Anal fissures are small cracks or tear in the anal canal causing a painful linear ulcer at the margin of the anus. Fissure causes itching, pain, or bleeding. It is a very painful situation that affects the anal region. In some cases, fissures heal by themselves within few weeks and in some cases, they may be acute or chronic. In most cases, anal fissures are caused by extending the anal mucosa beyond its capability. It can extend upward into the lower rectal mucosa or extend downward. These are also known as sentinel piles.
In some cases, anal fissure doesn’t heal and recurs or torn with bowel movements.
Symptoms
Causes of Fissures
Chronic constipation and passage of hard dry stool tear the anal lining upon defection. Diarrhea and inflammation of the anorectal area cause the fissure. Nervous tension over a prolonged period also increases changes of the fissure.
Major trauma that happened during pregnancy also can be a reason for fissure development. This cause is not very common as it is found only in women who had pregnancy ever in life. Anal intercourse is also a cause of fissure.
A low fiber diet may be the main cause of the development of fissures.
Diagnosis of Fissures
Diagnosis can be done by inspecting the anus closely first to identify tag or sentinel piles by gentle separation of anal verge skin. The fissure is examined with the help of a small-caliber anoscope and gloved finger well lubricated with lidocaine ointment if the fissure is not extremely painful. Otherwise, it needs to start direct treatment rather than inspection and spot the fissure while beginning to heal.
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