What is An Anal Fissure?
An anal fissure is a small tear in the thin lining of the anus. This is at the end of the digestive tract where bowel movements pass through. A newer tear is similar to a papercut while a more chronic tear will be deeper into the lining. When passing a bowel movement this can cause severe pain and discomfort which could also be accompanied by bleeding. Anal fissures can happen to anyone but are most seen in infants and older adults.
Anal fissure symptoms include but are not limited to:
- Painful bowel movements
- Long lasting pain (several hours) after a bowel movement
- Blood in the stool or tissue after a bowel movement
- Crack or lump around the anal fissure
If an anal fissure becomes infected, you may experience chills, fever, or discharge. Contact your provider immediately if you think your anal fissure may be infected.
Avoiding constipation and diarrhea can help prevent anal fissures. This can be done by increasing your intake of high-fiber foods and water. Additionally, exercising more or taking laxatives can assist with easier bowel movements.
Causes of Anal Fissures
An anal fissure can have many causes and it all depends on the age of the person along with their medical history. You could be more at risk of developing anal fissures if you have a history with any of the following:
- Chronic constipation or diarrhea
- Excessive straining during bowel movements
- Childbirth
- Passing large or hard stools
- Chron’s disease
- Inflammatory bowel disease
- Treated for HIV
- Anal intercourse
- Anal cancer
Diagnosis and Treatment for Anal Fissures
An anal fissure diagnosis will likely begin with a physical exam where your provider examens the area around the anus. They will look for the depth and location of the fissure to determine whether it’s a new or existing tear as well as if there may be any underlying conditions that have caused the fissure. If it’s believed that there could be an underlying cause, you may be required to have a colonoscopy, anoscopy or sigmoidoscopy to get a conclusive diagnosis.
If your anal fissure is not severe, the best treatment plan is to add more fiber to your diet and drink more water. Adding exercise and stool softeners can also be beneficial to help reduce constipation or strained bowel movements. To help promote relaxation of the muscles, a warm sitz bath for 10-20 minutes a day, can also help. For additional assistance in healing a fissure, there are also topical creams and over-the-counter medications to help with any unpleasant symptoms. Speak with your provider to figure out the best method for you.
For more severe or chronic anal fissures, surgery may be required. The most common procedure used on anal fissures is lateral internal sphincterotomy (LIS). An LIS procedure reduces pressure on the fissure by cutting the muscles that control the anus.