Anal Fissure: Causes, Symptoms, Treatment and Prevention

Overview of Anal Fissure

A tear or cut in the anus or anal canal is known as an anal fissure. This tear causes painful bowel movement along with itching, bleeding and often a foul-smelling discharge. It occurs because of the passage of large and hard stools. 

Usually, anal fissure is only about one centimeter across, but the pain caused by it can be very intense as the anus is a very sensitive body part. Even a small tear can be very discomforting. 

An anal fissure usually heals within 4-6 weeks, but if a fissure persists for more than 7-8 weeks, seeking a specialist doctor immediately is mandatory.

A recent study suggests that anal fissure is quite a common anorectal problem which ranks third after chronic constipation in terms of prevalence. Unhealthy eating habits causing constipation and a sedentary lifestyle are the risk factors leading to anal fissure.

Facts on Anal Fissure

• There are chances of fissure recurring even after using home remedies. Proper medical treatment is necessary to get rid of it.

• Pregnant women have a higher probability of getting an anal fissure in their later pregnancy and during childbirth.

• STDs such as Syphilis, HIV, HPV, and herpes are the infections that are associated with a higher risk of having anal fissures.

• If a fissure is left untreated for a long time, it has the potential to turn into hemorrhoids.

Causes of Anal Fissure

• Passing irregularly hard, large stool during bowel movements

• Constipation, irregular or unusual bowel movements especially the ones causing pain or irritation in the anus or anal opening at the time of passing stool or after the bowel movements.

• A severe case of chronic diarrhea

• Unhealthy anal intercourse

• Overstretching of the opening of the anus at the time of childbirth

• Anal Cancer, HIV AIDS, Syphilis and Inflammatory Bowel Disease are also the fiber potential causes of developing an anal fissure

Signs and symptoms of an anal fissure include:

• Severely painful bowel movements

•  Feeling of full bowel even after passing of stools many times

•  Blood stained stools or blood on the toilet paper after the bowel movement 

•  A visible cut or tear in the skin of the anus

•  Forming of a lump (skin tag) near the anal fissure  

Prevention from Anal Fissure

• Have high dietary fibers to keep conditions like constipation and diarrhea at bay. High diet makes the stools soft and bulky for easy passage of stools. When constipation and diarrhea keep recurring, the person becomes more prone to develop a fissure. Drinking 7-8 glasses of water is the simplest preventive measure for fissures. 

• In case you are already suffering from fissure, you must be very cautious to prevent it from getting severe. Avoid straining while passing stools. Always keep the anal region clean and gently wipe yourself after every bowel movement. Do not use scented toilet wipes as it may lead to inflammation. 

• Get rid of the inactive or sedentary lifestyle. Go for a walk, do yoga and perform light exercises that do not put much strain on the pelvic region. Refrain from lifting heavyweight as it might worsen the condition of Fissure and the person may develop multiple fissures.

• Avoid consuming processed meat, caffeinated beverages, polished rice, spicy and fried food. All of these are low in fiber and can even cause dehydration in the body by ultimately leading to constipation or diarrhea.

Diagnosis of Anal Fissure

The doctor will physically examine the anus to understand the cause of fissure depending upon its location. If a fissure lasts for more than 8 weeks, it is called chronic fissure which can turn severe with time.

• Anoscopy – An anoscope is a tube-like equipment that is inserted into the anus so that the doctor can clearly visualize the rectum as well as the anus 

• The doctor can also ask to get the flexible sigmoidoscopy done, a thin tube is inserted in the bottom part of the colon in this procedure. This test is performed when the patient is younger than 50 and has no chances of colon cancer.

• Colonoscopy can also be performed to confirm the fissure. A thin tube is inserted in the rectum to examine the entire colon.

Treatment of Anal Fissure

Homeopathy for fissure treatment

The most effective homeopathic medicines for fissure are: Nitric Acid – This homeopathic medicine has analgesic properties. It relieves the discomfort and soothes the irritation caused by the tear in the anal region. Nitric acid is also helpful in controlling the discharge from the fissure. Graphites – Graphites are supposed to be one of the best homeopathic medicine for fissure. It helps in getting rid of constipation so that there is no severe pain during bowel movements. Ratanhia – It provides instant relief to the acute pain as well as burning sensation. It also acts effectively to soothe the stinging feeling in the rectum. Home remedies also aid in providing symptomatic relief in a fissure. The most common and effective home remedies used in Fissure are as follows:

• Aloe Vera – It is the most simple and effective home remedy for fissure and other skin conditions. Use the gel only in pure form to avoid any side effects. Refrain from mixing anything to it for immediate relief. It soothes the burning sensation. But, do not forget to check for any signs of allergy from aloe vera. To confirm, apply a bit of aloe vera gel on your elbow and observe for 24 hours. Only when sure about it, use this home remedy regularly.
• Witch Hazel – It reduces the inflammation and immediately reduces the irritability, pain and subsides the swelling as well. It is easily available in different forms in the market. You can use witch hazel in liquid form as well as in the form of wipes.
• Sitz Bath – Sitting in a tub of warm water for 15-20 minutes daily increases the blood flow and offers relief after painful bowel movements. Dip only the hip or pelvis in the water and make sure that the water is not too hot. Mild temperature is apt for soothing purposes and cleaning the anal region. After taking a sitz bath, gently pat it dry and avoid rubbing the anus roughly as it may cause bleeding from the fissure.

Use ice packs every day for 10-15 minutes to reduce the swelling. Use some clothing to wrap the ice before applying. Directly using the ice on the affected area is a big no. 

Medication for Anal Fissure

 Some of the best and most effective Anal Fissure Medicine that can help in curing the condition of an anal fissure  are listed below:

• Allen A69 Anal Fissure Drop

• Osil Cream

• Secalia Cream

• Thank god Cream

• SbIratanhia Dilution 1000 Ch

Surgical Procedure- Laser Treatment for Anal Fissure

It is quite possible that all the medicines, creams and even traditional procedures fail to permanently cure fissure. Sometimes, the condition gets serious because of the usage of unprescribed medications by the patient. It is necessary to consult a specialist doctor before using any ointment or popping in any tablet. Old traditional surgery for fissure is obviously dreaded by the patients because of the complexity and pain involved in the process which does not allow the person to heal soon effectively. But with the medical advances and high precision equipment, the laser surgery for fissure takes about 30 minutes only. The treatment is performed under the daycare program and the patient is discharged within 24-48 hours. Laser treatment is minimally invasive and the patient hardly experiences any pain. It is the permanent solution for fissure, the patient is required to follow all the instructions given by the doctor to keep all the complications at bay. Pain-free laser treatment is certainly the best-suited alternative available. This treatment provides a guaranteed and instant cure. The laser surgery is completely safe and has no harm to the skin or organs of the human. There are no side effects of this treatment!