Anal fissure: Difference between revisions
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{{SI}}<br> | |||
{{Infobox medical condition | |||
| name = Anal fissure | |||
| image = [[File:Anal_fissure_2.jpg|thumb|Anal fissure]] | |||
| caption = Anal fissure as seen on [[anoscopy]] | |||
| field = [[Proctology]] | |||
| synonyms = [[Fissure in ano]], [[rectal fissure]] | |||
| symptoms = [[Pain]] during [[bowel movements]], [[bleeding]] | |||
| complications = [[Chronic fissure]], [[anal fistula]] | |||
| onset = [[Acute]] or [[chronic]] | |||
| duration = [[Weeks]] to [[months]] | |||
| causes = [[Trauma]], [[constipation]], [[diarrhea]] | |||
| risks = [[Constipation]], [[childbirth]], [[Crohn's disease]] | |||
| diagnosis = [[Physical examination]], [[anoscopy]] | |||
| differential = [[Hemorrhoids]], [[anal abscess]], [[anal cancer]] | |||
| prevention = [[High-fiber diet]], [[hydration]], [[stool softeners]] | |||
| treatment = [[Dietary fiber]], [[sitz baths]], [[topical anesthetics]], [[surgery]] | |||
| medication = [[Topical nitroglycerin]], [[calcium channel blockers]] | |||
| prognosis = Good with treatment | |||
| frequency = Common | |||
}} | |||
'''Anal fissure''', also known as '''fissura ani''', is a small tear in the [[anal canal]], typically causing [[pain]] and [[discomfort]] during and after [[defecation]]. The condition often leads to [[rectal bleeding]], particularly after bowel movements. The sharp, intense pain may last for minutes to hours, making defecation a distressing experience. | '''Anal fissure''', also known as '''fissura ani''', is a small tear in the [[anal canal]], typically causing [[pain]] and [[discomfort]] during and after [[defecation]]. The condition often leads to [[rectal bleeding]], particularly after bowel movements. The sharp, intense pain may last for minutes to hours, making defecation a distressing experience. | ||
== Causes == | == Causes == | ||
The exact cause of an anal fissure is not always clear, but several factors contribute to its development: | The exact cause of an anal fissure is not always clear, but several factors contribute to its development: | ||
| Line 10: | Line 30: | ||
* [[Pregnancy]] and [[childbirth]] | * [[Pregnancy]] and [[childbirth]] | ||
* Delayed [[diaper change]]s in [[infants]] | * Delayed [[diaper change]]s in [[infants]] | ||
Once a fissure occurs, it may take 6 weeks to 3 months to fully heal. During this period, the fissure can reopen easily, leading to recurring symptoms. | Once a fissure occurs, it may take 6 weeks to 3 months to fully heal. During this period, the fissure can reopen easily, leading to recurring symptoms. | ||
== Treatment == | == Treatment == | ||
Management of anal fissures involves a combination of [[medications]], [[lifestyle changes]], and, in some cases, [[surgery]]. Treatment options include: | Management of anal fissures involves a combination of [[medications]], [[lifestyle changes]], and, in some cases, [[surgery]]. Treatment options include: | ||
=== Medications === | === Medications === | ||
A [[healthcare provider]] may prescribe various treatments to relieve pain, reduce inflammation, and promote healing: | A [[healthcare provider]] may prescribe various treatments to relieve pain, reduce inflammation, and promote healing: | ||
* '''Topical pain-relief ointments''' | * '''Topical pain-relief ointments''' – Medications containing local anesthetics can help reduce [[pain]] and [[discomfort]]. | ||
* '''Suppositories''' | * '''Suppositories''' – Rectal medications that provide relief by coating and soothing the affected area. | ||
* '''Laxatives''' | * '''Laxatives''' – To prevent [[constipation]] and ease [[stool]] passage. | ||
* '''Zinc-based ointments''' | * '''Zinc-based ointments''' – Help protect and contract the skin, promoting faster healing. | ||
* '''Muscle relaxants''' | * '''Muscle relaxants''' – Medications such as nitroglycerin or calcium channel blockers may help relax the [[anal sphincter]] and improve [[blood flow]]. | ||
=== Home Remedies and Self-Care === | === Home Remedies and Self-Care === | ||
Patients can adopt several measures to promote healing and prevent recurrence: | Patients can adopt several measures to promote healing and prevent recurrence: | ||
| Line 30: | Line 46: | ||
* Using a [[stool softener]] if necessary. | * Using a [[stool softener]] if necessary. | ||
* Practicing proper [[hygiene]] and ensuring the anal area remains dry. | * Practicing proper [[hygiene]] and ensuring the anal area remains dry. | ||
* Taking warm [[sitz baths]] | * Taking warm [[sitz baths]] 2–3 times daily to relax the [[anal muscles]] and promote healing. | ||
=== Chronic Fissure Treatment === | === Chronic Fissure Treatment === | ||
If an anal fissure persists for more than 6 weeks, it is classified as '''chronic'''. Treatment options for chronic fissures include: | If an anal fissure persists for more than 6 weeks, it is classified as '''chronic'''. Treatment options for chronic fissures include: | ||
