What are Anal Fissures?
An anal fissure is a tear in the tissue that lines the anus. There are many different causes of anal fissures, including passing hard or large stools, constipation that causes straining during bowel movements, prolonged diarrhea, childbirth or an underlying medical problem such as Crohn’s disease. Overall, the main causes for anal fissure development is too much pressure, tight anal sphincter muscles and poor blood supply to the anus.
Signs and symptoms of an anal fissure may include:
- Pain or discomfort during or after a bowel movement.
- Bright red blood in stool or on toilet paper following a bowel movement.
- A visible tear in the anus or anal canal.
- Burning or painful itching.
- A skin tag on the skin near the anal fissure.
Anal fissures can either be acute, which means they have been present for less than six weeks, or chronic, which means that they have been present for more than six weeks or recur often. Both men and women can get anal fissures, as well as babies. However, your risk generally reduces as you age. Anal fissures may also be caused by certain medical conditions such as anal cancer, STDS or HIV, leukemia or complications from other GI conditions.
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How are Anal Fissures Diagnosed?
During your appointment, your GI provider will speak with you about your medical history and your symptoms, as well as perform a physical exam. Oftentimes the fissure is visible during a physical exam, which is enough for a diagnosis. Further testing may be needed if your doctor believes you may have an underlying condition, including an anoscopy, flexible sigmoidoscopy or colonoscopy.
Anal Fissure Treatment Options
In order to treat anal fissures, the pressure on the anal canal must be lowered to ease discomfort and bleeding. Depending on the severity of your fissures, conservative treatment options are usually tried first, followed by more aggressive options. Treatment choices may include:
- Drinking more fluids and increasing fiber intake.
- Soaking in a warm sitz bath to relax the anal muscles.
- Topical anesthetics such as lidocaine hydrochloride to help relieve discomfort.
- Blood pressure medications to help relax the anal sphincter.
- Topical Nitroglycerin to promote blood flow to the anal fissure and relax the anal sphincter.
- Surgery for those with chronic fissures who have not seen results from other treatments.
There are also some lifestyle changes that patients can make to help relieve symptoms, promote healing of anal fissures and prevent them from returning in the future. Eating 25-30 grams of fiber a day can help to keep stools soft to help fissures to heal. Drinking fluids regularly can also help to prevent constipation.
Your South Denver GI Team
At South Denver GI, our team of physicians and advanced practice providers have the expertise to provide you with outstanding care. If you would like to learn more about Anal Fissures or need to schedule an appointment at our office, contact us today!
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