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An anal fissure is a small defect of the skin on the inside of the anal canal, which can be caused by several factors. The most important issue with this condition is severe pain, which is the reason that anal fissures require treatment.

Anal Fissure: Causes And Risk Factors

Nearly any factor that puts pressure on the anal canal mucosa can cause anal fissures. Hard stools can occasionally cause the anal mucosa to tear up a bit, creating an anal fissure. Both constipation and diarrhea contribute to this condition. During childbirth, a lot of stress is also put on the anal canal, sometimes leading to anal fissures. Inflammations of the mucosa of the anal canal can lower its strength and elasticity and also contribute to the development of anal fissures.

Signs And Symptoms

The main symptom of anal fissures is pain, which becomes very severe during bowel movements. It is not rare that these fissures bleed, so the blood can be found on the toilet paper. This can frighten many persons into thinking that some more severe condition is the cause of the bleeding. The unpleasant feeling of irritation and itching in the anal region can also point to the development of anal fissures.

Diagnosis Of Anal Fissures

The diagnosis of anal fissure is easily made by physicians using a patient's anamnestic data and an examination of anal canal. Anal fissures are seen as defects in the skin around the anus or on the inside of anal canal. After making the diagnosis, the doctor should decide whether treatment is necessary, based on the severity of symptoms and objective findings.

Anal Fissure Treatment

Anal fissures usually heal spontaneously after several weeks. However, if the causative factor is not removed, the problem will continue or even become worse. People with hard stools should drink larger amounts of water and consume food rich in fibers. That way, the stool should become softer and prevent further development of the anal fissure. Good hygiene and soaking in warm water two to three times daily can help with the healing process.

Besides these simple measures, there is medication treatment and surgical treatment which is reserved for more severe cases. Medication treatment includes different topical creams containing various active substances. Nitroglycerin increases blood flow and speeds-up the healing of the fissure. However, nitroglycerin can be absorbed into the bloodstream and cause side effects, such as lowering blood pressure and headache. Corticosteroid creams decrease the inflammatory process and offer pain relief. In response to damage of the anal mucosa, anal the sphincter is contracted. In order to relieve this spasm, Botox injections and some blood pressure medications can be used.

Surgical treatment includes removal of a small part of the anal sphincter, which eliminates pain and improves the healing process. This procedure is, like all surgeries, associated with some potential risks.

In conclusion, lifestyle changes are the most important factor in the prevention of anal fissures. Proper hydration and nutrition rich in fibers should maintain normal stools. A sedentary lifestyle is not recommended and including more physical activity is beneficial for prevention of anal fissures. Bowels should ideally be evacuated when there are spontaneous bowel movements, although social situations do not allow that. Still, try as much as you can to go when you need to and not to force it when you don’t.

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