Anal Fissure

Anal Fissure

A small rip in the mucosa, a delicate, moist tissue that lines the anus, is known as an anal fissure. When you pass large or hard stools during a bowel movement, an anal fissure may develop. Anal fissures frequently result in discomfort and bleeding during bowel movements. Additionally, the muscle ring at the end of your anus may spasm (anal sphincter).

Causes

• Passing a lot of or tough stools
• Straining and being constipated during bowel movements
• Persistent diarrhea
• Anorectal inflammation brought on by Crohn's disease or similar inflammatory bowel condition
• Childbirth
• Throat cancer
• HIV
• Tuberculosis
• Syphilis
• Herpesrth

Treatment

• Most short-term anal fissures can heal at home in 4 to 6 weeks with proper care. After starting home treatment, bowel movement pain typically goes away within a few days.
• Nitroglycerin (Rectiv), which is given externally, is used to alleviate pain, promote healing, and aid relax the anal sphincter. When other conservative medical treatments fail, nitroglycerin is typically regarded as the preferred option. A headache, which might be very bad, is one of the possible side effects.
• Pain management may benefit from topical anesthetic creams like lidocaine hydrochloride (Xylocaine).
• An injection of Botulinum toxin type A (Botox) is used to relax spasms and paralyze the anal sphincter muscle.
• The anal sphincter can be relaxed with the aid of blood pressure drugs like oral nifedipine (Procardia) and diltiazem (Cardizem). These drugs can be used when nitroglycerin is ineffective or has serious negative effects. They can be ingested or used topically.

Surgical

• In order to lessen spasm, pain, and promote healing, doctors frequently perform a procedure known as lateral internal sphincterotomy (LIS), which involves severing a small portion of the anal sphincter muscle.

Anal Fissure

A small rip in the mucosa, a delicate, moist tissue that lines the anus, is known as an anal fissure. When you pass large or hard stools during a bowel movement, an anal fissure may develop. Anal fissures frequently result in discomfort and bleeding during bowel movements. Additionally, the muscle ring at the end of your anus may spasm (anal sphincter).

Causes

• Passing a lot of or tough stools
• Straining and being constipated during bowel movements
• Persistent diarrhea
• Anorectal inflammation brought on by Crohn's disease or another inflammatory bowel condition
• Childbirth
• Throat cancer
• HIV
• Tuberculosis
• Syphilis
• Herpesrth

Risk Factors

• Infancy
  • During the first year of life, anal fissures are common in infants; however, the cause of this is unknown to experts.
• Aging
  • Anal fissures in older people are sometimes brought on by sluggish circulation, which reduces blood flow to the rectal area.
• Constipation
  • The risk of tearing is increased by straining during bowel movements and passing hard stools.
• Childbirth
  • After giving birth, anal fissures are more prevalent in women.
• Crohn's Disease
  • The chronic intestinal inflammation brought on by this inflammatory bowel disease may make the lining of the anal canal more prone to tearing.
• Anal Intercourse.

Symptoms

• Occasionally severe discomfort during bowel motions
• After-bowel movement discomfort that may continue for several hours
• After a bowel movement, bright crimson blood might be seen on the toilet paper or stool.
• Inflammation or itching at the anus
• A skin break that is clearly apparent around the anus
• Skin tag is a tiny lump on the skin next to the anal fissure

Diagnosis

• History Taking
• Physical Examination
• Flexible Sigmoidoscopy
  • The bottom part of your colon will be punctured by your doctor inserting a thin, flexible tube with a tiny video inside. If you are under 50 and have no known risk factors for colon cancer or gastrointestinal conditions, this test may be performed on you.
• Colonoscopy
  • To examine your entire colon, your doctor will insert a flexible tube into your rectum. If you are older than 50, have risk factors for colon cancer, symptoms of other diseases, or other symptoms like diarrhea or abdominal pain, this test may be performed on you.

Treatment

• Most short-term anal fissures can heal at home in 4 to 6 weeks with proper care. After starting home treatment, bowel movement pain typically goes away within a few days.
• Nitroglycerin (Rectiv), which is given externally, is used to alleviate pain, promote healing, and aid relax the anal sphincter. When other conservative medical treatments fail, nitroglycerin is typically regarded as the preferred option. A headache, which might be very bad, is one of the possible side effects.
• Pain management may benefit from topical anesthetic creams like lidocaine hydrochloride (Xylocaine).
• An injection of Botulinum toxin type A (Botox) is used to relax spasms and paralyze the anal sphincter muscle.
• The anal sphincter can be relaxed with the aid of blood pressure drugs like oral nifedipine (Procardia) and diltiazem (Cardizem). These drugs can be used when nitroglycerin is ineffective or has serious negative effects. They can be ingested or used topically.

Surgical

• In order to lessen spasm, pain, and promote healing, doctors frequently perform a procedure known as lateral internal sphincterotomy (LIS), which involves severing a small portion of the anal sphincter muscle.

Complications

• Lack of healing. If an anal fissure doesn't heal after six weeks, it's termed chronic and may require additional care.
• Recurrence. After having an anal fissure, you are more likely to experience another.
• A rip that involves the nearby muscles. It may be more challenging for your anal fissure to heal if it extends into the muscle ring that keeps your anus closed (internal anal sphincter). An unhealed fissure can start a vicious cycle of pain that may need to be treated with drugs or surgery to both stop the pain and fix or remove the fissure.