Anal Fissure
An anal fissure is a small tear in the lining of the anus that typically presents with pain and bleeding during or after bowel movements. It most commonly occurs due to constipation, straining, and the passage of hard or bulky stools.
Less frequently, anal fissures may result from conditions such as anal cancer, AIDS, anal intercourse, or trauma to the anal area (such as insertion of foreign objects or intense scratching).
Symptoms
-
Bleeding from the anus
-
A tearing pain sensation
-
Itching around the anus
-
The tear can be felt by touch at the anus
Diagnosis
In patients with symptoms suggesting anal fissure, diagnosis can be easily made by visual examination of the anal area.
Medical Treatment
The first step in treating anal fissure is ensuring a proper diet and personal hygiene. Hard stool is associated with the development and persistence of anal fissure; therefore, adequate intake of water and fiber is important. The medications that can be used are:
-
Topical muscle relaxant drugs (creams or ointments)
-
Nitroglycerin creams
-
Calcium channel blockers (oral or topical creams)
-
Botox injection; temporarily paralyzes the muscles around the anal canal, reducing pressure.
Surgical Treatment
Surgical treatment involves cutting a part of the muscle around the anal canal (lateral internal sphincterotomy surgery) to reduce anal canal pressure and accelerate healing. After this treatment, patients are usually discharged the same day or may stay in the hospital overnight.
TREATMENTS
