Anal Fissures
Anal Fissures Facts
An anal fissure is a small tear or cut in the skin lining the anus, which can cause pain or bleeding.
What are the symptoms of an anal fissure?
The typical symptoms of an anal fissure are extreme pain during defecation and red blood streaking the stool. Patients may try to avoid defecation because of the pain.
What Causes an Anal Fissure?
A hard, dry bowel movement can cause a tear in the anal lining, resulting in a fissure. Other causes of a fissure include diarrhea and inflammation of the anorectal area.
Anal fissures may be acute (recent onset) or chronic (present for a long time or recurring frequently). An acute fissure is usually due to altered bowel habits. In contrast, a chronic fissure may be either due to poor bowel habits, overly tight or spastic anal sphincter muscles, scarring, or an underlying medical problem.
How Can a Fissure Be Treated?
An acute fissure is managed with non-operative treatments, and over 90% will heal without surgery. The key is to get the fissure treated as soon as possible before it becomes a chronic problem. We offer same and next day appointments especially when you are suffering in pain. A special medical cream is known to sure of the fissure very effectively when applied correctly. In addition, it is important to avoid constipation and promote soft stools with a high fiber diet, bulking fiber agents, stool softeners, and plenty of fluids. Warm sitz baths for 10-20 minutes at a time are soothing and relax the anal muscles to relieve the spasm and pain. A chronic fissure (lasting greater than one or two months) may require additional treatment or even surgery. During your office visit, we will examine the area to make sure the fissure is not associated with inflammatory bowel disease, infections, or even cancer.
What Can Be Done If a Fissure Doesn’t Heal?
A fissure that fails to respond to treatment should be re-examined to determine if a definitive reason exists for lack of healing. Such reasons can include scarring or muscle spasm of the internal anal sphincter muscle. Those which continue to cause pain and bleeding can be corrected by surgery.
What Does Surgery Involve?
Surgery usually consists of a small operation to cut a portion of the internal anal sphincter muscle. This helps the fissure to heal by decreasing pain and spasm. Cutting this muscle rarely interferes with the ability to control bowel movements and performed without an overnight hospital stay. Usually, complete healing occurs in a few weeks, although pain often disappears after a few days. Sometimes the area may not heal completely and further intervention is required. In rare cases, there can be issues with controlling the bowel. That is why it is important to see one of our specialists right away to try to heal the areas without surgery.
Will the Problem Return?
When the fissure is healed with medication or surgery, more than 90% of patients have no further trouble from fissures.
Can Fissures Lead to Colon Cancer?
No! A fissure cannot cause cancer. However, sometimes cancer can be mistaken as an anal fissure. It is therefore to have an evaluation of the area to make sure that there are no associated concerns.