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What is an Anal fissure?

An anal fissure is a small tear or cut in the lining of the anus, the opening where stool exits the body. These fissures are often caused by trauma to the anal canal and can lead to pain and bleeding during bowel movements. Common causes include constipation, passing hard or large stools, and conditions that result in decreased blood flow to the anal area.

Symptoms of an anal fissure may include sharp pain during bowel movements, bleeding, and sometimes spasms of the anal sphincter muscles. Acute fissures may heal on their own with proper self-care, including a high-fiber diet and keeping the anal area clean. In chronic cases or when conservative measures are not effective, medical interventions such as topical medications or, in some cases, surgery may be recommended.

Symptoms of Anal Fissure

  1. Pain During Bowel Movements: Sharp or burning pain while passing stool is a common symptom.

  2. Rectal Bleeding: Bright red blood on the toilet paper or in the toilet bowl during or after bowel movements.

  3. Spasms of the Anal Sphincter Muscles: In some cases, individuals may experience involuntary muscle contractions in the anal area.

  4. Tenderness or Discomfort: Pain or tenderness in the anal region, especially after bowel movements.

  5. Itching or Irritation: Persistent itching or irritation around the anus.

  6. Visible Tear: In some cases, a small tear or cut may be visible around the anal opening.

Causes of Anal Fissures

  1. Constipation: Straining during bowel movements due to constipation can lead to the development of anal fissures.

  2. Passing Hard or Large Stools: Stool consistency and size can contribute to the trauma of the anal canal, causing fissures.

  3. Chronic Diarrhea: Frequent and persistent episodes of diarrhea can irritate the anal region, leading to fissures.

  4. Childbirth: In women, childbirth can result in anal fissures due to the pressure and stretching of the anal canal during delivery.

  5. Anal Trauma: Injury or trauma to the anal area, such as from anal intercourse, may cause fissures.

  6. Anal Infections: Infections in the anal region can contribute to the development of fissures.

  7. Inflammatory Bowel Diseases (IBD): Conditions like Crohn’s disease or ulcerative colitis may increase the risk of anal fissures.

  8. Decreased Blood Flow to the Anal Area: Conditions that reduce blood supply to the anal region, such as anal spasm or certain vascular disorders, can contribute to fissures.

Diagnosis of Anal Fissure

The symptoms of anal fissures can be easily mistaken for those of piles or hemorrhoids, and discussing these signs with a doctor, even though it may feel uncomfortable, is crucial. A skilled proctologist, such as Dr. Subash K G, can diagnose anal fissures through a physical examination. While a visual examination is often sufficient, a rectal examination may be required for a more detailed diagnosis, involving the insertion of a gloved finger into the anus to feel for abnormalities.

Depending on the severity, additional tests may be recommended to rule out associated health conditions. These tests could include sigmoidoscopy, colonoscopy, or anoscopy. Dr. subash K G may also inquire about the onset of pain, the level of discomfort during bowel movements, family history, dietary habits, and physical activity to better understand the condition and recommend an appropriate course of treatment.