Anal Fissure

Definition

An anal fissure is a small, chronical tear in the thin, moist tissue (mucosa) that lines the anus. Anal fissures are very common in young infants but can affect people of any age, and more frequent at women to men. 

Risk factors

Till now, the causes of anal fissure are not identified yet. Risk factors that may increase your chance of developing an anal fissure include:

• Constipation. Straining during bowel movements and passing hard stools increase the risk of tearing.

• Childbirth. Anal fissures are more common in women after they give birth.

• Crohn's disease. This inflammatory bowel disease causes chronic inflammation of the intestinal tract, which may make the lining of the anal canal more vulnerable to tearing.

• Anal intercourse.

• Age. Anal fissures can occur at any age, but are more common in infants and middle-aged adults.

• Due to other diseases: Crohn's disease or another inflammatory bowel disease, Anal cancer, HIV, Tuberculosis, Syphilis

Symptoms

Signs and symptoms of an anal fissure include:

• Pain, sometimes severe, during bowel movements, especially pain after bowel movements that can last up to several hours

• Bright red blood on the stool or toilet paper after a bowel movement

• A visible crack in the skin around the anus or a small lump or skin tag on the skin near the anal fissureDiagnosisBased on clinical symptoms and anal injuries. 

Classification

- Acute anal fissure 

- Chronical anal fissure (Last up to 2-3 months) 

Complication

Complications of anal fissure can include:

• Failure to heal. An anal fissure that fails to heal within eight weeks is considered chronic and may need further treatment.

• A tear that extends to surrounding muscles. An anal fissure may extend into the ring of muscle that holds your anus closed (internal anal sphincter), making it more difficult for your anal fissure to heal. 

Treatment- Medications

• Using medicine: Changing the diet and lifestyle

• Procedure: Fixing the sphincter ani muscle, extending anus.

• Surgery: Removing the inflamed tissue with or without opening the sphincter ani internal muscle 

Prevention

An anal fissure can be prevented by taking measures to prevent constipation or diarrhea. Eat high-fiber foods, drink fluids and exercise regularly to keep from having to strain during bowel movements.