* '''Botulinum toxin (Botox) injection''' | * '''Botulinum toxin (Botox) injection''' – Helps relax the anal sphincter, reducing pressure and promoting healing. | ||
* '''Lateral internal sphincterotomy''' | * '''Lateral internal sphincterotomy''' – A surgical procedure where a small portion of the [[anal sphincter]] is cut to reduce tension and improve healing. | ||
* '''Dilation procedures''' | * '''Dilation procedures''' – Involves gentle stretching of the anal canal to reduce pressure. | ||
== Prevention == | == Prevention == | ||
To prevent recurrence, patients should take certain precautions for up to three months after healing. Recommended steps include: | To prevent recurrence, patients should take certain precautions for up to three months after healing. Recommended steps include: | ||
=== Dietary and Lifestyle Changes === | === Dietary and Lifestyle Changes === | ||
* Maintain a high-[[fiber]] diet to prevent [[constipation]]. | * Maintain a high-[[fiber]] diet to prevent [[constipation]]. | ||
| Line 46: | Line 59: | ||
* Drink enough [[water]] daily to keep [[bowel movements]] soft. | * Drink enough [[water]] daily to keep [[bowel movements]] soft. | ||
* Engage in regular [[physical activity]] to promote healthy digestion. | * Engage in regular [[physical activity]] to promote healthy digestion. | ||
=== Proper Hygiene Practices === | === Proper Hygiene Practices === | ||
* Ensure the anal area is completely dry after bathing or swimming. | * Ensure the anal area is completely dry after bathing or swimming. | ||
* Use soft toilet paper or baby wipes instead of rough tissues. | * Use soft toilet paper or baby wipes instead of rough tissues. | ||
* Wash the anal region with warm water rather than wiping aggressively. | * Wash the anal region with warm water rather than wiping aggressively. | ||
=== Sitz Baths and Skin Care === | === Sitz Baths and Skin Care === | ||
* Soak in a tub with warm water and baking soda for | * Soak in a tub with warm water and baking soda for 15–20 minutes to soothe irritation. | ||
* Apply a thin layer of oil, such as [[olive oil]] or [[coconut oil]], to keep the skin soft and prevent tearing. | * Apply a thin layer of oil, such as [[olive oil]] or [[coconut oil]], to keep the skin soft and prevent tearing. | ||
== When to See a Doctor == | == When to See a Doctor == | ||
While most anal fissures heal on their own, medical consultation is necessary if: | While most anal fissures heal on their own, medical consultation is necessary if: | ||
| Line 62: | Line 72: | ||
* The fissure does not improve despite treatment. | * The fissure does not improve despite treatment. | ||
* A lump or swelling is present near the anus. | * A lump or swelling is present near the anus. | ||
If blood is observed in the stool, it is essential to rule out other conditions such as [[hemorrhoids]] or [[colon cancer]]. | If blood is observed in the stool, it is essential to rule out other conditions such as [[hemorrhoids]] or [[colon cancer]]. | ||
== Gallery == | == Gallery == | ||
<gallery> | <gallery> | ||
File:Fissurektomie_Wunde_-_Anfangsstadium.jpg|Fissurectomy wound - initial stage | File:Fissurektomie_Wunde_-_Anfangsstadium.jpg|Fissurectomy wound - initial stage | ||
File:Fissurektomie_Wunde_nach_3_Wochen.jpg|Fissurectomy wound after 3 weeks | File:Fissurektomie_Wunde_nach_3_Wochen.jpg|Fissurectomy wound after 3 weeks | ||
| Line 78: | Line 85: | ||
* '''[[Digestive system disorders]]''' | * '''[[Digestive system disorders]]''' | ||
* '''[[Sitz bath]]''' | * '''[[Sitz bath]]''' | ||
{{Digestive diseases}} | {{Digestive diseases}} | ||
{{DEFAULTSORT:Anal Fissure}} | {{DEFAULTSORT:Anal Fissure}} | ||
Latest revision as of 13:47, 4 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC
| Anal fissure | |
|---|---|
 | |
| Synonyms | Fissure in ano, rectal fissure |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Pain during bowel movements, bleeding |
| Complications | Chronic fissure, anal fistula |
| Onset | Acute or chronic |
| Duration | Weeks to months |
| Types | N/A |
| Causes | Trauma, constipation, diarrhea |
| Risks | Constipation, childbirth, Crohn's disease |
| Diagnosis | Physical examination, anoscopy |
| Differential diagnosis | Hemorrhoids, anal abscess, anal cancer |
| Prevention | High-fiber diet, hydration, stool softeners |
| Treatment | Dietary fiber, sitz baths, topical anesthetics, surgery |
| Medication | Topical nitroglycerin, calcium channel blockers |
| Prognosis | Good with treatment |
| Frequency | Common |
| Deaths | N/A |
Anal fissure, also known as fissura ani, is a small tear in the anal canal, typically causing pain and discomfort during and after defecation. The condition often leads to rectal bleeding, particularly after bowel movements. The sharp, intense pain may last for minutes to hours, making defecation a distressing experience.
