An anal fissure is a small wound or tears in the mucous tissue that lines the lower part of the anus. Although it can occur from several causes, the most frequent is constipation, which causes continuous damage to the area due to the inability to pass such large and complex stools. The pain caused by anal fissures is characteristic and intense, so it is essential to see a doctor and start the appropriate treatment in each case. In most patients, conservative treatments give good results, but when they do not work and the lesion does not disappear with time, it will be strictly necessary to resort to other techniques such as surgery. At FastlyHealwe explain everything you need to know about this condition, and we detail the symptoms and treatment of anal fissures.
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Causes of anal fissure
The anal fissures are usually located at the back of the anus, and although they are more common in infants, they can also occur at any age. One of the most frequent factors that cause them is constipation. That minor crack would occur due to the tremendous pressure and repetitive damage that the anal mucosa suffers during the evacuation of stool.
However, constipation is not the only condition that can cause anal fissures; but it is also possible that they appear as a consequence of the following factors:
- Abundant diarrhea: if it is prolonged, it can end up causing a chemical burn and weakening of the anal mucosa and, consequently, producing a tear in it.
- We have reduced blood flow in the area, something familiar in older people.
- Hemorrhoids or excessive tension in the sphincter muscles.
- After delivery, due to the tremendous effort that is made during it.
- They can be secondary anal fissures of a chronic nature, which are caused by some systemic diseases such as Crohn’s disease, ulcerative colitis, intestinal tuberculosis, etc.
Symptoms of anal fissure
The symptoms associated with an anal fissure may appear suddenly or more slowly as time goes by. In general, patients with this rectal injury usually experience the following symptoms:
- Very intense and sharp pain. It usually appears at the beginning of defecation and is associated with the passage of stool through the anal canal. It is also vital since the sensation patients notice is as if they were being cut with a knife. It may only last a few minutes or persist until after a bowel movement for minutes or hours.
- I was itching and burning in the anus.
- The presence of blood in the stool can mainly be observed when cleaning after bowel movements. This is usually of small quantity and a light red color.
- Sphincter contracture: patients feel weight or discomfort in the rectal area throughout the day.
- Obstipation and prolonged constipation are caused by stopping defecation due to the pain felt during it.
Initial medical treatment for anal fissure
It is convenient to clarify that most anal fissures heal independently and disappear spontaneously without following a specific treatment. However, in the case of experiencing the symptoms or the intense and acute pain described in the previous section, it is essential to go to a medical consultation to rule out that the injury is a consequence of some more severe disease and to follow the specialist’s instructions that will help speed up your healing.
In cases in which anal fissures are not a complication and occur in healthy patients, it will be sufficient to initiate conservative medical treatment to reduce symptoms and decrease sphincter contraction. In this way, the doctor may suggest the following treatments and care:
- The application of anesthetic ointments in the rectal area usually contains anti-inflammatory components. These types of drugs reduce swelling and relieve pain. It has also been found highly effective in those ointments containing nitroglycerin, as they help relax the sphincter muscles and promote wound healing.
- Perform sitz baths with warm water to reduce discomfort and relax the sphincter muscle. To notice the improvement, they can be done 2 or 3 times a day, covering only the hips and buttocks.
- It is essential to make changes in lifestyle to combat constipation, the leading cause of anal fissures, as we have pointed out previously. It is advisable to increase fiber consumption in the diet, drink plenty of water and healthy fluids, set a schedule for meals, and not delay the time of stool and exercise. Likewise, it will be essential to avoid consuming all those foods that can further constipate the affected person.
- In addition, you can also use stool softeners and take a mild laxative prescribed, in all cases, by the doctor. All this will help break up the stool, make it thinner, facilitate evacuation, and not cause more damage to the open wound in the internal part of the rectum.
Secondary medical treatment for anal fissure
In specific cases in which the anal fissure does not heal with the mentioned initial treatments and care, it may be necessary to resort to other secondary alternatives, which may be:
- Injections of botulinum toxin in the anal sphincter cause relaxation and, consequently, improve constipation and all symptoms.
- Surgery: the internal lateral sphincterotomy technique is usually used, through which the internal anal sphincter is partially or cut on the same side of the fissure. Its duration does not usually exceed 45 minutes, and the patient can go home after it without a problem.
This article is merely informative, at FastlyHeal .com we do not have the power to prescribe medical treatments or make any type of diagnosis. We invite you to see a doctor in the case of presenting any type of condition or discomfort.
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I am a Surgeon with a diploma in comprehensive ultrasound and surgical care residency, an area I am specializing in. During the exercise of my profession, I have realized the need for patients to know the diseases they suffer, and I can tell you that a large part of their complications is due to a lack of information. Being a health web writer allows me to transmit my experience, without borders, to all those readers eager for knowledge, educate them in the prevention of diseases and promote a healthy lifestyle.