Specialist in General Surgery
Condition
An anal fissure is a small tear in the lining of the anal canal, simply put, the skin around the anus.
The anal canal is the lowest part of the large intestine. An anal fissure may occur an excessive strain is used to excrete hard or large stools during bowel movement. You may experience pain and bleeding in subsequent bowel movements.
The split in the skin may lead to severe pain and bleeding during and after bowel movements.
While it is usually not a severe condition, anal fissures can affect people of all ages who experience constipation. They are more likely to cause a tear in the anal canal during a bowel movement.
Typically, the tear will heal on its own within four to six weeks. Chronic anal fissures are diagnosed when the fissure persists beyond eight weeks without recovery.
Anal Fissure
Anal fissures are most commonly caused by damage to the lining of your anus or anal canal. It often occurs in people who have frequent constipation, where a particularly hard or large stool tears the lining of the anal canal.
Anal fissures can occur in people of all ages. Older adults are also prone to anal fissures due to decreased blood flow in the anorectal area. Women who are pregnant or have recently given birth are at higher risk for anal fissures due to straining during delivery.
People with Inflammatory Bowel Disease (IBD), such as Crohn’s disease, have an increased risk of developing anal fissures. The inflammation in the intestinal lining makes the tissue around the anus tear more easily.
People who frequently constipate have a higher risk of anal fissures as well. Passing large, hard stools and straining during bowel movements are the most common causes of anal fissures.
Occasionally, a sexually transmitted infection such as herpes or syphilis can infect and damage the anal canal. This results in anal fissure.
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Symptoms of an anal fissure include:
Do consult your doctor immediately should you have pain during bowel movements or observe blood during bowel movements.
While anal fissures cannot be prevented, there are preventive measures that you can take to reduce the risk of getting one. These are:
Your doctor will diagnose an anal fissure in a physical examination for you. This involves checking for the typical symptoms and examining the skin around your anus. The doctor may insert an anoscope into your rectum to make it easier to see the tear. Inspection of the anal canal through this thin tube may also help your doctor find other causes of anal or rectal pain, such as haemorrhoids.
In some instances, you may need a colonoscopy for a better evaluation of your symptoms.
While anal fissures are not associated with any serious diseases, such as bowel cancer, possible complications of an anal fissure may include:
Anal fissures usually do not require extensive treatments. However, specific remedies help to relieve the symptoms while promoting healing. These are:
For most people, anal fissure usually takes 1 to 2 weeks to heal. However, in cases where the anal fissure does not heal or persistently returns, you may need to undergo surgery.
Surgery is recommended for chronic anal fissure. This is especially so if other treatments such as changing your diet and using laxatives fail to work. Lateral Internal Sphincterotomy (LIS) is generally considered the most effective treatment for anal fissures, with more than 90 per cent of people experiencing good results in the long run.
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