Anal fissure

An anal fissure is a small tear in the skin that lines the anus. It causes an involuntary contraction of the anus and sharp pain when passing stool. Anal fissures are more likely to develop in children under the age of 2, and the elderly. Women who have just given birth also present a higher risk.

The more common causes of anal fissures include:

  • constipation
  • passing hard stool
  • diarrhea
  • chronic inflammatory bowel disease

And, the less common causes include:

  • certain sexual practices
  • bacterial abscess
  • tuberculosis
  • HIV
  • syphilis
  • certain types of cancer

Symptoms

Anal fissures are associated with a great deal of pain and discomfort when passing stool. Although the pain may disappear after a few minutes, it can reappear later on. Traces of blood may be visible on the outside surface of the stool or on the toilet tissue. Another common symptom is itching around the anus.

A persistent fissure may lead to chronic constipation due to fear of more pain on defecation, which may worsen the tear in the anus. This may cause the sphincter muscles (muscles that keep the anus closed) to be affected, resulting in painful spasms.

Prevention

The best way to prevent an anal fissure is to avoid constipation by eating a high fiber diet, increasing one's fluid intake, being physically active and passing stool when the need arises, thereby avoiding straining.

Treatment

Oftentimes, the fissure will resolve on its own after a few weeks.

A few measures can be used to reduce the pain and itchiness associated with anal fissures:

  • sitz baths for 10 to 15 minutes, 2 to 3 times a day
  • avoiding the use of scented soaps and toilet tissue
  • using a hydrocortisone cream or suppository

When necessary, an ointment containing nitroglycerin or nifedipine may be prescribed. Adverse effects have been associated with these treatments however, and are not appropriate for everyone. Surgery is also an option for those with chronic fissures.

If you think you may have an anal fissure, you should see your doctor since many of these symptoms are also related to other health conditions.

For more information, speak to your pharmacist!

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