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Anal Fissure : Definition, Causes, Symptoms, Diagnosis, Complication and Treatment

Friday, July 13th 2012. | Digestive System, Disease

Anal Fissure Definition

An anal fissure is an ulceration of the lining of the anus, which is most frequently caused by hemorrhoids or hard stools. If the cracks are inflamment, are increasing or not heal, small ulcers form. These cracks are mainly located at the back of the anus and are accompanied by pain, moderate to strong during or after the issuance of the saddle, which can last for hours.

Anal Fissure Causes

An anal fissure is mainly caused by hard stools. Upon issuance of stools, fecal matter is expelled through the sphincter at a very high pressure. Often, this region is already affected by prior lack of blood supply, by hemorrhoids or by eczema resulting from the increased pressure of the sphincter.

  • Hard stools
  • Insufficient irrigation of the anal area caused by an intense muscular pressure (tone)     Hemorrhoids (“varicose veins” in the anus)
  • Cryptitis (inflamed vertical grooves separating the anal columns)
  • Anal Eczema
  • Inflammatory polyp
  • Various chronic inflammations

Anal fissure disorders (symptoms)

The most common symptoms of an anal fissure include :

  • Pain of moderate to severe during or after the issuance of the stool.
  • Bright red bleeding in the anal region, mainly after the issuance of the stool, which can be found on toilet paper or on the surface of the stool
  • Moisture in the anal region
  • Increased anal sphincter tone (spasm of the sphincter)

Anal Fissure (img : colorectalsurgeonssydney.com.au)

Anal Fissure Examinations (Diagnosis)

The possibilities are: various Discussed for consideration in a debate Between doctor and patient.

  • Anamnesis
  • Inspection of the anus
  • Palpation (examination)
  • Proctoscopy (examination of the anus by moyen de endoscope year)
  •  In patients over 40 years in case of doubt, a colonoscopy Should Be Performed to exclude intestinal polyps or cancer annually.

Anal Fissure Treatment Options

In general, cracks heal quickly by themselves when the stools are soft. If this is not the case, the following possibilities are envisaged:

Acute anal fissure

WLA essential measure is to regulate stool consistency using a stool softener (sound, vegetable fibers), of sitz baths with chamomile and nitrated ointment that will result in relaxation of the sphincter. It is also possible to lower the pressure at the sphincter using botulinum toxin, to cauterize the mucosal injury by means of silver nitrate or promote coagulation by infrared light. Finally, one can still apply a healing ointment. When these means are insufficient, fissurectomy may be necessary, it is to surgically eradicate the crack. Then the wound heals from the outside inwards, but sitz baths disinfectants should also be practiced.

If cracks reappear or if there is no improvement, it is called chronic anal fissure. Inflamment like crevasses, continually and tear can not heal, ulcers of small elongated form. Chronic anal fissure.

It is treated the same way that an acute anal fissure.

Regulation and loose stools are needed.
Sitz baths with chamomile, nitrated ointment to relieve pressure at the sphincter and possibly fissurectomy are also indicated.

Anal Fissure Possible complications

As with any surgery, wound infection, fever and a bad reaction to medications or bandages may occur.
If the sphincter is greatly affected, anal incontinence may result.

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