What is fissure?

An anal fissure is a small tear in the thin, moist tissue that lines the anus. The anus is the muscular opening at the end of the digestive tract where stool exits the body. Common causes of an anal fissure include constipation and straining or passing hard or large stools during a bowel movement. Most anal fissures get better with simple treatments, such as increased fiber intake or soaking in a warm-water bath. Some people with anal fissures may need medicine or, occasionally, surgery.

Symptoms

• Pain during bowel movements.
• Pain after bowel movements that can last up to several hours.
• Bright red blood on the stool or toilet paper after a bowel movement.
• A visible crack in the skin around the anus.
• A small lump or skin tag on the skin near the anal fissure.

Causes

• Hard stools especially associated with constipation - The increased pressure exerted in an effort to pass the hard stools causes tearing of the delicate perianal skin.
• Diarrhoea - The frequent forceful bowel movement causes tearing of the anal skin.
• Iatrogenic - A tear may occur during insertion of a rectal thermometer, USG probe, endoscope, enema tube.
• Childbirth
• Anal sex - Commonly encountered in homosexuals.
• Rare causes - Crohns disease, leukaemia, tuberculosis, sexually transmitted diseases, viral infections etc.

Treatments

• Lateral Internal Sphincterotomy
• Botulinum Toxin Injection
• Advancement Flap Surgery
• Laser Surgery