An anal fissure is a small crack or tears in the thin, moist tissue lining the anus. The anus is a highly sensitive part of the body, therefore, a small tear in this region can result in severe pain.

It is the most common cause of rectal bleeding in infants and young children. It can be acute or chronic, if the anal fissure lasts less than 6 weeks it is called acute and if it lasts longer than 6 weeks it is known as chronic anal fissure.

CAUSES:

It is caused by trauma to the lining of the anus from a stretching of the anal canal. The cause of the trauma may include

• Passing large or hard stools.
• Chronic diarrhea
• Childbirth
• Constipation
• Anal intercourse
• Crohn’s disease
• Bowel disease due to inflammation
• Sexually transmitted disease
• Other underlying conditions include anal cancer, tuberculosis, leukemia

SYMPTOMS:

• Pain during bowel movements
• Deep burning sensation after bowel movements
• Visible tear in the skin that surrounds the anus.
• The lump of skin near the anus.
• Itching in the anal area
• Bright red blood during stool or bowel movements.
• Frequent urination or discomfort while urinating.

DIAGNOSIS:

• Firstly, the doctor will inspect the anus area by anoscope for the confirmation presence of any fissure and will ask the patient about the symptoms.
• Flexible sigmoidoscopy.
• Colonoscopy

TREATMENT:

• Acute cases do not require treatment as the fissure resolves itself within a few weeks.
• Change in the diet by including more fibers and fluids to keep the stool soft.
• Nitroglycerin has been found effective by causing the relaxation of the internal and external sphincters.
• Botulinum toxin has been used in treating muscle spasm related disorder including anal fissure.
• Anesthetic cream for pain relief.
• Surgery is the last resort for chronic cases includes the lateral internal sphincterotomy in which a small portion of the anal sphincter is cut to reduce spasm, pain and improve healing.