An anal fissure is a small cut or tear in the lining of the anus. The crack in the skin causes severe pain and some bright red bleeding during and after bowel movements. At times, the fissure can be deep enough to expose the muscle tissue underneath.
In most cases, the tear heals on its own within four to six weeks. In cases where the fissure persists beyond eight weeks, it’s considered chronic.
Certain treatments can promote healing and help relieve discomfort, including stool softeners and topical pain relievers.
If an anal fissure doesn’t improve with these treatments, you may need surgery.
An anal fissure may cause one or more of the following symptoms:
An anal fissure most often occurs when passing large or hard stools. Chronic constipation or frequent diarrhea can also tear the skin around your anus. Other common causes include:
A doctor can usually diagnose an anal fissure simply by examining the area around the anus. However, they may want to perform a rectal exam to confirm the diagnosis.
Using an anoscope may also help your doctor find other causes of anal or rectal pain such as hemorrhoids.
Most anal fissures don’t require extensive treatment. However, certain home remedies can help promote healing and relieve uncomfortable symptoms. You can treat an anal fissure at home by:
If your symptoms aren’t relieved within two weeks of treatment, see your doctor for further evaluation. Your doctor can make sure you have the correct diagnosis and can recommend other treatments.
A calcium channel blocker ointment can relax the sphincter muscles and allow the anal fissure to heal.
Another possible treatment is Botox injections into the anal sphincter. The injections will prevent spasms in your anus by temporarily paralyzing the muscle. This allows the anal fissure to heal while preventing new fissures from forming.
If your anal fissure fails to respond to other treatments, your doctor may recommend lateral internal sphincterotomy ( anal fissurectomy). This surgical procedure involves making a small incision in the anal sphincter to relax the muscle. Relaxing the muscle allows the anal fissure to heal.
An anal fissure can’t always be prevented, but you can reduce your risk of getting one by taking the following preventive measures:
Anal fissures may cause sharp pain and small amounts of bright red blood with bowel movements. If it becomes a chronic anal fissure, skin tags may develop in the area associated with a chronic local infection.
Conditions associated with anal fissures include previous anal surgeries, inflammatory bowel disease, local cancers, and sexually transmitted diseases.
Some conditions that may more directly lead to anal fissures are ones that induce trauma to the area, such as vaginal delivery, anal sex, or passing hard stool.
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