Anal fissure

What is it?

It is a painful crack in the internal lining of anus. This condition is common in all age groups. It is not a cancer.

What are the causes?

In patients who have constipation hard stools may tear the internal lining and cause an anal fissure. Some of these are associated with childbirth. Rarely, it is because of another illness such as tuberculosis or a type of inflammatory bowel disease known as Crohn's disease.

What are the symptoms?

Passing stool is very painful and this pain may persist. Occasionally there is bright red bleeding that may stain the stool or come in drops.

What is the treatment?

Some fissures get better without any special treatment. However, most require treatment, as it is a very painful condition. Steroid ointments, painkillers, local anaesthetic creams and warm baths relieve pain but do not help in healing. Nitroglycerin (0.2%) applied locally twice daily every day for 6 weeks will cure about 70% of these fissures. This ointment is very difficult to obtain in India. The side effects of this ointment application include troublesome headaches and even faintness. Quick healing can be achieved by partially dividing the anal sphincteric muscle, but this requires an operation. Anal dilatation is a rather crude method of overcoming spasm of the anal sphincter and this may result in complete damage to the sphincter especially in women.

What are the prevention?

The best way to avoid an anal fissure is to avoid constipation which can be done by taking a diet rich in dietary fibre which includes fruits, green leafy vegetables, wheat flour (atta) and the like.

What are the complications?

After this operation minor leakage of stool for a variable length of time may occur. The ability to distinguish between wind and stool may be lost temporarily. There is complete recovery in almost all the cases.

DoctorNDTV Team

Subash Gupta#/doctor/subash-gupta-108562#108562#Entity

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