What is Fissure?

An anal fissure is a small tear or crack in the skin lining the anus, often appearing as a narrow sore along the anal canal. This condition can cause pain and bleeding, especially during bowel movements. Factors such as constipation and diarrhea commonly contribute to its development. Anal fissures may be temporary or persistent, frequently recurring if the underlying cause is not treated

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Identifying the Signs

Pain During Bowel Movements

Pain during bowel movements (dyschezia) can result from digestive issues, infections, or rectal conditions. It may be sharp, burning, or aching and can indicate an underlying medical problem

Anal Fissure

A visible tear or cut in the skin around the anus or anal canal is known as an anal fissure. It can cause sharp pain, bleeding, and discomfort during and after bowel movements

Bright Red Blood During or After Passing Stool

Seeing bright red blood in the stool or on toilet paper can be alarming. It often indicates bleeding from the lower digestive tract, such as the rectum or anus

Burning or Itching in the Anal Area

Burning or itching in the anal area (Pruritus Ani) may result from infections, digestive issues, skin conditions, poor hygiene, allergies, or other irritations

Types

Lateral Internal Sphincterotomy (LIS)

Several surgical options are available for treating anal fissures, including:

This procedure involves making a small cut in the anal sphincter muscle to relieve spasms and promote healing. It is highly effective for chronic fissures that do not respond to other treatments.

Open Fissure Surgery

In this method, the surgeon makes a small incision in the anal sphincter to relax the muscle, promoting fissure healing. While effective, it carries risks, including persistent incontinence, difficulty controlling gas or stool, and potential complications, requiring careful evaluation before surgery to ensure the best treatment outcome.

Laser Fissure Surgery

This minimally invasive procedure is performed under local or general anesthesia. A laser probe directs infrared radiation or laser beams to the fissure, improving blood circulation and accelerating healing. In laser sphincterotomy, the sphincter muscle is precisely cut using a laser, reducing pressure and aiding in recovery. This technique is generally less painful and less invasive than traditional surgical methods.

Causes

Constipation

Straining during bowel movements and passing hard stools can cause small tears in the anal lining

Diarrhea

Frequent loose stools can irritate and weaken the anal tissue, making it more prone to fissures

Hard Stools

Hardened stools exert pressure on the anal canal, increasing fissure risk significantly.

Anal Trauma

Injuries from medical procedures, anal intercourse, or insertion of foreign objects can contribute to fissures

Childbirth

The stress of vaginal delivery can lead to fissures, especially in new mothers

Inflammatory Bowel Disease (IBD)

Conditions like Crohn’s disease can make the anal tissue more susceptible to tears

Spasms of the Anal Sphincter

Increased muscle tension in the anal region can delay healing and worsen fissures

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