Anal Fissures

What is an anal fissure?
Anal fissure is a common ailment which is caused due to a tear or wound in the ligaments of the lower rectum, the result of which causes severe itching and pain in those areas during bowel movements. Though this is common among a lot of people, it has to be treated seriously and ignorance may possibly lead to other complications. Most fissures occur along the midline-the top or bottom-of the anus.

Whom does it affect?
Anal fissures affect people of all ages. Both men and women are equally affected with respect to the causes of the disease. Such fissures are particular among women after their child-birth and also in children during constipation due to the weak formation of their muscles.

Causes of Anal Fissures
During bowel movements, in some people, there is an extra tension in the muscular rings of the anus. Though the outer sphincter muscle is under the control of the person, the inner muscle may not be such. Hence, when there is an extra pressure, the inner sphincter muscle tends to develop a fissure which results in the reduction of the blood flow to that part of the body. Hence, the ligaments become weak and may develop a tear and frequent blood loss.

In general, most fissures are caused due to the over stretching of the mucous membranes and the sphincter muscles thereby. This condition is generally led to by various causes such as

• Severe and chronic constipation
• Applying a lot of strain during stool movements
• If the stool is hard and dry
• Lack of relaxation during repeated diarrhea
• Crohn's disease or inflammatory bowel disease
• Ulcerative colitis
• Tight sphincter muscles
• Anal intercourse
• Anal probing
• Lack of fiber in the diet

Symptoms and effects
Anal fissures are generally accompanied by a stinging and burning pain during bowel movement and may persist for a few hours. They often itch severely and bleed occasionally. There may be a yellow discharge.

Blood that comes out during bowel movements does not mix with the stool and rather comes separately causing severe burning pain. Fissures may also be painless and the wound caused due to it takes months to be healed. This is often accompanied by blood with the stool.

Prevention of Anal fissures
Anal fissures can be prevented by taking the following measures

• Proper diet, by including lots of fibre in one’s food regularly. And more important is the consumption of a large amount of water.
  
• Complications like diarrhea and constipation must be treated with care.
  
• Avoiding straining and pressurizing the anus during bowel movements
  
• Keep the anus clean and hygiene

If symptoms of anal fissures are seen, the usage of a stool softener can prevent further complication of the fissure.

Treatment
Most of the anal fissures are treated with ordinary home treatment which gets cured in a week or two. These are called acute fissures. But fissures like chronic anal fissure may take more than a month or even more. Such cases require medication and further complicated cases require surgery for their cure.

Common fissures like symptomatic fissures are treated by consumption of fiber diet, by using stool softeners and by having a sitz bath. Medication is not required for these cases and a single pain-killer will do.

Pediatric fissures which occur in infants are due to constipation and they can be treated by treating the constipation.

Certain deep fissures can be treated only due to surgery. The surgery is, in general, referred to as surgical sphincterotomy. This includes exercising a portion of the sphincter muscles and stretching or dilating the anal canal slowly which increases blood flow to that zone.