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How Anal Fissures are Diagnosed?

Written and reviewed by
MS - General Surgery, MBBS
General Surgeon, Jaipur  •  31 years experience
How Anal Fissures are Diagnosed?

An anal fissure is a small tear or crack in the lining of the anus which causes sharp pain, bleeding, itching, or burning.

An anal fissure can affect people of all ages, and it’s often seen in infants and young children. Constipation is a common problem in this age group and it is a major cause of this problem.

An anal fissure usually isn’t a serious condition. In most cases, the tear heals on its own within four to six weeks. In cases where the fissure persists beyond eight weeks, it’s considered chronic, or long term.

Symptoms-

  1. A visible tear in the skin around the anus
  2. A small lump of skin just next to the tear
  3. A sharp pain in the anal area during bowel movements
  4. Streaks of blood on stools or on wiping
  5. Burning or itching around the anus

Causes-

  1. Straining during childbirth
  2. Straining during bowel movements as a result of constipation
  3. Chronic constipation
  4. Diarrhea
  5. Inflammatory bowel disease (IBD)
  6. Overly tight anal sphincter muscles

In rare cases, an anal fissure may develop due to:

  1. Anal cancer which occurs due mostly to ano-receptive sex without barrier protection
  2. HIV infection
  3. Tuberculosis
  4. Syphilis
  5. Herpes

Let’s take a closer look at these risk factors.

  1. Anal fissures are common in infants and young kids. Older adults also become prone to anal fissures as the blood flow to the anorectal region decreases.
  2. Women also become prone to these fissures due to straining during childbirth.
  3. The inflammation that occurs in the intestinal lining in people with IBD makes the tissue around the anus more prone to tearing, further causing fissures.
  4. People who frequently experience constipation are at an increased risk for fissures. Also, one can suffer from fissures due to straining and passing large, hard stools. In both these cases, one may experience tears in the anal lining.
  5. Frequent diarrhea can also tear the skin around the anus and so can ano-receptive sex without protection. This can lead to sexually transmitted diseases like genital herpes, HIV/AIDS and infection with HPV virus which causes anal cancer.

Treatment-

Treatment usually helps control anal fissures and the discomfort it causes. Your doctor will prescribe stool softeners and topical pain relievers to stem discomfort. However, if these do not make your anal fissure go away then surgery may be required. And in addition to this, your doctor will also need to look for other underlying causes that can cause anal fissures like for example anal cancer.

Diagnosis

  1. An anal fissure can be diagnosed by simple physical exam. The doctor looks at the area around your anus and follows it up with a rectal exam to confirm the diagnosis.
  2. This can mean the use of an anoscope. In this, the doctor inserts an anoscope into your rectum to be able to see the anal tear.
  3. An anoscope is a thin tube and it allows doctors to inspect the anal canal. An anoscope is also used to diagnose other causes of anal or rectal pain such as hemorrhoids or piles. If you wish to discuss about any specific problem, you can consult a General Surgeon.
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