What is Anal Fissure?

An Anal fissure is a small crack or tear or ulcer (open sore) in your skin in ano-rectal region. Fissures are characterized by extreme Pain, Burning sensation & needle pricking sensation during defecation & in extreme cases throughout the day also. Sometimes fissure causes bleeding also. About one in 10 people get an anal fissure at some point in their life. Anal fissures usually develop at the part of your anus towards your back – in line with the cleft of your buttock or in front of your anus, or even both together. An anal fissure will usually heal within five to six weeks, and it’s called an acute anal fissure. If it lasts for longer than this it’s known as a chronic anal fissure. Anal fissure can come at any age, but it’s most common in people aged 20 to 50. 

Symptoms of Anal Fissure's :-

In Anal fissure, you can have the following symptoms.

•  A sharp, searing or burning pain in, or around, your bottom, which can last for a couple of hours after you go to the toilet. Some people describe the pain of an anal fissure as like passing broken glass.
•  Spasms in anus.
• Sometimes small Bleeding during defecation.
•  A sentinel pile. This is a tag of skin that can develop on the edge of your anus below the fissure. This can develop after you get the fissure.

These symptoms may be caused by something other than an anal fissure. One condition they’re often confused with is piles (haemorrhoids), for example. If you have any of these symptoms, contact your Doctor.

Diagnosis of anal Fissure

Initially General Physician will check the symptoms & will examine the anal area to check the fissures. He will prescribe you with some basic treatments of fissure. However if the symptoms of fissure will not go in 5-7 weeks, GP may refer you to see a colorectal surgeon. He will suggest some other tests to find out other bowel problems, such as a proctoscope test. This involves using a narrow tube to look at the inside of your rectum and large bowel. Or an ultrasound scans. After examining you carefully again he further will suggest for next treatment plan or Fissure surgery.

Self-help in Anal Fissure

After diagnosed with Anal Fissure there are some basic changes related to diet & lifestyle. It’s important to keep your faeces soft & smooth bowels. This will help to stop you stretching your anus, and with the pain caused by the fissure. There are following precautions :-

•  Eating a healthy balanced & fibre rich diet.
•  Taking a fibre supplement like psyllium husk (isabgol).
•  Drinking enough fluids so you don’t become dehydrated.
•  Avoiding oily & fat rich heavy food.
•  Lite but regular exercise.
•  Warm Sitz Bath (5–10 minutes) helping in easing discomfort & inflammation.

Causes of Anal Fissure

There are lots of reasons for having anal fissure however most commonly it is caused by a hard or painful bowel movement, which damages the surrounding skin. Some other reasons for Anal Fissure are :-

•  Straining during bowels – sometimes due to constipation.
•  Improper eating habits & lifestyle.
•  Severe diarrhoea.
•  Inflammatory bowel disease, such as Crohn’s disease.
•  Having an infection in the skin around your anus, e.g. sexually transmitted infection.
•  Because of taking painkillers for long term, that contain opiate.
•  Trauma – for example, through having anal sex.
•  Anal cancer
•  Pregnancy.

Treatment of Anal Fissure

Generally an anal fissure will heal within few weeks without any treatment. An anal fissure usually heals if you make some dietary & lifestyle changes along with medicines, or use creams. If it doesn’t get better, generally Doctors advice for surgery