Anal Fissures

Anal fissures are cuts or tears in the area around the anus. They’re a common condition in this area of the body and can affect people of all ages. They will cause pain during bowel movements which can often become extremely severe and painful.

The Cause of Anal Fissures

Fissures may be caused due to trauma, and this is usually during bowel movement. This could be hard stool or diarrhea, or in some cases the insertion of items into the anus (such as rectal thermometers, enema tips, or an endoscope) which can cause a fissure. It may also be caused by a tear to the perineum during childbirth (the area between the vagina and anus) which can extend to the anus.

The most common location of anal fissure is the part of the anus closest to the spine. If the fissure does not occur in this area then there may be another underlying cause. This can include anal cancer, leukaemia, Crohn’s disease, viral infections, tuberculosis, gonorrhoea, Chlamydia, human immunodeficiency virus (HIV) and others.

Treatment for Anal Fissures

General treatment can first involve measures such as adding bulk to the stool and softening the stool with certain products. Patients may also alter their diet temporarily, avoiding sharp foods that are harder to digest (popcorn, nuts and so on). Warm baths are encouraged as a way of relaxing spasms within the muscles of the anus.

Further treatment may be needed in some cases where general treatment is not successful. This could include the use of anaesthetics and steroids in order to reduce the pain during bowel movements. There are also several drugs that can help with the symptoms of an anal fissure.

Surgical treatment may be required where the internal anal sphincter is cut and divided. Some fissures may also need to be biopsied. There is a low risk of incontinence following this kind of surgery.