WHAT IS AN ANAL FISSURE?
An anal fissure is a small wound on the skin around the anus. It typically causes a significant amount of pain and often results in bleeding. Anal fissures are a common condition and are frequently mistaken for other conditions that cause bleeding and pain, such as hemorrhoids. WHAT ARE THE
SYMPTOMS OF AN ANAL FISSURE?
Typical symptoms include pain during and after bowel movements, often accompanied by bright red bleeding. Patients may dread the moment of defecation, knowing that they will experience pain for many hours afterward. Deliberate delay in evacuation can lead to increased fecal hardness, worsening the situation. Itching around the anus, especially during non-acute phases, can also be present.
WHAT CAUSES AN ANAL FISSURE?
Anal fissures are often caused by excessive contraction of the internal anal sphincter (involuntary), which can be due to various factors. Anxiety and stress are among the primary factors that predispose to increased tension of the internal anal sphincter. This excessive and constant contraction results in an area of ischemia (reduced blood circulation) in the anal skin, leading to the formation of a wound, typically located in the posterior region. Commonly, it is said that the fissure is located at 6 o'clock in the anus, considering the anus as a clock face. Less frequently, fissures may be found in other areas of the anus. Other causes can include trauma, chronic constipation, profuse diarrhea, or inflammatory conditions of the anal region. Anal fissures can be acute or chronic.
HOW IS AN ANAL FISSURE TREATED?
Most acute anal fissures are treated with medical therapy. It is recommended to follow a high-fiber diet and increase fluid intake, along with the use of stool softeners if necessary. If the fissure is caused by the excessive tone of the internal anal sphincter, frequent warm water baths lasting 10-15 minutes each may be necessary to relax the sphincter. Often, anal dilations with specific devices (DILATAN) or the application of Nifedipine or Nitroglycerin-based creams in the anal canal, causing relaxation of the internal sphincter through a chemical reaction, may be recommended. When medical treatment fails, surgical intervention may be necessary, which can involve a partial section of the internal anal sphincter (partial sphincterotomy) or complete removal of the fissure without sphincterotomy (fissurectomy).
CAN AN ANAL FISSURE RETURN?
An anal fissure can recur, especially if predisposing factors like anxiety, constipation, or diarrhea persist. Sometimes, symptoms decrease or disappear, but the fissure remains and can become symptomatic again after some time. Surgery often provides a definitive solution, and healing typically occurs within a couple of weeks.
CAN AN ANAL FISSURE LEAD TO RECTAL OR COLON CANCER?
No, an anal fissure cannot lead to rectal or colon cancer. However, the persistence of an anal fissure after medical or surgical treatment should prompt a specialist to conduct further examinations to rule out chronic inflammatory bowel diseases or the presence of anal cancer.
An anal fissure is a small wound on the skin around the anus. It typically causes a significant amount of pain and often results in bleeding. Anal fissures are a common condition and are frequently mistaken for other conditions that cause bleeding and pain, such as hemorrhoids. WHAT ARE THE
SYMPTOMS OF AN ANAL FISSURE?
Typical symptoms include pain during and after bowel movements, often accompanied by bright red bleeding. Patients may dread the moment of defecation, knowing that they will experience pain for many hours afterward. Deliberate delay in evacuation can lead to increased fecal hardness, worsening the situation. Itching around the anus, especially during non-acute phases, can also be present.
WHAT CAUSES AN ANAL FISSURE?
Anal fissures are often caused by excessive contraction of the internal anal sphincter (involuntary), which can be due to various factors. Anxiety and stress are among the primary factors that predispose to increased tension of the internal anal sphincter. This excessive and constant contraction results in an area of ischemia (reduced blood circulation) in the anal skin, leading to the formation of a wound, typically located in the posterior region. Commonly, it is said that the fissure is located at 6 o'clock in the anus, considering the anus as a clock face. Less frequently, fissures may be found in other areas of the anus. Other causes can include trauma, chronic constipation, profuse diarrhea, or inflammatory conditions of the anal region. Anal fissures can be acute or chronic.
HOW IS AN ANAL FISSURE TREATED?
Most acute anal fissures are treated with medical therapy. It is recommended to follow a high-fiber diet and increase fluid intake, along with the use of stool softeners if necessary. If the fissure is caused by the excessive tone of the internal anal sphincter, frequent warm water baths lasting 10-15 minutes each may be necessary to relax the sphincter. Often, anal dilations with specific devices (DILATAN) or the application of Nifedipine or Nitroglycerin-based creams in the anal canal, causing relaxation of the internal sphincter through a chemical reaction, may be recommended. When medical treatment fails, surgical intervention may be necessary, which can involve a partial section of the internal anal sphincter (partial sphincterotomy) or complete removal of the fissure without sphincterotomy (fissurectomy).
CAN AN ANAL FISSURE RETURN?
An anal fissure can recur, especially if predisposing factors like anxiety, constipation, or diarrhea persist. Sometimes, symptoms decrease or disappear, but the fissure remains and can become symptomatic again after some time. Surgery often provides a definitive solution, and healing typically occurs within a couple of weeks.
CAN AN ANAL FISSURE LEAD TO RECTAL OR COLON CANCER?
No, an anal fissure cannot lead to rectal or colon cancer. However, the persistence of an anal fissure after medical or surgical treatment should prompt a specialist to conduct further examinations to rule out chronic inflammatory bowel diseases or the presence of anal cancer.