All You Need To Know About Anal Fissure

An anal fissure, or an anal ulcer, is a break or tear in the skin or muscle of the anal canal. Anal fissures cause severe pain and may result in bleeding during and after bowel movements. Sometimes, the fissure even cuts through the skin and exposes the muscle tissue underneath which might cause severe pain. In most cases, it is a temporary situation and heals on its own within four to six weeks. If it persists even after that, it is considered to be long term. It is advisable to get medical assistance if it becomes chronic. Here, we have compiled everything that you need to know about anal fissures.

What are the causes of an anal fissure?

Most often, anal fissure occurs with the passing of large and hard stool, which causes the anal mucosa to stretch beyond its capability. Constipation or frequent diarrhea can also cause the tear in the skin. It might also result from Inflammatory Bowel Disease (IBD), infection and cancer. Though anal fissures can affect people of all ages, it is generally seen in infants and young children as constipation is a common problem in these age groups. It can also occur due to:

1. Straining during childbirth

2. Decreased blood flow to the anorectal area

3. overly tight or spastic anal sphincter muscles

In some cases, it is seen to have developed from:

1. Anal cancer

2. HIV

3. Tuberculosis

4. Syphilis

5. Herpes

Who is most prone to an anal fissure?

Anal fissures are common during infancy. Older adults are also prone to anal fissures due to decreased blood flow in the anorectal area. Even the people with constipation are at a high risk of developing anal fissure. During and after childbirth, women are at risk for anal fissures due to straining during delivery.

People with IBD, such as Crohn's disease, also have a higher risk of developing anal fissures.

How can it be treated?

In most cases, it is a temporary situation and heals on its own within four to six weeks that's why mostly non-surgical treatments are recommended initially. The home remedies to it include:

1. Drinking a lot of fluids

2. Eating more fibrous food such as raw fruits and vegetables.

3. Taking warm baths to relax anal muscles, relieve irritation and increase the blood flow.

4. Applying pain relievers like lidocaine to the anus.

5. Applying a calcium channel blocker ointment to relax the sphincter muscles thus allowing the fissure to heal.

Botox injections to the anal sphincter can help prevent spasms in your anus by temporarily paralyzing the muscle, thus allowing the old fissures to heal while preventing new fissures from forming.

Lateral internal sphincterotomy (LIS) is the surgical procedure of choice for anal fissures due to its simplicity and its high success rate

Okay, but can't we prevent it from happening altogether?

Anal fissures can definitely be prevented by:

1. Keeping the anal area dry

2. Cleansing the anal area gently with mild soap and warm water

3. Avoiding constipation by drinking plenty of fluids, eating fibrous foods, and exercising regularly.

4. Changing diapers frequently for infants.