Anal Fissures: Causes, Symptoms, Treatment & Prevention

When there is a small tear in the mucosa, there lie moist tissues which line the anus and this is known as an anal fissure. Anal fissures may develop when the individual passes hard or large stools during the bowel movement. Anal fissures result in discomfort and bleeding during bowel movements. Additionally, there might be spasms at the end of the anus.

Anal fissures can affect persons of any age, but they are most frequent in newborns and infants. Most anal fissures improve with treatment like sits baths or increased fibre consumption. Anal fissure sufferers sometimes require medication or surgery.

Symptoms

Signs and symptoms of an anal fissure include:

• Severe discomfort during bowel motions
• Continuing pain after a bowel movement that may continue for several hours
• The appearance of blood on the toilet paper or stool
• A skin break that is clearly apparent around the anus
• A feeling of a tiny lump on the skin next to the anal fissure

Causes

There are reasons that can cause anal fissures. Below are some of the common causes of anal fissures.

• Passing large or hard stools
• Feeling constipated during bowel movements
• Anal intercourse
• Chronic Diarrhoea
• Childbirth

Other than the above mentioned, there are some causes that are not common.

• Anal cancer
• Tuberculosis
• HIV
• Inflammatory bowel disease
• Syphilis

Risk Factors

You may be more susceptible to getting an anal fissure if you have the following factors:
Constipation: The danger of tear is increased by straining during bowel motions and passing firm stools.
Childbirth: There are times when post-delivery, women are more likely to develop anal fissures.
Age: Anal fissures can develop at any age, but they are more frequent in young children and middle-aged people.
Crohn’s illness: Crohn’s illness leads to chronic intestinal inflammation which may render the lining of the anal canal as it is more prone to wear and tear.

Diagnosis

In addition to performing a physical examination that includes an examination of the anal region, your doctor will also ask about your medical history. This examination will help identify the root cause of the anal fissure and allow the doctor to plan to next course of action because the position of the fissure provides clues as to its cause. Instead of the rear or front of the anal hole, a fissure is more likely to be a symptom of another condition, like Crohn’s disease. If your doctor suspects an underlying issue, they might advise more testing:

Anoscopy: Tubular device inserted in the anus to allow your doctor to have a better vision of the rectum and anus.
Flexible sigmoidoscopy: Your doctor will insert a thin, flexible tube with a tiny video into the bottom portion of your colon.
Colonoscopy: Your doctor will insert a flexible tube into your rectum to inspect the entire colon. This test will help identify risk factors for colon cancer, signs of other conditions, or other symptoms such as abdominal pain or Diarrhoea.

Treatment

As per diagnosis, below is the treatment plan for anal fissures.

• Increase the intake of fibre and fluids to allow your bowel movement to be soft and smooth.
• Soaking in warm water or a sits bath can help relieve the pain caused due to anal fissures.
• anal fissure
• Lateral internal sphincterotomy is a surgical procedure done to treat an anal fissure, a tear in the opening of the anus that causes pain, bleeding and itching.

Prevention

If you are someone who suffers from severe constipation or Diarrhoea then it might not be possible to avoid anal fissures. Eating food high in fibre, and consuming a good quantity of fluids can help prevent or reduce the pain, itching and bleeding caused due to anal fissures. It is recommended to exercise regularly to be able to keep yourself away from frequent bowel movements.

Lifestyle and Home Remedies

Making necessary changes in your every routine can help relieve the discomfort and promote the healing process of anal fissures.
Boost your intake of fibre
Consuming 25 to 30 grams of fibre daily can keep stools soft and speed up the healing of fissures. Fruits, vegetables, nuts, and whole grains are examples of foods high in fibre.
Take fibre supplements
In order to avoid gas and bloating, gradually increase your consumption of fibre.
Drink enough water
Constipation can be avoided with fluids and for that, the easiest way is to consume at least 8-11 glasses of water every day.
When having a bowel movement, avoid struggling
Pressure from straining might produce a new tear or cause an existing tear to reopen.

FAQ’s –

How long do anal fissures last?

Anal fissures usually take approximately 2 weeks to recover. Anal fissures can be back if the person frequently suffers from constipation or diarrhoea or is left untreated.

What happens if a fissure goes untreated?

Untreated fissures might result in serious consequences. First off, delaying therapy can potentially delay a proper diagnosis because the state of the fissure deteriorates with each passing day. An incorrect diagnosis of an anal fissure may also cause other illnesses, like serious infections or even cancer, to go unnoticed and untreated.

How do you heal an anal fissure?

Anal fissures take some time to heal. The doctor will prescribe certain medicines to relieve the pain and discomfort, suggest the patient consume food and vegetables rich in fibre content and increase the intake of fluids.