Dealing with Anal Fissures

Two circular muscles surround your anus, called the anal sphincters, which help control bowel movements. If these muscles tighten or spasm, they can reduce blood flow to the delicate tissue around the anus. This raises the risk of tearing.

Understanding Anal Fissures

An anal fissure is a small tear in the anal canal. It is the last part of the digestive tract, where stool exits the body. These fissures usually happen when the area stretches too much. This can occur from passing hard stools or other types of anal trauma. Once the tear occurs, the exposed tissue can get inflamed, causing a painful cycle of spasms and more tearing.

Causes of Anal Fissures

Factors that can increase the risk of anal fissures include chronic constipation, straining during bowel movements, diarrhea, inflammatory bowel diseases, and even certain medical procedures or conditions that affect the anus or rectum. Pregnancy and childbirth can also lead to anal fissures, as the pressure during childbirth can cause tearing in the area.

Symptoms and Diagnosis

The most common symptoms of anal fissures are sharp, burning pain during and after bowel movements. You may also see bright red blood on toilet paper or your stool. You might also notice a small tear or cut around the anus or a skin tag near the fissure. In more severe cases, people may experience muscle spasms, itching, or a feeling that they haven’t fully emptied their bowels.

To diagnose an anal fissure, your doctor will likely start with a simple physical exam by gently inspecting the anus. Sometimes, tests like a rectal exam or endoscopy are needed. They rule out other conditions and confirm the diagnosis.

Treatment and Management of Anal Fissures

The treatment for anal fissures depends on how severe they are and how long you’ve had them. In most cases, non-surgical treatments can help ease the pain and promote healing.

Conservative Treatments

For acute anal fissures, the first step is usually making some lifestyle changes and using over-the-counter treatments. Increasing fiber intake and drinking more water can soften stools, making bowel movements easier and less painful. Topical medications like nitroglycerin, calcium channel blockers, or steroid creams can also help relax the anal muscles and improve blood flow, speeding up the healing process.

Warm sitz baths—where you soak the anal area in warm water for 10-15 minutes—can also provide relief. These simple self-care steps are often the most effective way to treat anal fissures.

Surgical Interventions

Your doctor may recommend surgery for fissures that don’t heal with conservative treatments. The most common procedure is lateral internal sphincterotomy. It involves a small cut in the sphincter muscle. This reduces tension and increases blood flow.

Although surgery has a high success rate, it does come with risks, such as infection, bleeding, or even temporary loss of bowel control. Doctors usually try all other options before recommending surgery.

Preventing and Managing Recurrent Anal Fissures

Maintaining good bowel habits is important to prevent fissures from coming back. This may involve:

• Consuming a high-fiber diet and staying well-hydrated to promote regular, soft bowel movements.
• Avoiding straining or prolonged sitting during bowel movements.
• Treat any underlying conditions, like inflammatory bowel diseases, that may be risk factors.
• Practicing good hygiene and gently cleaning the anal area after each bowel movement.
• Seeking prompt medical attention at the first signs of an anal fissure to prevent it from becoming chronic.

If you experience new symptoms, seeking medical advice early can stop a small problem from becoming a long-term issue.

Self-Care Tips for Managing Anal Fissures

Along with medical treatments, some simple self-care tips can help reduce pain and promote healing at home. It’s vital to keep the anal area clean and dry. So, gently pat it dry after bathing or using the bathroom. This can help prevent irritation. Wearing loose, soft clothes, like cotton, can reduce friction and discomfort. Using unscented, soft wipes or a bidet instead of rough toilet paper can also soothe sensitive skin. Avoid sitting for long periods, and consider using a cushioned seat or doughnut pillow to ease pressure on the area.

Complications and Considerations

While most fissures heal on their own or with basic treatment, some can lead to more severe complications if left untreated, such as:

• Chronic anal fissures: Fissures that fail to heal within 6-8 weeks, often due to persistent muscle spasms or poor blood flow, can become chronic and more challenging to treat.
• Anal stenosis: Chronic anal fissures can cause inflammation and scarring. This can narrow the anal canal, making bowel movements painful and difficult.
• Anal fistulas: In some cases, an unhealed anal fissure can burrow deeper into the surrounding tissues, creating a small, abnormal tunnel or fistula that connects the anal canal to the skin around the anus.

It is essential for individuals experiencing persistent or worsening anal fissure symptoms to seek prompt medical attention to prevent the development of these more severe complications.

Contact Us for Treatment

Though anal fissures can be painful and disruptive, they are manageable with the proper care and attention. By learning the causes, symptoms, and treatments, you can find relief and take control of the condition. With proper medical care and good bowel habits, most people can heal from fissures and prevent their return.

GastroMD is one of the leading gastroenterology practices in the Tampa Bay area. We perform many diagnostic procedures using state-of-the-art equipment in a friendly, comfortable, and inviting atmosphere where patient care is always a top priority. Our team of professionals looks forward to working with you. Contact us today!