Fissure: Causes, Symptoms, and Treatment
21
April
Fissure: Causes, Symptoms, and Treatment
Anal fissures are a common yet often under-discussed medical condition that can cause significant discomfort and distress. If you've experienced sharp pain during or after bowel movements, noticed blood on toilet paper, or felt a burning sensation in your anal area, you might be dealing with an anal fissure.
In this blog, we’ll explore what anal fissures are, what causes them, how they can be treated, and when to see a doctor. Whether you’re experiencing symptoms yourself or looking for information to help someone you care about, this guide offers practical advice and reassurance.
What is an Anal Fissure?
An anal fissure is a small tear or cut in the lining of the anus. This delicate skin can easily become damaged, especially during hard or strained bowel movements. Once the skin is torn, passing stool can become extremely painful, and the cycle of pain can make the fissure worse over time.
Anal fissures are typically classified as either:
- Acute – new and usually heal within a few weeks with proper care.
- Chronic – last more than 6 weeks and may require more intensive treatment.
Common Causes of Anal Fissures
Several factors can lead to the development of anal fissures. The most common include:
- Constipation and hard stools
- Straining during bowel movements
- Chronic diarrhea
- Childbirth
- Anal sex
- Inflammatory bowel diseases like Crohn’s disease
- Tight anal sphincter muscles, which can reduce blood flow to the area and delay healing
In children, anal fissures are also common and usually caused by passing large or hard stools.
Symptoms of Anal Fissures
The symptoms of anal fissures are quite distinct. They may include:
- Sharp, stinging pain during or after bowel movements
- Bright red blood on toilet paper or in the stool
- A visible tear near the anus
- Itching or irritation around the anal area
- A small lump or skin tag near the fissure (in chronic cases)
The pain may be intense enough to cause anxiety about going to the bathroom, which can unfortunately make constipation worse and prolong healing.
Diagnosis
If you're experiencing symptoms of a fissure, it's important to consult a healthcare provider. A simple physical examination is often sufficient to diagnose a fissure. In some cases, especially if the fissure doesn’t heal or if another condition is suspected, your doctor may recommend further tests such as a sigmoidoscopy or colonoscopy.
Treatment Options for Anal Fissures
1. Home Remedies and Lifestyle Changes
Most acute fissures heal on their own or with conservative treatment. Here are some effective home remedies:
- Increase Fiber Intake: Eating more fruits, vegetables, and whole grains softens stools and makes them easier to pass. Consider a fiber supplement if necessary.
- Stay Hydrated: Drink plenty of water to help keep stools soft.
- Sitz Baths: Sitting in warm water for 10–15 minutes several times a day (especially after bowel movements) helps relax the anal muscles and promotes healing.
- Avoid Straining: Don’t delay or force bowel movements. Go when you feel the urge and try to stay relaxed.
- Topical Ointments: Over-the-counter creams that contain hydrocortisone or lidocaine can reduce pain and inflammation.
2. Medications
If home treatments aren’t enough, your doctor might prescribe:
- Topical Nitroglycerin: Helps increase blood flow to the area and promotes healing. It may cause headaches in some users.
- Calcium Channel Blockers (like nifedipine or diltiazem): These are used topically to relax the sphincter muscles and reduce pain.
- Botox Injections: Temporarily paralyze the anal sphincter to reduce spasms and allow healing. This is often used for chronic fissures.
3. Surgical Treatment
When fissures become chronic or don’t respond to medical therapy, surgery may be considered. The most common surgical option is:
- Lateral Internal Sphincterotomy (LIS): This involves making a small cut in the anal sphincter muscle to relieve tension, reduce spasms, and promote healing. It has a high success rate and is often performed as a day-care procedure.
In rare cases, if surgery is not suitable, your doctor may recommend anal dilation or other interventions.
Preventing Recurrence
Even after a fissure has healed, it’s important to take steps to prevent it from returning. Here are a few tips:
- Maintain a high-fiber diet
- Drink at least 8 glasses of water daily
- Establish a regular bathroom routine
- Avoid prolonged sitting on the toilet
- Exercise regularly to promote digestion
- Address underlying conditions such as IBS or IBD with your doctor
When to See a doctor
While many fissures heal on their own, you should seek medical attention if:
- The pain or bleeding persists for more than a few weeks
- You notice blood in your stool frequently
- There’s no improvement despite home treatment
- You have a chronic condition like Crohn’s disease
- You develop additional symptoms like fever, pus, or severe swelling
Prompt medical attention can prevent complications and ensure effective healing.