Anal Fissure

If a fissure (anal tear) is not treated, it can lead to more serious problems over time. Here are the possible consequences of an untreated fissure:

• Chronic Condition: Acute (newly developed) fissures can become chronic if left untreated. Chronic fissures are more difficult to heal and cause more severe pain.
• Pain: Severe pain during bowel movements is the most common result of an untreated fissure. This pain may cause the patient to avoid defecation, which can trigger constipation and worsen the condition.
• Infection and Abscess: Because the fissure is constantly exposed to stool, it can become infected. The infection may lead to the formation of an abscess (a collection of pus), causing severe pain, swelling, and fever.
• Fistula: If the abscess is not treated, a fistula (an abnormal tunnel between the anus and the skin) may form. A fistula causes discharge, pain, and discomfort.
• Anal Stenosis (Narrowing of the Anus): Long-term fissures can cause muscle spasms and narrowing in the anal area. This condition makes defecation difficult and increases pain.
• Psychological Effects: Constant pain and discomfort can lower quality of life and lead to anxiety or depression.

For these reasons, it is important to see a doctor and receive appropriate treatment when fissure symptoms are noticed. Early diagnosis and treatment can prevent complications and shorten recovery time.

Also known as an anal fissure, it is a small tear that occurs on the inner surface of the anus and is a quite painful condition. Usually caused by the passage of hard stool or straining, this tear can lead to severe pain, bleeding, and itching during and after defecation. An anal fissure can be either acute (short-term) or chronic (long-term) and can significantly reduce the quality of life. With early diagnosis and appropriate treatment, the chance of recovery is quite high. On this information page, you can learn detailed information about anal fissures and discover ways to prevent this condition.

An anal fissure, also known as a rectal tear, is a small tear that occurs at the exit of the anus, on the inner surface of the anal canal. This tear usually causes severe pain and bleeding during defecation. Although it appears small in size, an anal fissure is a very painful condition.

An anal fissure is a small tear that develops at the exit of the anal canal (the inner part of the anus) and often results in severe pain and bleeding. The main causes of this condition include:

• Constipation: The passage of hard and large stools through the anus can strain the anal canal and cause tearing. This is one of the most common causes of anal fissures.
• Diarrhea: Frequent and watery bowel movements can also irritate the anal area, leading to fissure formation, especially in cases of prolonged diarrhea.
• Anal Trauma: Physical trauma to the anal area, such as anal sex, insertion of foreign objects into the anus, or tears occurring during childbirth, can cause fissures.
• Insufficient Blood Flow to the Anal Area: Reduced blood flow to the anal region can weaken the tissues and increase the risk of fissure formation.
• Inflammatory Bowel Disease (IBD): Conditions such as Crohn’s disease can lead to fissures in the anal region.
• Excessive Tightness of Anal Muscles: Over-tightening of the anal sphincter muscles can make stool passage difficult, predisposing to fissure formation.
• Other Causes: In rare cases, certain infections or underlying health conditions may also lead to anal fissures.

It is a condition that can cause severe pain and negatively affect quality of life. Therefore, it is important to consult a doctor if symptoms are noticed.

An anal fissure, a small tear that occurs at the exit of the anal canal (the inner part of the anus), causes distressing symptoms such as severe pain and bleeding. The common symptoms of an anal fissure include:

• Severe Pain During Defecation:
  The most typical symptom is sharp, tearing pain felt during defecation. The pain appears with the passage of stool or immediately after and can last for minutes or even hours.
• Bleeding:
  Bright red blood may be noticed on toilet paper or on the surface of the stool. The bleeding is usually small in amount.
• Itching and Discomfort in the Anal Area:
  Due to the fissure, there may be itching, irritation, and a constant feeling of discomfort in the anal region.
• Visible Tear in the Anal Area:
  In some cases, a small tear or fissure can be visibly seen at the edge of the anal canal.
• Difficulty in Defecation:
  Due to the pain, the person may avoid straining, which can make defecation more difficult.
• Swelling in the Anus:
  Pain and swelling may occur in the anal area.

Important Note:
If you are experiencing symptoms of an anal fissure, it is important to consult a doctor for accurate diagnosis and appropriate treatment.

