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What is fissure?

An anal fissure is a small tear in the thin, moist tissue that lines the anus and may occur when you pass hard stools during a bowel movement. It can bleed and make bowel movements very painful. Sometimes the pain lasts for hours after you've gone to the bathroom.

Possible Causes: 

An anal fissure is a small cut or tear in the lining of the anus. This causes pain and some bleeding during and after bowel movements. At times, the fissure can be deep enough to expose the muscle tissue underneath. Trauma or injury to the anal canal due to any of the following reasons may cause anal fissures:

  • The most common cause of this condition is passing hard or large stools.
  • Constipation or diarrhoea can tear the skin around the anus.
  • Inflammatory Bowel Disease (IBD)
  • Straining during childbirth.
  • Decreased blood flow to that region.
  • Tight sphincter muscles.
  • Sometimes haemorrhoid fissures may be related to other conditions such as anal cancer, HIV, TB, herpes or syphilis.

Risk Factors: 

Persons between the age of 20 and 40, both men and women, are likely to suffer from anal fissures. Certain medical conditions such as Crohn’s Disease, anal cancer, leukaemia, STDs and HIV may also suffer from anal fissures.

Signs & Symptoms: 

The main symptom of anal fissures is pain during and following bowel movements. Other symptoms could be bleeding, itching, or a discharge that smells foul. You may notice a small lump of skin near the tear.

Diagnosis: 

At Medcare, the doctor will diagnose an anal fissure during a visual exam. Further tests may be suggested in order to know whether there is any other underlying condition. This testing could be done by anoscopy or flexible sigmoidoscopy or colonoscopy.

Treatment Options: 

Schedule a consultation at Medcare to know the best fissure treatment options for you and how to cure fissures permanently. Fissure treatment without surgery may include certain medications to be taken orally or applied locally. These help to reduce the pain and relax the anal sphincter. In some cases, Botox® injections are prescribed in order to paralyse the anal sphincter muscle and relax the spasm.

If you have a chronic anal fissure or if the symptoms are very severe, then your doctor may suggest surgery. The procedure is called lateral internal sphincterotomy (LIS). A small portion of the anal sphincter muscle is cut to reduce spasm and pain and promote healing.

Observe the signs that a fissure is healing and schedule follow up consultations as recommended.

FAQs: الأسئلة الشائعة:
  • How can I prevent anal fissures?

    A: Many of the precautions to prevent anal fissures are similar to the prevention of haemorrhoids. Eat plenty of fibre and drink enough water so you can avoid being constipated. Exercise regularly to keep your digestion moving and your weight under control. If you have the urge to have a bowel movement, don’t delay it.

  • Can anal fissures heal on their own?

    A: Yes, for some people, anal fissures heal on their own within a few weeks. You should keep your stools soft by eating more fibre and drinking more fluids. Soaking in warm water for 10 to 20 minutes, several times a day, helps to relax the sphincter muscles and enables healing.

  • How do Botox® injections help anal fissures?

    A: Botox® injections are used to treat chronic and acute anal fissures. These temporarily paralyse the sphincter muscle, relieve pain and encourage healing in 60% to 80% of patients.

  • How long do fissures take to heal?

    A: You can resume work and get back to your routine a week or two after surgery for an anal fissure. However, if you opt for home therapy, fissures could take about four to six weeks to heal.

    The first line of treatment usually recommended is home therapy. The most common recommendation involves dipping your buttocks in warm water for 20 minutes, twice or thrice a day to promote healing of the fissure.

    However, in case of surgeries, it will probably take about six weeks for your anus to heal completely. While you won't face any issues after the recovery, you may find it difficult to hold back your stool when passing gas.

    Need successful treatment for anal fissures? Book an appointment with a Medcare specialist today.

  • How do you tell if you have hemorrhoids or fissures?

    A: Fissures and haemorrhoids are similar in some aspects and therefore tend to be confusing. For instance, both conditions are in and around the anus, can result from straining during bowel movement and can cause bleeding. 

    However, this is where the similarities end as anal fissures are essentially tears of the sensitive mucosal lining of the anus. Haemorrhoids, on the other hand, are swollen or dilated veins of the rectum or anus. The diagnosis is usually made by examining the affected area through either an anoscopy or sigmoidoscopy.

    Unsure whether you have haemorrhoids or fissures? Consult a Medcare specialist today for accurate diagnosis and treatment.

  • How do you permanently heal a fissure?

    A: Anal fissures that last longer than six weeks are deemed 'chronic'. While they can be healed with prescription drugs and home remedies, surgery may be recommended in some cases.

    Home treatments include measures to add bulk to the stool or soften it, like consuming a high-fibre diet, having sitz baths and drinking lots of fluids. Prescription drugs, on the other hand, include ointments containing anaesthetics, steroids, nitroglycerin, and calcium channel blocking drugs (CCBs).

    Surgery by lateral sphincterotomy is usually the last resort for patients on whom non-surgical treatments have failed or who are intolerant to it.

    Looking for a permanent solution for your fissures? Book an appointment with a Medcare specialist today.

  • What happens if a fissure goes untreated?

    A: Prolonged neglect of anal fissures can make the condition painful and overwhelming. You can become discouraged from defecating, which can lead to severe conditions such as constipation and formation of fistulas. Untreated anorectal fistulas have been reported to cause carcinoma, the most common type of cancer in humans.

    Faecal impaction is also a consequence of an untreated fissure where a large, hard mass of stool gets stuck in the colon or rectum and cannot be pushed out; this can cause grave illness or even death if not treated.

    Often, anal fissures are misdiagnosed as haemorrhoids by both the patient and the physician because of similar symptoms. Misdiagnosis can turn an acute fissure into a chronic fissure, which is more challenging to treat.  

    Get accurate treatment for your fissures now. Book an appointment with a Medcare specialist today.

  • Which treatment is best for fissure?

    A: Acute anal fissures are more common and can be cured at home while chronic fissures usually need medicine or surgery.

    Some of the most common ways to treat fissures at home include staying hydrated, adding fibre to your diet, avoiding a delay in bowel movements and soaking yourself in warm water for 20 minutes to promote healing.

    There are also medications like nitrate ointment that increases blood flow to the sphincter and anal canal, and botox injections to relieve sphincter pain. Surgery is advised only if everything else fails, and usually only for patients suffering from chronic fissures.

    Want to know the right treatment for your fissure? Book an appointment with a Medcare specialist today.

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