The Problem No One Wants To Talk About: Anal Fissures

29 December 2016
 Categories: Health & Medical , Blog


Dealing with an anal fissure can be a literal pain in the derriere to deal with. It can also be an embarrassing condition that interferes with living life to the fullest. Here is what you need to know about this condition.

What Is An Anal Fissure?

A fissure is essentially a crack in the anus or anal canal. It can be very painful, and will cause rectal bleeding.

What Causes An Anal Fissure?

Most of the time, an anal fissure is caused by trauma to the rectum, but there are other non-traumatic causes as well. Chronic constipation may lead to an anal fissure. Another common cause is childbirth, which places a lot of pressure on the rectum, and the perineum may be ripped during delivery, tearing the rectal region. Trauma to the anus may also be caused by an anal probe when a procedure such as a colonoscopy or prostate ultrasound is performed and the delicate lining is inadvertently damaged.

Other conditions can result in an anal fissure. Anal and rectal cancer will sometimes result in a spontaneous fissure. Crohn's Disease, which is an inflammatory bowel disease with features of both chronic constipation, diarrhea, and inflammation of the digestive tract, can be another underlying cause of an anal fissure as anal ulcerations are a hallmark of the condition. Leukemia, tuberculosis, and viruses like herpes, HIV, gonorrhea, syphilis, and chlamydia can also lead to an anal fissure. Additionally, anal sex can cause severe trauma.

What Are The Symptoms Of An Anal Fissure?

Severe pain and rectal bleeding are the most common symptoms. The pain is usually intermittent, occurring in between bowel movements. Because it can be so painful to have a bowel movement, psychological constipation can become a problem, where the body and mind work together to avoid it. Unfortunately, the impacted stool can become even more of a problem and cause more pain and damage when it is eventually passed. Anal itching is also a common symptom, as is a foul-smelling leakage of pus from an infected fissure.

How Is An Anal Fissure Treated?

Because of its location, its exposure to toxins, and the fact that the digestive system cannot be put on bed rest and given a break from performing, anal fissures can be very difficult to treat. Depending on the location of the pain, an endoscopic procedure from places like Pilipshen Colon & Rectal Surgical Services may be gently performed to rule out any intestinal blockage, tumor, or cancer of the bowel. If the pain is outside, the doctor may just visually inspect the anus.

Care begins with starting a high-fiber diet immediately. A diet high in fiber also requires an increase in fluids to help the stool pass with less effort. A warm sitz bath after each bowel movement is recommended rather than using toilet paper. This is a system that sits on the toilet and is similar to a bidet, using water to irrigate the area. Depending on the severity and location of the fissure, you doctor may recommend a combination of topical ointments, internal medications, and surgery to correct any underlying problems.