Anal fissure

21:54 - 4 May , 2021

Disease

What is Anal fissure?

It is a condition that consists of a tear in the tissue mucosa that lines the anus, mainly caused by constipation and hard voluminous bowel movements, producing varying pain and bleeding, depending on the severity of the tear.

Anal fissures can occur in individuals of all ages, although they are more common in infants.

Classification:

  • Acute: thin cut that disappears in a few days.
  • Chronic: This is a deep tear with fleshy growths. It usually lasts more than two months.

There are several causes for its appearance, such as:

  • Chronic diarrhea.
  • Intense effort during bowel movements.
  • Constipation.
  • Bulky and hard stools.
  • Labor.
  • Anal sex.

On rare occasions:

  • Anal cancer.
  • Crohn’s disease.
  • Herpes.
  • Syphilis.
  • AIDS.

Symptoms

The characteristic symptoms consist of:

  • Intense pain when defecating.
  • Sore anus after stool.
  • Spasms in the anal sphincter.
  • Itching, burning, and irritation of the skin around the anus.
  • Lump near the anal fissure.
  • Cracking of the skin around the anus.
  • Evidence of bleeding in the stool or on toilet paper.

If an anal fissure does not heal in about two months, it can cause major discomfort that requires immediate treatment to avoid complications.

Diagnosis and treatment

Once the doctor analyzes your symptoms and clinical history, you will have a physical examination including an examination of the anal area. If deemed necessary, they will request additional tests to corroborate the cause of your anal fissure, among them:

  • Anoscopy.
  • Biopsy.
  • Colonoscopy.
  • Sigmoidoscopy.

The treatment plan will be established based on the severity of the symptoms, but in all cases, it will seek to eliminate the factors that cause it.

Most anal fissures improve with a high-fiber diet, increased fluid intake, warm sitz baths, and medications such as nitroglycerin, numbing creams, botox injections, and blood pressure medications.

If the anal fissure is chronic, you may require surgery to remove a minimal muscular part of the anal sphincter, which will reduce the painful spasmodic processes, contributing to fissure repair.

It is important to consider that when you experience an anal fissure it is likely that you will have it again in the future.

Preventive Measures:

  • Eat foods rich in fiber (fruits, vegetables, and grains).
  • Drink plenty of fluids.
  • Exercise regularly.
  • Stop using tobacco, alcohol, and drugs.

At ABC Medical Center’s Internal Medicine Department, we offer health care services with the highest quality and safety, from the prevention, diagnosis, timely treatment, and monitoring of infectious, respiratory, endocrinological, dermatological, rheumatic, nephrological, gastrointestinal, and hematological pathologies of both chronic-degenerative diseases and acute conditions, through a comprehensive and multidisciplinary model.

Fuentes:

  • medlineplus.gov
  • mayoclinic.org
  • msdmanuals.com
  • cun.es
  • topdoctors.es
  • medigraphic.com
  • Cervantes-Peláez D, Rojas-Peláez Y, Rodríguez-Gutiérrez D, et al. La esfinterotomía lateral interna subcutánea cerrada en pacientes con fisura anal crónica. AMC. 2020;24(1):77-88.
  • Blanco AE, Gámez PA, Ferrer RH, et al. Efectividad del lisado plaquetario en la cicatrización de las fisuras anales. Revista Cubana de Cirugía. 2018;57(1):49-57.
  • Salas SE. Fisuras anales. Rev Med Cos Cen. 2015;72(615):261-264.
  • Rodríguez-Wong U. Esfinterotomía lateral interna en el tratamiento quirúrgico de la fisura anal crónica. Rev Hosp Jua Mex. 2008;75(3):203-205.

						
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