Anal fissure: causes, symptoms and treatment

Anal fissure: causes, symptoms and treatment


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THE anal fissure it is an ulcer of the mucosa of the anus that causes a wound in the anal folds. The symptoms of anal fissure can be confused with those of hemorrhoids and the main difference between them is severe rectal pain and the appearance of blood stains on the toilet paper when cleaning. The development of an anal fissure is associated with trauma to the lining of the anus, such as constipation, severe diarrhea and hemorrhoids.

  • Symptoms of anal fissure

  • Where the crack appears

  • Causes of anal fissure

  • Diagnosis of anal fissure

  • Treatment of anal fissure

  • When to operate an anal fissure

  • Postoperative of anal fissure surgery

Symptoms of anal fissure

Symptoms include severe pain when defecating and spots of blood on toilet paper when cleaning. It is also possible to observe the occurrence of pus and itching in some cases.

Where the crack appears

The anal fissure usually develops in the anterior or posterior margin of the anus. If the ulcer is located elsewhere – on the lateral margins of the anus, for example – or does not cause severe pain, tests must be carried out to confirm the diagnosis. In these cases, it can be an inflammatory bowel disease (Crohn’s disease or ulcerative colitis) or other infectious diseases and tumor ulcers.

Causes of anal fissure

Both the constipation chronic as to the occurrence of diarrhea very liquid and irritating can cause anal fissure. Postpartum women are also at risk of cracking. Other less frequent causes are tuberculosis, syphilis and inflammatory bowel diseases. Finally, the intense practice of anal sex without lubrication and other appropriate care can also favor the appearance of cracks in the anus.

Diagnosis of anal fissure

The diagnosis of anal fissure is made by a proctologist through digital rectal examination. To confirm the diagnosis, it is also necessary to rule out other possible diseases that produce symptoms similar to those of anal fissure. In this sense, it is possible to perform complementary exams to assess the occurrence of hemorrhoids, rectal fistulas, anal condyloma, anal ulcers, rectal polyps, among other conditions.

Treatment of anal fissure

Average, 50% of anal fissures heal naturally or with medical treatment. For that, it is recommended the use of compounds of seeds and vegetable fibers that soften the feces and facilitate the evacuations during the recovery of the anal mucosa. Physical exercise, a diet rich in fiber and proper hygiene are also essential. In addition to these treatments, the doctor may also prescribe medication to reduce blood circulation in the anal area. In some cases, the use of ointments or creams anesthetics and anti-inflammatory drugs can relieve symptoms. The combination of these treatments usually avoids surgery.

When to operate an anal fissure

Surgery is only necessary when all the treatments mentioned above have no effect. Surgical intervention consists of performing a small cut in the anal sphincter to allow your relaxation and healing.

Postoperative of anal fissure surgery

Complete recovery and healing from surgery to correct a hard anal fissure three to four weeks, but the pain disappears in the first few days. The results of this intervention are excellent and the patient’s improvement is practically immediate. More than 90% of operated patients do not have any fissures again.

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