What is Anal Fissure?
Anal fissure occurs because of a tear or cut in the anus, that extends up into the anal canal. Anal fissures are a common condition that happens with many people across the globe and are responsible for 6-15 patient percent visits to a colorectal surgeon.
Anal fissure can happen to anyone. Both men and women, young and old are affected with this malady. Fissure in the anal tract causes severe pain during defecation and bowel movement. In fact fissure in the anus, is the most common cause of rectal bleeding during childhood and infancy.Anal fissures typically happens in the specialized tissue that lines the anal canal and anus, known as anoderm. Unlike skin, anoderm do not have sweat glands, hairs or sebaceous glands. But it has a plethora of sensory nerves that can even sense light touch and pain. This abundance of nerves in the anoderm tissue is what makes anal fissures so painful. This most sensitive anoderm moves up for the entire length of the anal canal till it ends and meets the demarcating line where the rectum starts, which is known as the dentate line.
Anal fissures are caused owing to trauma in the anal canal or in the anus. The most common cause for this trauma is bowel movement. So anal fissures can always be caused by repeated episodes or diarrhea or hard stool (constipation). Many a time insertion of an enema tip, rectal thermometer, ultrasound probe (for examination of the prostate), and endoscope can result in enough trauma for development of an anal fissure. During childbirths, trauma in the perineum tissue, can also cause a tear that can extend into the anoderm.The most common location where this disease is diagnosed is the part of the anus, which is closest to the spine.
Other causes for development of this malady are infectious diseases are viral infections like herpes, gonorrhea, syphilis, chancroid, chlamydia, tuberculosis and HIV. Also patients who suffer from Crohn’s disease, 4% of such patients develop anal fissures as the primary manifestation of their disease. Anal fissures are diagnosed by physical examination of the patients. In case rectal bleeding is present sigmoidoscopy and colonoscopy are done at times to confirm the diagnosis. Even in the case of acute fissures, non-operative therapies proves successful in majority of the patients. Initial treatment of this painful colorectal disease involves prescribing stool softening medications, followed by increase in liquid intake and sitz bath.
Sitz bath increases the flow of blood to the anus, which relaxes the rectal spasm and cleans the anus without irritating the anoderm, if done particularly after passing of the stool.
If you think fissure and fistula are the same, you are mistaken. While the term fissure refers to the tear of the skin, fistula refers to the abnormal tube-like passages or connections between organs. Fissures get cured with or without treatment in a few days to few weeks, and do not lead to complications. On the contrary, fistulas when left untreated may lead to complications.
So, read on further to know about the distinction, how to recognize the symptoms and avail treatment.
What is anal fissure?
An anal fissure can occur due to various reason, such as prolonged diarrhea, anal sex, vaginal childbirth, rectum cancer, etc. For majority of the cases, it is usually due to constant constipation or strained bowel movements, that tear down the muscles controlling the sphincters to the inner rectum or the anal canal.
What is anal fistula?
Anal fistulas are not tears but abnormal abscesses near the anus, filled with pus. In fistula, a tunnel is formed under the skin which connects these abscesses to the infected glands. Fistulas are usually the results of present or previous abscesses. If ignored or left untreated, one single fistula can lead to the development of a more complex fistula, where the single fistula tract ends up creating multiple openings.
Symptoms of anal fissure and anal fistula
Some of the common symptoms of an anal fissure are excruciating pain in the anal area every time the bowel movement occurs, constant itching or burning sensation in and around the anus, bloody stool and visible tears and cracks around the anus.
For anal fistula, some of the very common symptoms are a throbbing pain in the anus, which continues to increase, difficulty in sitting down for longer period, swelling and redness around the anus, accompanied by skin irritation, discharge of blood and pus, and at times fever.
To completely cure anal fissure and fistula, it is the various surgical options that are the most effective ones. However, when diagnosed in its earliest form, medications like antibiotics, analgesics, and antipyretics can often help. It is solely depending on the location, type, and size or severity of the fistula or fissure, the treatments may vary from person to person and so does the recovery time.
