An anal fissure is a painful open sore or tear in the delicate tissues of the anal canal. Initially, only the epithelium is involved but over time, the full thickness of your anal mucosa gets affected. You may end up tearing your anal lining while passing large or hard stools. The prevalence of annal fissures is almost equal in both men and women. They are especially common in middle-aged and young people. However, people of all ages can develop anal fissure as well, including infants.
If you develop an anal fissure, you are likely to feel a sharp pain while having a bowel movement. Moreover, the stool may be accompanied by bloody spots. Some of the leading causes for anal fissures include childbirth and constipation. Chronic diarrhea and anal intercourse are the other common risk factors for anal fissure. An anal fissure can negatively impact the overall health and wellbeing of an individual due to the pain and discomfort while having a bowel movement.
While it might be embarrassing discussing anal fissure with a heath practitioner, it is important to seek timely medical attention as it aids in alleviating pain and suffering. Anal fissure can be prevented by consuming foods rich in dietary fiber, while regular exercise and intake of fluids also help. Practice good anal hygiene by lubricating the anorectal area. Soaking the anorectal area in a warm bath also helps. Surgery is only recommended in case all the other treatment measures have failed.
What are the possible causes of anal fissure?
Anal fissures are a result of several risk factors. They include:
Trauma to the anal canal might lead to the development of anal fissures. Some of the leading causes of this trauma include:
Having to strain while having a bowel movement. This is usually common in case one is passing hard, dry and large stool
When foreign objects are inserted into the anus, this might lead to stretching and hence, anal fissure
Straining during childbirth
Women are more likely to develop anal fissure owing to the straining they experience during childbirth
Inflammatory bowel disease (IBD)
People with IBD are more likely to present with persistent diarrhea or constipation. IBDs such as ulcerative colitis and Crohn’s disease affect bowel movement. The straining experienced while having a bowel movement causes trauma to the lining on your anal canal and hence causes an anal fissure.
Sexually transmitted infections (STIs)
At times, STIs, including herpes and syphilis, may also lead to anal fissure. This is because STIs infect the anal canal, and hence cause damage.
Tight anal sphincter
If your sphincter muscle is unusually tight, this results in significant pressure build up in the anal canal. Therefore, your anal canal is highly prone to tearing.
Poor blood supply
If the flow of blood to your anal canal is poor, or has decreased, this can also trigger the development of anal fissures. Blood flow has also been shown to contribute significantly to healing of anal fissures. On the other hand, non-healing fissures are characterized by reduced blood flow.
Signs and Symptoms of anal fissures
People with anal fissure manifest the following signs and symptoms:
Pain during bowel movements
This pain can be sharp, with a burning or stinging sensation. Pain from an anal fissure might be for a very short while. Alternatively, it can linger for a few hours following a bowel movement
An anal fissure may also be accompanied by bleeding during bowel movements. In this case, you might notice bright spots of blood on your toilet bowl or tissue paper. Blood due to a fissure is distinct form the stool. If you notice very dark blood that is inseparable from the stool, this could be indicative of an even more serious condition. It is important that you inform your doctor whether your bowel movements is accompanied by blood.
Anal fissure tends to be very itchy as a result of irritation to the tissues near your anal canal
When you have an anal fissure, it becomes increasingly harder to have a bowel movement as the process gets very painful. Consequently, you are likely to develop constipation, leading to fewer bowel movements than usual.
Tear on the anal canal
A visible tear either in the anal canal or anus is a sign of anal fissure
Other symptoms include:
- Foul discharge
- The skin around your anus might have a visible crack on it
- You are also likely to have a small skin tag or lump adjacent to the anal fissure
How can we diagnose anal fissures ?
We have expert proctologists at our state-of-the art healthcare facility who will conduct a comprehensive rectal examination to make a diagnosis for anal fissure.
A physical exam and medical history provide your doctors with sufficient information to make a diagnosis for an anal fissure. During the physical exam, the doctor will gently inspect your anus or anal regions for any visible tear. You are likely to feel embarrassed or uncomfortable while the doctor is conducting this physical exam, but this is necessary to make a proper diagnosis for anal fissure.
A physical exam also allows the doctor to distinguish an acute anal fissure from a chronic anal fissure. A chronic fissure persists for over eight weeks. It is also characterized by an external or internal fleshy growth. The tear is also deep, unlike the case with an acute anal fissure. You doctor can also find out the cause of your fissure from its location. For instance, if the fissure is located on the side of your anal opening, as opposed to the front or back, this is indicative of a different disorder, like Crohn’s disease. After conducting a physical exam, your doctor might feel compelled to order further tests to check if there could be an underlying condition. Some of the additional tests include:
In this test, the healthcare professional takes a long flexible tube and inserts into your rectum. This allows the specialist to inspect your colon in its entirety. A colonoscopy is best suited for patients aged 50 and above. It is also ideal for patients who are highly prone to colon cancer.
Your doctor inserts a tubular device up your anus. The device allows your doctor to closely inspect your anus and rectum.
How do we treat anal fissures?
Lifestyle modification is the primary treatment remedy for treating anal fissures. In this case, we advise our anal fissure patients to consume a high-fiber diet that includes whole grains, fruits, and vegetables. Such a diet helps soften the stool. It is also effective in relieving constipation. Additionally, patients are advised to increase their intake of fluids and in particular, water. This helps ease bowel movements. Medication is also prescribed to ease the itchiness and pain that often accompanies anal fissures. Moreover, if your doctor has determined that blood flow to your anal area has reduced, medication may be prescribed to improve the flow of blood.
