Anal fissure or ulcer of anus is generally a tiny cut in the anal lining that sometimes move up the canal; quite a universal condition equally prevalent among men and women of various ages. Fissures are painful, severe during passing stools. Among infants, bleeding of rectum is due to these anal fissures. Anal fissures occurs in anoderm that is specific tissue lining. Anoderm unlike normal skin is very sensitive without oil or sweat glands nor hairy growth and thus prone to easy pain due to wear and tear.
Anal fissures crop up while passing large and hard stools thereby being resultant of either constipation or recurrent episodes of diarrhoea. For unfamiliar reasons almost 80% of babies develop fissures in their 1st year. However, grownups witness the same condition due to reduced blood supply in anorectal region. Women under trauma of excessive strain during normal child birth through vagina are at risk of having fissures. Crohn’s disease is inflammatory bowel disease that leads to tear in the anal lining. Another vital cause of fissures formation is the sphincter muscles of anus that may for some reason develop spasm or become extra tight, thus creating added pressure on anal lining while emptying of bowels.
Occasionally a trauma of thermometer insertion, endoscopy, and scan of prostate gland, anal sex or enema is sufficient to create the condition. In some of the atypical cases, fissures are a side effect of cancer of anus, HIV, TB and few STDs like Syphilis and Herpes.
When the internal and external anal sphincters relax while passing bowel, sometimes despite the passing the sphincter fails to go back to normalcy; on the contrary involuntarily vigorously contract before going to resting phase. The sudden pressure difference creates an overshoot thereby dilating the fissures and impedes it from healing. The poor blood supply is another perpetrator towards worsening the condition.
Fissures are manually examined by a doctor. Fissures shows one or more symptoms listed below:
- Evidently clear cut in the skin in the region of anus
- Minor lump adjacent to the cut
- Unbearable pain while passing stools
- Bright red blood discharge noticed on defecated stuff
- Inflammation and itching of anal area
In certain cases fissures are simply a wound without any symptoms of pain or itching other than bleeding that does not heal.
Most fissures heal by itself in matter of few weeks or feel at ease by introducing high fibre diet and increasing fluid intake that in return clears the constipation. OTC medication also helps in getting rid of the symptoms easily. Stool softeners and fibre supplements help relieve the stool hardening. Sitz bath is another way to appease the anal muscles wherein the blood flow increases in the anorectal area and also reduces itchiness. Ointments are also helpful in increasing the blood flow for better healing. Topical creams help get rid of pain and provide comfort. There are certain ointments that eradicate the sphincter muscle spasm that further encourages healing. Botox injections are effective way to temporarily set in paralysis of the sphincter muscles that inhibits formation of further fissures. In case any of these procedures fail to provide solution to distressed fissure, doctors recommend surgical method of anal sphincterotomy.
Fissures can be avoided by taking good care of anal hygiene both among adults and babies and introducing fibre rich food products to diet besides regular intake of water and fluids. At Koya Stopiles Clinic, the doctors provide accurate medication and treatment for complete relief and ward off fissures in future.
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