An anal fissure is a small tear in the thin, moist tissue (mucosa) that lines the anus. An anal fissure may occur when you pass hard or large stools during a bowel movement. Anal fissures typically cause pain and bleeding with bowel movements. An anal fissure usually isn’t a serious condition. It can affect people of all ages, and it’s often seen in infants and young children since constipation is a common problem in these age groups.
Symptoms:
- Pain, sometimes severe, during bowel movements
- Bright red blood on the stool or toilet paper after a bowel movement
- A visible crack in the skin around the anus
- A small lump or skin tag on the skin near the anal fissure
- Pain after bowel movements that can last up to several hours
cause:
- straining during childbirth or bowel movements
- inflammatory bowel disease (IBD), such as Crohn’s disease
- decreased blood flow to the anorectal area
- overly tight or spastic anal sphincter muscles
Prevention
For adults, the following may help prevent anal fissures:
- Avoid straining when defecating. This includes treating and preventing constipation by eating food rich in dietary fiber, drinking enough water, making occasional use of a stool softener, and avoiding constipating agents
- Careful anal hygiene after defecation includes using soft toilet paper and cleaning with water, plus the use of sanitary wipes.
- In cases of pre-existing or suspected fissure, use of a lubricating ointment .
- In infants, frequent diaper change can prevent anal fissure
Diagnosis
- External anal fissures on anal verge can be diagnosed by visual inspection.
- Internal anal fissures on anterior side, posterior side or throughout the inner circumference of the anal sphincter muscle can be diagnosed with slit / split proctoscope, transparent plastic proctoscope or by Digital rectal examination with finger inside the anal sphincter muscle.
