Anal fissure
It is a small crack or tears in the lining of the anus. The crack in the skin exposes the muscle tissue underneath, cause bleeding and severe pain during and after bowel movements. It may occur when passing hard or large stools, straining during childbirth. An anal fissure cause bleeding during and after bowel movements and sharp pain and it also causes itching and burning in the anal area.
Symptoms:
- A skin tag or small lump of skin, next to the tear
- streaks of blood on stools or on tissue paper after wiping
- A visible tear in the skin around the anus
- burning or itching in the anal area
- Sharp pain in the anal area during bowel movements
Causes:
- Straining during childbirth
- Chronic constipation or frequent diarrhea
- Crohn’s disease or another inflammatory bowel disease
- Decreased blood flow to the anorectal area
- Overly tight or spastic anal sphincter muscles
- Anal cancer
- HIV
- Tuberculosis
- Syphilis
- Herpes
Diagnosis: By digital rectal exam, during this exam, an endoscope or anoscope is inserted into the rectum to make it easier to see the tear. This medical instrument has thin tubes with attached cameras and lights.
Treatment:
- Taking fiber supplements and increasing intake of fibrous foods, such as vegetables and raw fruits
- Using over-the-counter stool softeners
- Taking warm baths called Sitz baths to relax the anal muscles, increase blood flow to the anorectal area and relieve irritation.
- Applying topical pain relievers, such as Anusol-HC and Lidocaine, to the anus to ease discomfort
- Applying a nitroglycerin ointment, such as Cortisone-10, to the anus to promote healing and to promote blood flow to the area
- A brand of calcium channel blocker ointment that can relax the sphincter muscles and allow the anal fissure to heal.
- Botox injections into the anal sphincter. The injections will prevent spasms in the anus.
- An anal sphincterotomy. This is a surgical procedure that involves making a small incision in the anal sphincter to relax the muscle, these allows the anal fissure to heal. This is likely to be considered if less invasive therapies have failed.
