Anal Fissure Overview

A tear that develops in the lining of anal canal or lower rectum, an anal fissure is a painful condition that causes extreme pain during bowel movements. Though anal fissure is a common problem, it mostly affects young people. Anal fissures extend from the anal opening, located posterior in the midline due to poor perfusion of the anal wall.

Symptoms of Anal Fissures

If you experience any of the following signs or symptoms, you may be suffering from anal fissure:

• Pain in the anal canal during bowel movements
• A skin tag or lump close to the anal
• Burning sensation in the anal
• Blood in stools
• Itching in the anal canal

Causes of an Anal Fissure

Anal fissures may be the result of injury or trauma to the anal canal when:

• You have repeated episodes of diarrhea
• You pass stool
• Experience frequent constipation and pass a hard stool
• You have had a delivery, since childbirth can result in trauma or straining in the anal canal
• You suffer from irritable bowel syndrome
• You have extremely tight anal sphincter muscles

Fissures may also be caused by anal intercourse. Some people suffering from Crohn's disease may also experience anal fissure because swelling in the intestinal lining weakens the tissue, making it vulnerable to tearing.Experts are also of the opinion that fissure may be caused due to severe tension or stress in the muscular rings or splinters that control the anus. The inner sphincter is under pressure all the time. Any increase in the tension in the area can cause spasm and reduce flow of blood to the anus, resulting in an anal fissure. Sometimes the pressure is so tense that it prevents the fissure from healing.

Anal Fissure Diagnosis

A visual examination of the anal canal can help a doctor diagnose an anal fissure. In some cases, the doctor may need an endoscope or anoscope to diagnose the tear. While some anal fissures heal with simple home remedies, such as prescription stool softeners or changes in eating habits, sometimes you may need warm baths to relax anal muscles and promote blood flow in the area to relieve irritation and alleviate discomfort. You may need topical pain relievers for application on the anus to relieve pain, widen blood vessels, relax sphincter muscles, and promote healing of the anal fissure.Another less common treatment for anal fissures is Botox, injecting Botox injections into the sphincter to temporarily paralyze the muscle, prevent formation of new fissures and spasms in the anus. In patients, where anal fissure does not respond to other treatments, an anal sphincterotomy may be required, which involves making a small incision in the sphincter to promote healing and relax the muscle.Anal fissures are a common occurrence during infancy, affecting 80 percent of infants. Reduced blood flow in anorectal may cause anal fissures in older adults.