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Anal Fissure

An anal fissure is a small tear or open wound in the tissue of the anus and it can cause pain and/or bleeding during a bowel movement. An anal fissure can develop in anyone, regardless of gender and age, but is most common in infants and small children due to constipation.

Causes
  • Infants and small children.
  • Elderly.
  • Constipation.
  • Vaginal childbirth.
  • Patients suffering from Crohn’s disease.
  • Anal intercouse.
  • A visible tear or wound around the anus.
  • Anal pain or burning, sometimes severe, during bowel movements.
  • Pain after bowel movements that can last up to several hours
  • Blood on the stool or toilet paper after a bowel movement.
  • Itching or irritation around the anus.
  • A small bump or skin tag on the skin near the anal fissure.
  • Patient history and symptoms, including toileting habits.
  • Physical examination of the anus where the doctor may use a gloved finger to feel inside the anus or use an anoscopy.
  • Laboratory tests to diagnose other problems, such as syphilis or HIV.
  • Caring for yourself and changing your behaviors to make bowel movements easier.
    • Eat more high-fiber foods and drink plenty of water.
    • After passing stool sit in warm water to stimulate blood circulation to the anus and to help the sphincter relax. Do this 2-3 times a day for 10-20 minutes each.
    • Exercise regularly to move your bowels and promote regular bowel movements.
    • If constipation is severe, take fiber supplements, laxatives, or stool softeners, as recommended by the doctor.
  • Medication
    • Topical medication to alleviate pain.
    • Medication to relax the sphincter, such as nitroglycerins or injecting Botulinum toxin.
    • Antibiotics if the wounds become inflamed or infected.
  • Surgery
    • Lateral internal sphincterotomy to release the sphincter muscles to alleviate pain when passing stool; bowel movements will be easier and the wound will heal more quickly.
  • Keep the anus and surrounding area clean and dry.
  • Drink plenty of water and eat high-fiber foods.
  • Exercise regularly to stimulate the digestive system.
  • If you have diarrhea, treat it as soon as possible.
  • In infants, change their diapers often to prevent irritation that can develop into wounds.

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