Though, these conditions cannot be cured with dietary changes or exercise, following a healthy diet can boost healthy bowel movement, reducing chances of constipation or diarrhea that results in fissures.
Prevention is always better than cure. Therefore, it is essential that you visit the nearest medical facilities once you notice any signs of fissure or fistula , to avail the right treatment and get relief from the symptoms quickly. In case you have a concern or query you can always consult an expert & get answers to your questions!
An anal fistula, is also called as fistula- in -ano, it is a small channel that develops between the end of the large intestine called the anal canal and the skin near the anus. This is a painful condition, especially when the patient is passing stools. It can also cause bleeding and discharge during defecation.
Genesis of fistula-in-ano
Almost all anal fistulae occur due to an anorectal abscess that begins as an infection in one of the anal glands. This infection spreads down to the skin around the anus causing fistula-in -ano. The anorectal abscess usually leads to pain and swelling around the anus, along with fever. Treatment for anorectal abscess involves incising the skin over the abscess to drain the pus. This is done usually under local anesthesia. A fistula-in-ano happens when there is failure of the anorectal abscess wound to heal completely. Almost 50% of patients with an abscess go on to develop a chronic fistula-in-ano.
A clinical evaluation, including a digital rectal examination under anesthesia, is carried out to diagnose anal fistula. However, few patients may be advised screening for rectal cancer, sexually transmitted diseases and diverticular disease.
The only cure for an anal fistula is surgery. The type of surgery will depend on the position of the anal fistula. Most patients are treated by simply laying open the fistula tract to flush out pus, called Fistulotomy. This type is used in 85-95% of cases and the fistula tract heals after one to two months.
Other techniques like Fibrin glue and Bioprosthetic plug are also used to surgically treat anal fistulas. In the Fibrin glue technique, glue is injected into the fistula to seal the tract, after which the opening is stitch closed. Bioprosthetic plug is a cone shaped plug made from human tissue, which is used to block the internal opening of the fistula. After this stitches are used to keep the plug in place.
Whatever the surgical technique, one can experience minor changes in continence. Patients usually don’t require antibiotics after surgery but have to take pain medication. They may also have to use gauze to soak up drainage from anus. After surgery, patients should seek help if they have increased pain or swelling, heavy bleeding, difficulty in urination, high temperature, nausea or constipation. If you wish to discuss about any specific problem, you can consult a General surgeon.
Anal fissures are the small tears formed in the anal lining. They are also known as anal ulcers. An anal fissure causes a lot of pain and bleeding during your bowel movements. Usually a fissure heals automatically in a few days time. It can be treated with simple home remedies as well.
Individuals of all age groups can suffer from anal fissures. It is not a very serious problem and heals on its own in a few weeks. Although it can heal itself, there are certain treatments which can help relieve the pain you get from an anal fissure.
An anal fissure has quite a lot of symptoms for you to understand what you are suffering from:
Although most fissures do not require treatment, there are a few remedies that will help cure them faster:
Related Tip: "What Are Anal Fissures and How Can You Deal With Them?"
Anorectal diseases, affect the rectum or the muscles surrounding the analregion. Some of these conditions can be difficult to live with, as the symptoms interfere with everyday life. Here is a look at two of the most common anorectal diseases, their symptoms, and their treatment.
Anal fistula is an unnatural tunnel formation between the anus and a portion of the surrounding skin. It is usually caused due to an infection or blockage in the anal cavity. Here are some common symptoms associated with anal fistulas-
If you have anal fistula, you need to seek immediate treatment. Here are some forms of treatment used to manage the condition-
A small tear or cut in the lining of the anus is known as an anal fissure. Often, such a tear causes discomfort and bleeding during bowel movement. Its symptoms include-
Here is a look at the treatment options open to you, if you suffer from anal fissure-
Consult a surgeon immediately if you notice signs of either of these disorders near your anal region. The doctor will advise you regarding the treatment.
Nowadays new and effective method to treat high and complex fistula known as vaaft. Advantage of vaaft like minimal post operative pain reduced hospital stay, requires very small incision instead if very long incision, sphincter preservation in the high fistula, you can get back to work soon as compare to conventional fistula surgery
What is Anal Fissure?