Anal fissures are small tears that can form in the anal canal, often as a complication of hard or dry bowel movements. Although these tears generally do not cause any serious complications, they can be painful and lead to blood appearing in the stool, which can be disconcerting.
Symptoms
An anal fissure, when it causes symptoms, typically manifests during bowel movements, notes the Mayo Clinic. Patients with an anal fissure may experience pain or a burning sensation during a bowel movement. These symptoms will then go away when the bowel movement is over. Patients often experience bleeding from their anal region; this can manifest as blood on the edges of the stool. Blood may also appear on toilet paper or other material used to wipe the anus after defecation. Patients may also develop irritation or itching around the anus. In some cases a visible crack in the anal lining can be seen.
Causes
Anything that causes trauma to the anal region can lead to an anal fissure, says the American Society of Colon and Rectal Surgeons. A hard or dry bowel movement is one common cause of an anal fissure. Anal fissures can also develop as a result of inflammatory bowel disease due to the stress it puts on the lining of the large intestines. Prolonged periods of diarrhea or constipation can also lead to a tear developing in the anus. In rare cases, an anal fissure can also result from anal sex.
Risk Factors
Patients are more likely to get anal fissures when they are very young or when they are elderly, according to the Mayo Clinic. Although researchers don't understand the condition's tendency to appear during infancy, the elderly often have poor circulation, which can impair rectal blood flow and make the tissue there weak. Patients who are constipated or have Crohn's disease are also more likely to develop an anal fissure. Finally, women who have given birth have an increased risk of developing an anal fissure.
Diagnosis
Anal fissures can be diagnosed via a visual inspection of the anus, says the American College of Gastroenterology. A digital rectal exam is often not necessary because the procedure can cause undue pain in patients suffering from an anal fissure. An anoscope, which is a small flexible camera, can also be used to visualize the inside of the anus to determine how far the fissure travels.
Treatment
In most cases, an anal fissure will heal on its own. Patients can consume a high fiber diet, take fiber supplements and stool softeners and increase their fluid intake. This will help soften the stool and will make healing of the fissure easier. Warm baths, which can be taken for 10 to 20 minutes several times a day, can help relax the muscles around the sphincter. If the fissure persists, surgery may be required to repair the fissure.
