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Anal Fissure: Causes, Prevention, and Treatments

Published on Dec 11, 2017 and last reviewed on Dec 23, 2021   -  5 min read

Abstract

Pain in the anus is one of the most common complaints encountered in outpatient clinics. The patient sometimes describes the pain as 'my worst pain ever. This article provides some suggestions on how to avoid this annoying issue by making a few dietary and lifestyle changes.

Contents
Anal Fissure: Causes, Prevention, and Treatments

What Is an Anal Fissure?

An anal fissure is a tear or ulcer that develops in the lining of the anal canal after passing a hard motion. It affects one in ten people at some point in their lives. All age groups and both sexes are affected equally. The anal fissure produces pain and bleeding during bowel movements. Anal sphincter muscle, a ring muscle at the end of your anus, may exhibit spasms.

What Causes an Anal Fissure?

The following are the most common causes of anal fissure:

Less severe causes of an anal fissure are:

What Are the Signs and Symptoms of Anal Fissure?

Anal fissure has the following manifestations:

What Increases the Risk of Developing Anal Fissure?

  1. After Delivery: The occurence of anal fissures in women is common after childbirth.
  2. Constipation: The risk of developing anal fissures is increased in people who strain and pass hard stools during bowel movements.
  3. Anal fissures are common in people who have anal sex.
  4. Crohn’s Disease: The lining of the anal canal is inflamed in Crohn’s disease, which is an inflammatory bowel disease. This, in turn, makes it more sensitive and increases the chance of developing anal fissure.
  5. Age: Although anal fissures can occur at any age, middle-aged adults and infants have an increased risk.

What Is the Course of Anal Fissure?

Usually, it resolves over four to six weeks. But, it can recur if there is constipation or hard motion. In some people, the condition turns chronic and lasts for years. Few develop complications such as anal stricture and require surgery.

What Can We Do to Prevent Anal Fissures?

How Is an Anal Fissure Diagnosed?

Complete medical history is obtained from the patient, and a gentle physical examination of the anal fissure is done. In most cases, an anal fissure can be diagnosed with visual inspection as it is often visible.

The cause of the anal fissure can be determined from the location itself. An underlying disorder like Crohn’s disease causes an anal fissure that has an opening on the side rather than having it on the front or back.

An anal fissure can be diagnosed by:

In addition to physical examination, the following tests can be performed to determine the cause:

What Is the Treatment of Anal Fissures?

What Are the Complications of Anal Fissures?

  1. Chronic Anal Fissure: If the anal fissure does not respond to treatment in eight weeks, it is considered chronic anal fissure, which might require further treatment.
  2. Recurrence: Recurrence of anal fissures is common.
  3. Tear Extending to Surrounding Muscles: In some cases, an anal fissure may extend and reach the internal anal sphincter muscle, a ring of muscle responsible for keeping the anus closed. This makes the healing of anal fissures difficult and causes discomfort.

What Lifestyle Changes Help in Treating Anal Fissures?

  1. An anal fissure can be healed by keeping the stools soft by daily taking around 25 to 30 grams of fiber. Whole grains, fruits, vegetables, and nuts are fiber-rich foods. Fiber supplements can be taken if required, but it should be noted that fiber should be taken gradually, as it can produce abdominal bloating and gas problems.

  2. Constipation can be prevented by drinking adequate amounts of water.

  3. Straining during bowel movements should be avoided because it creates pressure that might cause a new tear or open up an already healed tear.

  4. In children with anal fissures, frequently changing the diapers and washing the area gently help promote healing.

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Last reviewed at:
23 Dec 2021  -  5 min read

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