The treatment of an anal fissure varies depending on whether the fissure is acute (newly developed) or chronic (long-term). The goal of treatment is to relieve pain, promote healing, and prevent recurrence. Here are the main methods used in the treatment of anal fissures:

1. Conservative (Non-Surgical) Treatment:

• High-Fiber Diet: Consuming fiber-rich foods (fruits, vegetables, whole grains) is important to soften the stool and make its passage easier.
• Plenty of Water Intake: Drinking plenty of water helps soften stool and prevent constipation.
• Warm Sitz Baths: Sitting in warm water for 10–15 minutes several times a day can relax the anal area, reduce muscle spasms, and accelerate healing.
• Topical Anesthetic Creams and Pain Relievers: Creams containing lidocaine or nitrates, as well as pain relief medications, can be used to ease discomfort.
• Stool Softeners (Laxatives): Laxatives may be prescribed to prevent constipation and facilitate bowel movements.
• Nitrate Creams: Nitrate-based creams help increase blood flow to the anal region by dilating blood vessels and relaxing sphincter muscles, promoting fissure healing.
• Botulinum Toxin (Botox) Injection: Temporarily paralyzes the anal sphincter muscles, reducing spasms and supporting healing.

2. Surgical Treatment:

• Lateral Internal Sphincterotomy (LIS): A surgical procedure performed in chronic or treatment-resistant cases. A small portion of the internal sphincter muscle is cut to reduce spasm and promote healing.
• Fissurectomy: In some cases, the fissure itself may be surgically removed.
• Anal Flap Advancement: The affected area is covered using tissue taken from another part of the body.

Treatment Process:

• The treatment process varies depending on the condition of the fissure and the patient’s response.
• Conservative treatment methods are usually the first-line approach.
• Surgical treatment is considered in chronic cases or when conservative methods fail.

Important Notes:

• If you experience symptoms of an anal fissure, it is important to consult a doctor (usually a general surgeon or proctologist) for accurate diagnosis and appropriate treatment.
• Your doctor will determine the most suitable treatment plan for your condition.
• Self-treatment attempts may worsen the condition.

Anal fissure surgery is a surgical procedure performed to treat chronic anal fissures that do not heal with medication or other conservative methods. The main goal of the surgery is to promote healing by reducing spasm in the anal sphincter muscle.

Types of Surgery:

• Lateral Internal Sphincterotomy (LIS):
  
  • This is the most common type of anal fissure surgery.
  • A small portion of the internal sphincter muscle is cut to reduce muscle spasm and improve blood flow.
  • This creates a suitable environment for the fissure to heal.
  • It is usually performed under local anesthesia and takes a short time.
• Fissurectomy:
  
  • This procedure involves the direct removal of the fissure.
  • It is more effective in treating accompanying conditions such as sentinel pile (skin tag) or anal papilla hypertrophy (enlargement of anal papillae) that may develop alongside the fissure.
• Anal Flap Advancement:
  
  • The area of the fissure is covered using tissue taken from another region.
  • This surgical technique is generally preferred for chronic fissure cases in which other treatment methods have failed.

1.Chronic Anal Fissure

A chronic anal fissure is a small tear that occurs at the exit of the anal canal (the inner part of the anus) and causes distressing symptoms such as severe pain and bleeding. While acute (newly developed) fissures usually heal with conservative (non-surgical) treatments, chronic cases that persist for a long time may require surgical intervention.

Causes of Chronic Anal Fissure:

• Persistence: Acute fissures that do not heal and recur over time may become chronic.
• Anal Muscle Spasm: Long-lasting fissures can lead to spasm in the anal sphincter muscle, making healing difficult and increasing pain.
• Difficulty Passing Stool: Chronic constipation or diarrhea can make stool passage difficult, preventing the fissure from healing.

Treatment of Chronic Anal Fissure:

• Ineffectiveness of Conservative Treatments: Conservative methods such as a high-fiber diet, drinking plenty of water, warm sitz baths, and medications are often insufficient in chronic cases.
• Surgical Intervention: In chronic and treatment-resistant cases, surgery (lateral internal sphincterotomy) may be necessary.

Postoperative Care:

• Pain Management: Post-surgery pain can be controlled with pain relievers.
• Facilitating Defecation: A fiber-rich diet, adequate water intake, and stool softeners help ease bowel movements and speed up healing.
• Anal Hygiene: Keeping the anal area clean and dry reduces the risk of infection.
• Regular Follow-up: Regular medical check-ups after surgery are important to monitor the healing process and prevent possible complications.
• Important Note: The treatment of a chronic anal fissure is personalized according to the patient’s condition and the doctor’s evaluation.

2.Does an anal fissure heal on its own?
Most anal fissures heal within a few weeks with home remedies and lifestyle changes. However, in some cases, medical treatment may be necessary.

3.Which doctor should you see for an anal fissure?
You should consult a general surgery specialist or a gastroenterologist for an anal fissure.

4.Is anal fissure surgery risky?
As with any surgical procedure, anal fissure surgery carries some risks; however, these risks are rare.

5.How long does recovery take after anal fissure surgery?
The recovery period varies from person to person but generally takes a few weeks.

6.How can anal fissures be prevented?
Preventing constipation, maintaining soft bowel movements, using lubricants during anal intercourse, and paying attention to anal hygiene can help reduce the risk of developing an anal fissure.