WHAT IS ANAL FISSURE?

An anal fissure is a tear in the lower rectum associated with pain and bleeding while passing stool.

It is a very painful condition and is usually associated with trauma to the rectal mucosa due to various causes causing tears in the mucosa.

Anal fissures are very common in young infants but can affect people of any age. Most anal fissures get better with simple treatments, such as increased fiber intake or sitz baths. Some people with anal fissures may need medication or, occasionally, surgery.

WHAT ARE THE RISK FACTORS FOR ANAL FISSURES?

Factors that may increase your risk of developing an anal fissure include:

• Infancy: Many infants experience an anal fissure during their first year of life.
• Aging: Older adults may develop an anal fissure partly due to slowed circulation, resulting in decreased blood flow to the rectal area.
• Constipation: Straining during bowel movements and passing hard stools increase the risk of tearing.
• Childbirth: Anal fissures are more common in women after they give birth.
• Crohn's disease: This inflammatory bowel disease causes chronic inflammation of the intestinal tract, which may make the lining of the anal canal more vulnerable to tearing.
• Anal intercourse.

WHAT ARE THE COMPLICATIONS OF ANAL FISSURES?

Complications of anal fissure can include:

• Failure to heal: An anal fissure that fails to heal within six weeks is considered chronic and may need further treatment.
• Recurrence: Once you've experienced an anal fissure, you are prone to having another one.
• A tear that extends to surrounding muscles: An anal fissure may extend into the ring of muscle that holds your anus closed (internal anal sphincter), making it more difficult for your anal fissure to heal. An unhealed fissure can trigger a cycle of discomfort that may require medications or surgery to reduce the pain and to repair or remove the fissure.

WHAT ARE THE SYMPTOMS OF ANAL FISSURE?

Symptoms of an anal fissure include:

• While passing stool sharp pain in the anus is usually severe.
• Burning is also seen in the anus.
• Itching in anus.
• Bleeding while passing stool is seen.
• Sometimes there would be no symptom except bleeding.

WHAT ARE THE COMMON CAUSES OF ANAL FISSURE?

Any injury or trauma to the anal canal may cause a fissure.

Causes of injury may be:

• Constipation is a common cause of fissure as passing and staring at hard stool may cause tears.
• In people who pass frequent stool or have frequent diarrhea, tears can occur.
• When a large lump of stool is passed, it may cause a tear.
• If a rectal examination is not done properly, it may also tear the lining of the rectum.
• People who perform anal sex can also suffer from fissures.
• During childbirth, a woman can have a tear.

Less common causes of anal fissures include:

• Anal cancer
• HIV
• Tuberculosis
• Syphilis
• Herpes

HOW TO DIAGNOSIS ANAL FISSURE? 

Symptoms and rectal examination are enough to diagnose the case.

WHAT TREATMENT OPTIONS ARE AVAILABLE?

Treatment of fissure includes:

• Relieving the symptoms like pain and itching.
• Management of the cause for the tear.

HOW TO MANAGE A CASE OF ANAL FISSURE?

• A Sitz bath is advisable for the patient to relieve the symptoms of the fissure.
• Advice patient to sit in warm water for 20 minutes 2-3 times a day.
• Avoid chances of constipation.
• Dietary management of constipation is advised.
  
• Kindly refer to our blog for the management of constipation.
• Keep yourself hydrated by drinking plenty of water.
• Be active and do regular physical exercise.
• Don't strain sitting at the pot.
• Use the toilet when you have the urge.
• Advise patient to take fiber-rich diet and papaya daily.
• Avoid coffee, carbonated drinks.
• Don't rub or scratch the area.
• Take homeopathic medicines.

WHAT IS THE HOMEOPATHIC MANAGEMENT OF ANAL FISSURE?

Homeopathic medicines not only relieve the symptoms of the fissure but would also help in keeping the stool soft. Constipation can also be relieved by medicines.

Medicines like Aesculus, SULPHUR, SEPIA, ALOES, GRAPHITES, PSORINUM, THUJA, etc are a few medicines that are effective in the treatment of fissures depending on the symptoms.

WHAT ARE THE DOS AND DON’TS FOR ANAL FISSURE?

DO’S

• Drink plenty of water.
• Avoid constipation.
• Do regular exercise.
• Do sitz bath and sit warm water.
• Eat a healthy fiber-rich diet.
• Use the toilet when you have the urge to pass stool.

DON’TS

• Don’t strain.
• Don’t drink much coffee, carbonated drinks.
• Don't rub or scratch the anal region.

SIMPLE STEPS TO AVOID CONSTIPATION