An anal fissure can be a source of intense discomfort and pain. The treatment of these fissures centers around a balanced diet that promotes a healthy digestive tract. Over 90 percent of anal fissures heal without surgery, according to the American Society of Colon & Rectal Surgeons.
An anal fissure is a tear or a cut that is located along skin that covers the anus. Constipation and passage of hard stool can cause a fissure in this area. Additional causes include prolonged diarrhea due to the irritation and breakdown of the skin, or trauma from blunt objects. Patients with fissures complain of pain after a bowel movement and experience bleeding. The tear causes the muscles that surround the anal sphincter to spasm, causing the pain. The spasms can also cause additional tearing and decreased blood flow to the area, which prevents healing. Rarely, a fissure can be a sign of more serious conditions such as Crohn’s disease, HIV, syphilis, tuberculosis, or leukemia and medical attention is advised.
Treating a Fissure
The American Society of Colon & Rectal Surgeons recommends treating the constipation or diarrhea as the initial treatment for fissures. They recommend soaking the area in warm water 3 to 4 times a day and utilizing stool softeners or fiber laxatives during the healing period. Patients should also avoid constipating foods and increase fluid and fiber intake since fiber supplements make stool easier to pass.
Generally, foods that cause constipation are low in fiber and high in fat. There are two types of fiber: soluble and insoluble. Fiber is found in fruits, vegetables, and grains; it is the part of food that the human body cannot digest. Insoluble fiber, found mainly in plant leaves, peels, skins, and the coverings of whole grains, passes through the intestines in close to its original form, helping to make stools easier to pass. The American Dietetic Association recommends 25 to 30 g of fiber daily. To increase your fiber intake, you should choose whole grains over refined grains, whole fruits and vegetables instead of juice, brown rice over white rice and replace meat with legumes.
Foods that Cause Constipation
Foods that are likely to cause constipation include high fat snacks like potato chips and doughnuts, cheese products such as pizza, and marbled meats and fried products. You should also avoid foods that have gone through a lot of processing, including frozen meals and packaged foods, as they can also cause constipation. If pain continues, a physician may recommend using a range of pain medications locally, or a botulism toxin injection to paralyze the muscles in the anus. Chronic fissures may require surgery.
- "Schwartz's Principles of Surgery";Kelli Bullard-Dunn et al.;2010
- "Aliment Pharmacol Therapy"; treatment of perianal fistulizing Crohn's disease; Rutgeerts P;2004
- American Society of Colon and Rectal Surgeons Fissures
- American Diabetes Association Food and Fitness
- AskDrSears.com: Fantasic Fiber