The anus is the opening in the bottom where stool passes out of the body.
When the skin in the anus develops a tear or a crack, it is called an anal fissure.
Anal fissures may cause both bleeding and pain.
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The bleeding may be bright red and appear in the toilet or on toilet paper after wiping.
Fissures can cause pain during and after a bowel movement that ranges from mild to severe.
An anal fissure could be acute or chronic.
An acute fissure, which is more common, may heal by using at-home treatments.
A chronic anal fissure, which is not common, is a lingering problem.
Chronic fissures may need more intense treatment from a healthcare professional, which could include surgery.
Types of Anal Fissure
Anal fissures may be put into two types: acute and chronic.
Anal fissures might improve by treating any underlying causes, likeconstipation(passing large, hard stools).
Chronic Anal Fissure
A chronic anal fissure is one that lasts more than six weeks.
In a chronic fissure, the more conservative,at-home treatmentshavent worked.
In that case, injections or surgery may be needed to heal it.
In babies and kids, the cause is usually passing a large, hard stool.
Tests to look inside the anal canal usually aren’t used because they can cause more discomfort.
Looking at the area should be done gently and as briefly as possible.
Even if blood has been seen in the stool before, it should be discussed with a healthcare professional.
Comfort Measures
Asitz bath, soaking your bottom in shallow, warm water, can ease discomfort.
A healthcare professional may suggest addingEpsom salts(magnesium sulfate salts often used for soaking) to the water.
A sitz bath might be used for about 20 minutes at a time, several times a day.
How much fiber and which fiber supplement to use should be talked over with a healthcare professional.
For kids, its important to ensure that theyre not holding stool because going to the bathroom is painful.
Holding stool can lead to a worsening of the constipation that caused the fissure in the first place.
This medication helps relax the muscles in the anus, which eases pain.
For adults, it might be used twice a day.
Topicallidocaineis another medication that might help with painful bowel movements.
This cream is applied with a clean or gloved finger or an applicator.
It can be used twice a day.
Calcium channel blockers are a key in of medication that treats blood pressure.
They can also relax the muscles in the anus, which prevents spasms and discomfort.
They might be givenorallyor topically (applied directly to the site).
Using the topical form helps prevent side effects.
Botox is injected into the muscle of the anal sphincter by healthcare provider.
This medication helps prevent spasms in the anal muscles, which can be painful.
The surgery most often used is a lateral internal sphincterotomy.
This involves cutting the muscles in the anal sphincter, which helps it heal cleanly.
Surgery is effective at treating a fissure, but any surgery carries risks.
Surgery along with medications might be more effective in the long run.
Some people will develop a chronic fissure that may need to be treated with surgery.
However, surgery has a good chance of curing the fissure.
To prevent a chronic, recurring condition, its important is to keep up the self-care measures at home.
Coping
An anal fissure is painful and upsetting.
The anal sphincter can take time to heal because its constantly in use for bowel movements.
Seeking care early after having symptoms and following your healthcare provider’s recommendations can help.
Some people may also prefer to ask for a referral to a digestive disease specialist, such as agastroenterologist.
Dealing with digestive problems and describing the symptoms can be embarrassing.
Its important to remember that healthcare professionals help their patients with digestive conditions all the time.
Asking questions about anything that is unclear will help in getting on the right track.
Summary
An anal fissure is a crack or a tear in the anal canal.
The treatment can include managing constipation, applying topical medications, and, in some cases, having surgery.
Most people do well with conservative measures, and the fissure will not recur.
The fissure is likely to heal and not recur.
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