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Anal fissure

An anal fissure is a tear in the lining of the anal canal which causes pain during the bowel movement. It does not lead to serious problems. Most anal fissure can be healed with home remedies within few days or weeks. These are called as an acute anal fissure. Some may take more than 8 to 12 weeks for healing. This is called as a chronic anal fissure. This will require medical treatment.

What causes an anal fissure?

An anal fissure is caused by injury or trauma to the anal canal. Injury can happen due to the following reasons:

  • When you pass large tools
  • When you have constipation
  • When you have repeated diarrhea
  • Childbirth can cause trauma to the anal canal.

Anal intercourse, rectal exam and other foreign particles can also cause an anal fissure. There are 2 muscular rings called as sphincter that controls the anus. Extra pressure or tension in these muscles can cause an anal fissure.

  • A sharp or burning pain during the bowel movement. The pain may be severe and last for a brief or several hours.
  • Itching
  • One may have to bleed. You may notice red spots of blood in the toilet bowl.

How is an anal fissure diagnosed?

The doctor can diagnose your anal fissure from your symptoms and physical exam. The physical examination includes:

  • Looking at the fissure by gently separating the butt.
  • The doctor inserts a gloved finger into the anal canal
  • Anoscopy that uses a short, lighted scope to look into the canal.

The doctor waits until the fissure heals to begin the exam. If an immediate test is needed then a medicine is used to numb the area.

How is it treated?

Acute anal fissure can be healed by home remedies within 4 to 6 weeks. The pain due to anal fissure will begin to heal within few days after the treatment begins. There are several steps that help to heal the fissure:

  • To prevent constipation include foods that are rich in fibers such as fruits, vegetables, grains etc
  • Drink plenty of fluids.
  • Do exercise every day.
  • Take time for your bowel movements and do not exert pressure.
  • Take stool softeners or laxatives to make bowel movements less painful.
  • Sit in a tub filled with warm water for 2 to 3 times a day. This is called as a sitz This soothes the torn tissue and helps relax the internal sphincter.
  • Instead of using toilet paper, use baby wipes or medicated pads to clean after the bowel movements.

Never try to avoid having bowel movements. Knowing the fact that it might hurt will make you anxious but trying not to have a bowel movement will only result in constipation. This will worsen the condition and keep the fissure open and painful throughout.

What happens if it doesn’t heal on its own?

About 9 out of 10 anal fissure issues will heal with home remedies. But not all the fissure heal on its own. Some require medical treatments. These require nitroglycerin cream, high blood pressure pills or injections of Botox. If these medicines don’t stop your symptoms then you will have to undergo a surgery.

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