Causes[edit]
The exact cause of an anal fissure is not always clear, but several factors contribute to its development:
- Constipation and straining during bowel movement
- Excessive tension in the anal sphincter
- Reduced blood circulation to the anal region
- Skin irritation due to improper drying after bathing or swimming
- Excessive stretching of the anal canal
- Pregnancy and childbirth
- Delayed diaper changes in infants
Once a fissure occurs, it may take 6 weeks to 3 months to fully heal. During this period, the fissure can reopen easily, leading to recurring symptoms.
Treatment[edit]
Management of anal fissures involves a combination of medications, lifestyle changes, and, in some cases, surgery. Treatment options include:
Medications[edit]
A healthcare provider may prescribe various treatments to relieve pain, reduce inflammation, and promote healing:
- Topical pain-relief ointments – Medications containing local anesthetics can help reduce pain and discomfort.
- Suppositories – Rectal medications that provide relief by coating and soothing the affected area.
- Laxatives – To prevent constipation and ease stool passage.
- Zinc-based ointments – Help protect and contract the skin, promoting faster healing.
- Muscle relaxants – Medications such as nitroglycerin or calcium channel blockers may help relax the anal sphincter and improve blood flow.
Home Remedies and Self-Care[edit]
Patients can adopt several measures to promote healing and prevent recurrence:
- Eating a high-fiber diet, including whole grains, vegetables, and fruits.
- Staying hydrated by drinking plenty of fluids.
- Using a stool softener if necessary.
- Practicing proper hygiene and ensuring the anal area remains dry.
- Taking warm sitz baths 2–3 times daily to relax the anal muscles and promote healing.
Chronic Fissure Treatment[edit]
If an anal fissure persists for more than 6 weeks, it is classified as chronic. Treatment options for chronic fissures include:
- Botulinum toxin (Botox) injection – Helps relax the anal sphincter, reducing pressure and promoting healing.
- Lateral internal sphincterotomy – A surgical procedure where a small portion of the anal sphincter is cut to reduce tension and improve healing.
- Dilation procedures – Involves gentle stretching of the anal canal to reduce pressure.
Prevention[edit]
To prevent recurrence, patients should take certain precautions for up to three months after healing. Recommended steps include:
Dietary and Lifestyle Changes[edit]
- Maintain a high-fiber diet to prevent constipation.
- Avoid foods that can harden stool, such as white bread, cheese, and caffeine.
- Drink enough water daily to keep bowel movements soft.
- Engage in regular physical activity to promote healthy digestion.
Proper Hygiene Practices[edit]
- Ensure the anal area is completely dry after bathing or swimming.
- Use soft toilet paper or baby wipes instead of rough tissues.
- Wash the anal region with warm water rather than wiping aggressively.
Sitz Baths and Skin Care[edit]
- Soak in a tub with warm water and baking soda for 15–20 minutes to soothe irritation.
- Apply a thin layer of oil, such as olive oil or coconut oil, to keep the skin soft and prevent tearing.
When to See a Doctor[edit]
While most anal fissures heal on their own, medical consultation is necessary if:
- Pain persists for more than 6 weeks.
- Bleeding occurs frequently.
- The fissure does not improve despite treatment.
- A lump or swelling is present near the anus.
If blood is observed in the stool, it is essential to rule out other conditions such as hemorrhoids or colon cancer.
Gallery[edit]
-
Fissurectomy wound - initial stage -
Fissurectomy wound after 3 weeks -
Fissurectomy wound after 12 weeks
See Also[edit]
| Digestive system diseases | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
This digestive diseases related article is a stub.
|
