Anal Fissures: Signs, Symptoms, Causes & Diagnosis
An anal fissure is a tiny cut or tears in the mucosal lining of the anus which causes pain and bleeding during and after bowel movements. Sometimes, the fissure can expose the muscle tissue under the mucosal lining in the anus.
Generally, an anal fissure is not a serious medical condition, and in most cases, it heals on its own within a few weeks. However, if it doesn’t heal, it is considered chronic and needs treatment.
There are several treatments to heal fissures and relieve discomfort. However, if an anal fissure is persistent, one may need surgery to treat it completely.
Signs & symptoms of anal fissure
An anal fissure involves tearing or cracking of the inner lining of the anus. The following may be the symptoms of this condition:
- Inflammation or itching in the anus
- Blood in faeces or stools
- Small lump of skin beside the crack or tear
- Pain during bowel movements
- A visible crack in the anus
- Trouble in urinating
- Foul-smelling discharge
Trauma or tear to the anus can lead to anal fissures and such traumas could be caused by the following:
- Chronic or long-term constipation: When the stools are hard, they can damage or tear the inner lining of the anus.
- Prolonged diarrhoea
- Anal sex
- Insertion of foreign objects into the anus
- Forced bowel movement especially when the stool is large, hard and dry.
There are some other causes of anal fissures which are as follows:
- Poor bowel habits
- Extremely tight anal sphincter muscles
- Certain diseases like Crohn’s disease, ulcerative colitis, anal cancer, leukaemia, STDs, etc.
- Decreased blood flow to the anorectal area
Your doctor can diagnose an anal fissure just from the symptoms. However, it becomes important to examine the area for the presence of a fissure, either by visual inspection or by feeling the skin cracks with the fingertip by the doctor.
In some cases, the following tests may be prescribed to determine the underlying cause of the fissure:
This test is used to find any abnormality in the lower part of the colon or sigmoid colon.
The large intestine is examined in the test.
Both these tests are done using a flexible, lighted tube that is inserted in the intestine through the anus to visually inspect the affected areas.
They are highly advanced and specialised diagnostic methods used by the doctors at Yashoda Hospital and Research Centre, Nehru Nagar, Ghaziabad, if the situation is critical. Our advanced facilities and experienced doctors will cater to your every need with utmost sincerity while maintaining your comfort and privacy.
The objective of treatment of an anal fissure is to lower the pressure on the anal tract by making the stools softer and easing the discomfort by stopping bleeding. To accomplish this, traditional treatments are tried first which may include the following:
- Balanced food and drinks:
Your doctor may advise you to eat fibrous foods, drink more fluids, and avoid caffeine products and take some stool softeners to prevent constipation.
- Sitz Bath:
You may be asked to sit in warm water for 10-20 minutes several times a day for relaxing the anal muscles.
- Gentle cleansing of the anus and rectum.
- Avoid prolonged sitting on the toilet.
- Using lubricants like petroleum jelly to lubricate the anorectal area.
In most cases, anal fissures heal after these practices. However, if the fissure is still present, the following prescriptions may be given by the doctors:
- Anti-inflammatory creams/gels: Suppositories, foams, or creams containing hydrocortisone may be given to reduce inflammation.
- Botox or Botulinum toxin type A may be injected into the anal sphincter to temporarily paralyze it. This will aid in healing and pain relief.
- Creams and ointments: One or more of the following may be given to treat the condition:
- Medicated cream to heal the fissure
- Topical muscle relaxant to relax the anal muscles
- Anaesthetic ointment to reduce the pain
- Nitrogen or calcium channel blocker ointments to relax the anal muscles and increase blood flow to the affected area thereby, promoting healing.
- Surgery: If the fissure does not heal from the treatments because of scarring or muscle spasms of the anal sphincter, your doctor may suggest surgery.
In the surgical method, a small cut is made on the sphincter muscle to reduce pain and spasms. This allows the fissure to heal. The surgery can be on an outpatient basis under which you can go home the same day after it is done.
To help you find the best doctors for the treatment of anal fissures we have jotted down some of the best doctors at Yashoda Hospital and Research Centre, Nehru Nagar, Ghaziabad:
Dr. Ashish Gautam is a renowned and extremely experienced gastrointestinal, bariatric, and trauma surgeon – the best GI surgeon in the entire Delhi NCR. An expert in all kinds of abdominal surgeries, his vast experience comes from having performed over 20,000 laparoscopic procedures such as lap colorectal, lap bariatric, laparoscopic common bile duct surgeries and video-assisted thoracoscopic surgeries.
Dr. Gautam received extensive surgical training at S.N. Medical College, Maulana Azad Medical College, Lok Nayak Hospital and Sushruta Trauma Centre.
After this training, he pursued his fellowship in minimal access and bariatric surgery. Apart from the previously mentioned achievements, Dr Gautam is famous for his expertise in serious trauma and gunshot injury surgeries along with treating breast disease and cancer surgeries.
He also has experience in thyroid and parathyroid surgeries through an advanced minimal access approach.
Book your appointment at Yashoda Hospital and get the best treatment for anal fissures.