Anal fissure: what you need to know!

Anal fissure

If you experience pain in the anus during bowel movements, notice blood on the toilet paper or in the toilet bowl, or have significant discomfort during prolonged walking or physical activity,

there is a high likelihood that you have an anal fissure.

What is an anal fissure?

It is a linear or elliptical defect in the lining of the anal canal. If the condition persists for a long time, scar tissue forms along the edges of the fissure, and granulation tissue may develop, forming what is known as a ”sentinel pile” (anal polyp).

Types of anal fissures:

By clinical course

• acute fissure – from the time the lining tears to several days or weeks afterward; it is characterized by smooth, well-defined edges
• chronic fissure – a long-standing fissure with scarred edges and anal (sentinel) polyps.

By location

• posterior – on the posterior wall of the anal canal;
• anterior – on the anterior wall;
• opposing – on both the posterior and anterior walls of the anal canal.

Causes:

Frequent consumption of spicy or salty foods and alcohol irritates the mucous membrane and makes it more susceptible to injury;

Irregular bowel movements—hard stools passed once every few days with significant straining and discomfort, or, conversely, diarrhea—are the most common precursors of anal fissures;

As a consequence of chronic diseases of the upper gastrointestinal tract: gastritis, cholecystitis, colitis, and gastric or duodenal ulcers;

• Injuries, anal sex;
• Pregnancy and childbirth;
• Diagnostic procedures performed during intestinal examinations (colonoscopy).

Complications of an untreated anal fissure:

• Bleeding—repeated trauma damages the blood vessels of the anal canal, causing them to bleed during or after a bowel movement
• Paraproctitis—a bacterial infection of the fatty tissue surrounding the rectum
• Fistula—an abnormal channel forms between the fissure and adjacent tissues
• Damage to the anal sphincter—with a very long-standing anal fissure, the sphincter may become injured, causing severe pain and potentially impairing its function
• Malignant transformation—the development of a malignant process

Diagnostic methods:

• Medical history
• Physical examination
• Digital rectal examination
• Anoscopy
• Sigmoidoscopy

Treatment methods:

In most cases, acute anal fissures respond well to conservative treatment: ointments, suppositories, sitz baths, and dietary changes. In such cases, a rapid recovery can be expected.

A chronic fissure requires surgery. Unfortunately, it is unlikely to heal on its own. An effective treatment is minimally invasive surgery involving excision of the affected mucosal tissue down to healthy tissue, followed by suturing.

If you have any of the symptoms listed above, we recommend that you do not endure them and seek qualified care at Lviv Medical Center. We will select an individualized treatment plan to help you forget about discomfort and enjoy life without pain.

STAY HEALTHY!!!