Contents: Anal Fissures Definition and what they are — Causes of Anal Fissures — Anal Fissure Symptoms and Hemorrhoids — Anal Fissure Treatment — Home Remedy and Home Treatment for Anal Fissures — Painful, Deep, Chronic Anal Fissures WONT Normally Heal of Their Own Accord — Painful, Deep, Chronic Anal Fissures Treatment — 1.. The most traditional method of dealing with a chronic anal fissure is surgery — Anal Fissure and Internal lateral sphincterotomy — 2.. Painful, Deep, Chronic Anal Fissure Pharmaceutical (Drug) Treatment — Anal Fissure Conclusion
Anal Fissures – Definition and what they are
An anal fissure is a quite painful health problem that comes in several different varieties.
Some anal fissures can and should be treated at home, while others need to be seen by a doctor in order to fully resolve.
An anal fissure is an unnatural crack or tear in the skin of the anus, usually extending from the anal opening.
An anal fissure is most often found right on the midline of the anus, following the natural cracks in the area, as this part of the anal wall is relatively unsupported by either muscle or tendon. As in nature, the weakest area cracks or tears first.
Causes of Anal Fissures
Anal fissures are a traumatic injury caused by stretching the mucus tissues of the anus beyond their capability to stretch, so constipation is, of course, one of the most common causes of anal fissures.
Other common causes of anal fissures include overzealous straining to defecate, severe and chronic diarrhea, Crohn’s disease, ulcerative colitis, and genetically-related over tight sphincter muscles.
Other causes: Anal fissures are commonly seen in women following childbirth and in infants suffering from constipation.
Anal Fissure Symptoms and Hemorrhoids
Symptoms of an anal fissure are bright red blood on underwear, in toilet water, or on toilet paper, and severe sharp pain in the area when any kind of pressure is applied.
Anal fissures can infrequently swell up due to infection or irritation, because a fissure is a cut in the body, but they do not generally have the distinctively lumpy feel of a hemorrhoid, mostly an anal fissure is a tear in the anus, while a hemroid is a lump in the anus.
However, as fissures and hemorrhoids share quite a few causes in common, they are frequently found together.
If you experience any bleeding from the anus or rectum, you always need to see a doctor as there are several life-threatening conditions that also result in anal bleeding.
Anal Fissure Treatment
However, if you are diagnosed with an anal fissure, you will want to know exactly how deep the anal fissure is, as the depth of the anal fissures determines the treatment to be used.
Home Remedy and Home Treatment for Anal Fissures
Any anal fissure less than a quarter-inch (0.64 cm) deep can and should easily be treated at home with increased fiber intake, use of a footstool while on the toilet, avoidance of strain on the area, and keeping the anus hygienic and lubricated with a water-based solution.
Never use petroleum based salves on the area, as petroleum can harbor very aggressive bacteria which can cause a bad infection.
Warm, plain water sitz-baths can help with both hygiene and pain relief of anal fissures.
In addition, do not use harsh or perfumed toilet paper on an anal fissure. Soft, unscented toilet paper or moistened wipes are the best and most soothing options.
Over the counter ibuprofen or acetaminophen should take care of any pain issues.
Surgery or pharmaceutical treatment should not be needed to fully resolve any anal fissure that is this shallow, and the fissure should completely go away within a couple of weeks.
Painful, Deep, Chronic Anal Fissures WONT Normally Heal of Their Own Accord
However, painful, deep, or chronic fissures will usually not self heal because the skin of the anus has a poor blood supply and naturally experiences many muscle spasms over the course of a day.
This combination practically guarantees that any anal fissure deeper than a quarter of an inch will not have the nutrients it needs to properly heal, while any healing that does manage to occur will be disturbed by the movement of the anal sphincter itself on a daily basis.
Painful, Deep, Chronic Anal Fissures Treatment
As of 1994, there are two different treatments by which to treat a deep, chronic anal fissure.
It is important to be familiar with both, as you will need to work with your doctor to determine the best treatment for you.
1.. The most traditional method of dealing with a chronic anal fissure is surgery.
Anal fissure surgery may be performed on an in or outpatient basis, depending on the surgical method used and the severity of the fissure.
Anal dilation used to be practiced commonly for anal fissures, matter of fact I had such a surgery many years ago, but it has been phased out of modern practice due to the very high incidence of both fecal and flatus incontinence that accompanied the procedure.
Anal Fissure and Internal lateral sphincterotomy
Today’s most commonly performed surgery for anal fissures is called internal lateral sphincterotomy, which is a Latin way of saying closing up the fissure from the inside out.
This anal fissure surgery boasts a 95% success rate, but the risk of incontinence is still present as a long-term complication, along with the possibility of shock, trauma, infection, and risks from anesthesia that accompany any surgery.
In addition, this surgery can be quite painful.
For these reasons, anal fissure surgery is not seen as the most preferable method by many people. However, for those that need it, it can be a lifesaver.
If it turns out that surgery is the best option for you, following all of your doctor’s instructions both before and after surgery will minimize any problems or side effects.
These will usually include instructions on eating and drinking the day before the surgery, dietary instructions for afterwards, and lifting restrictions.
Your doctor may also instruct you to stay home from work for a time, and will probably also prescribe several medications including antibiotics and pain management drugs.
You may also have physical therapy exercises to do to ensure full recovery.
Getting support and assistance through the post-surgical period is frequently essential, not to mention quite comforting to most people.
2.. Painful, Deep, Chronic Anal Fissure Pharmaceutical (Drug) Treatment
The other option that has only been available since 1994 is the possibility of treatment through pharmaceuticals.
The first medication used was nitroglycerine cream with a fair success rate.
Then researchers started exploring nifedipine ointment in 1999, followed by topical diltiazem in 2000. All of these medications serve to increase blood supply to the area, which brings sufficient nutrients to allow healing to progress.
In 1993, researchers also started injecting a small amount of botulinum toxin into the anal sphincter muscle to stop the spasming that was interfering with anal fissure healing.
The proponents of drug therapy for anal fissures claim a 98% effectiveness when these medications are used in proper combination, but this claim is currently hotly contested in the medical world.
Anal Fissure Conclusion.
It is up to you to determine with your doctor which method, surgical or pharmaceutical, you wish to use.
However, if your doctor is unwilling to listen to and discuss your priorities and wishes, then you are well within your rights to find a different doctor.
If you and your doctor disagree, your doctor should be willing and able to explain why he or she disagrees in language you can easily understand and for a reason that makes sense.
While a deep anal fissure can be quite the problem, with sufficient discussion you should be able to find the best treatment method for you.
Whatever anal fissure treatment you decide to be the best way to deal with the immediate problem, remember to find and treat the original cause of the anal fissure as well, otherwise it will just return.
Armed with knowledge and in cooperation with a knowledgeable and caring medical staff, you should be able to fully recover from any anal fissure and remain untroubled by them in the future.
Research and main write by Loni L. Ice, editing and additional writing by D. S. Urquhart.