Anal Fissure

An anal fissure is a crack or tear in the skin of the anal canal.  If acute they may cause severe  pain during and after defecation but with chronic fissures pain intensity is often less.Anal fissure is the commonest cause anal pain.Anal fissures are often accompanied by bleeding ,which is usually bright red in colour.Constipation remains the sole or the primary cause of initiation of a fissure. Passage of hard stool, irregularity of diet, consumption of spicy and pungent food, faulty bowel habits and lack of local hygiene can contribute for initiation of a fissure.

   Thus avoiding straining during defecation and constipation by eating food rich in dietary fiber, drinking plenty of water  and  avoid constipating agents such as caffeine avoid anal fissures. Similarly, diarrhea should be treated promptly to reduce anal strain. Anal hygiene after defecation is very important aspect of prevention. Anal area should be kept as clean as any other part of body. A lubricating ointment/jelly can be used in early cases sourness of anal region.

Non-surgical treatment or the conservative treatment is the first-line treatment of acute and chronic anal fissures.It usually includes warm sitz baths, topical anesthetics, high-fiber diet and stool softeners.

Surgical treatment, under general anaesthesia, is either anal dilatation (stretch) (Lord's operation) or lateral sphincterotomy where the internal anal sphincter muscle is incised. Both operations aim to decrease sphincter spasm and  thereby restore normal blood supply to the anal mucosa......

Submitterd by - Sunil Kaul