatment/drc-20351430

https://emedicine.medscape.com/article/196297-overview

 

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