We only recommend surgery to correct an anal fissure after the combination of diet and medication has failed. This usually happens for a specific patient profile. In choosing the surgical procedure, our proctologists also take into consideration the contemporary conditions that characterize a specific patient. The increased uptake of innovative technology in the medical field over the past few years has greatly revolutionized fissure treatment. This has made it possible for proctologists to admit a patient for surgical treatment to correct anal fissures and discharge them on the same day.
At our healthcare facility, we boast of a highly qualified medical team who are also highly experienced in treating anal fissures. The team consists of proctologists, trained anesthesiologists, nursing assistances, as well as OT assistants. Thanks to this highly trained and effective team, we are in a position to conduct such advanced procedures as laser surgery to correct anal fissures.
Laser surgery differs based on whether we are dealing with acute or chronic anal fissure. In case of acute anal fissure, the surgical procedure is simple and painless. Due to its simple nature, the laser procedure is also non-invasive. Consequently, the likelihood for complications is very low. The surgical procedure has also proven to be an effective mode of treating anal fissure.
If you are dealing with chronic anal fissure, we recommend that you undergo laser fissurectomy. Since the presentation of chronic anal fissure varies form one patient to another, it is important that the surgical treatment be individualized. The surgical procedure involved is known as laternal internal sphincterotomy (LIS). The doctor usually cut a small part of your anal sphincter. The goal is to minimize pain and spasm, thereby promoting healing.
Most patients that undergo this procedure for anal fissure, report significant relief from pain several days post-operation. The surgical team often decide on the most effective anaesthesia for application during surgery. This decision is of course arrived at following consultation with the patient. Some of the available choices are:
- Local anaesthesia where numbing is only evident on your rectum and anus
- General anaesthesia; here, the medication involved puts a patient in a state of deep sleep throughout the surgical procedure
- Saddle block; this entails administering spinal anesthesia in low doses. The goal is to numb the patient from their waist down
Before the appointed day of the surgical procedure, we make arrangements to have you picked form your home by our hospital van. We also assist you in completing any paperwork involved, such as singing of consent forms, before surgery commences. More importantly, we prepare you psychologically for the procedure so that you are relaxed and ready.
Post-op care and diet
You are likely to feel anal and rectal pain following fissure surgery. To mitigate this pain and make you feel comfortable, the doctor will often prescribe painkillers. However, you can also play a contributing role in your own recovery while at home. One way of doing this is by taking a sitz bath. This requires that you sit in a warm bathtub for some time, usually 10-20 minutes. The bath should be taken each time you have a bowel movement. A sitz bath has been proven to relieve the pain brought about by muscle spasms. This contributes to healing after fissure surgery.
There is a low possibility of an anal fissure relapse. However, this can be avoided by dietary modification.
- We advise our patients who have undergone fissure surgery to increase their daily intake of fiber-rich foods. Examples of such foods are pasta and rice. Fruits and vegetables are also good sources of dietary fiber.
- We recommend that you eat 3-5 portions of vegetables and fruits each day. It is important also that you drink a lot of fluids daily, and in particular, water.
- Keep away from spicy and fatty foods, as these are likely to cause constipation. Other foods like tortilla chips and nuts should also be avoided.
- We follow up on our patients after surgery through phone calls. We are also available 24/7 for any complications or queries that you might have.
If you have ever suffered from anal fissure, then you are probably familiar with the excruciating pain felt around your anal sphincter while having a bowel movement. Anal fissure may also be accompanied by bleeding, and hence the risk of infection. While sitz baths and stool softeners may help to manage such pain, home remedies are rarely helpful in the long-run. It may be necessary to undergo a surgical procedure to treat an anal fissure.
At goficure, we have a state-of-the-art facility with the most advanced laser surgical equipment in Bangalore for treating anal fissures. We advise our patients to undergo laser surgery for managing anal fissures over conventional surgery for a number of reasons.
- First, laser surgery is less invasive, meaning faster recovery and a reduced risk for infection.
- It is also cost-effective, takes a shorter time to administer and the chance of recurrence is greatly reduced.
- Our surgeons are among the most highly experienced and skilled in treating anal fissure in Bangalore.
- We offer highly discounted consultation with our healthcare team so that you can get a proper diagnosis in good time.
- goficure will also help you to make the necessary arrangements for surgery at specialty hospitals across Bangalore.
- We offer transport services to and from surgery.
Our post-op consultation is one of the best in Bangalore.
We make a point to check with you on your progress. We liaise with nutritionists across Bangalore who will guide you on the most effective diet plans to ensure a quicker recovery. Our healthcare team will also offer valuable tips on how to reduce the risk of recurrence.
1. Dedicated Medi-Pal
A dedicated Medi-Pal is assigned to you. Your Medi-Pal will be your one point contact throughout the treatment and post-op period. They will always be available for you
2. Quick doctor’s appointments
After understanding your concerns, your Medi-Pal will schedule your consultation with a specialist doctor. Your doctor will carry out necessary tests and advise the course of treatment
3. Hassle-free treatment
If you opt to get the surgery done, goficure will take care of it completely. Right from booking your surgery, claiming your insurance to being with you throughout the procedure, your Medi-Pal will do it all
4. Post-op recovery support
Your Medi-Pal would ensure quick recovery. This includes booking your follow up consultations and helping you with doctor-recommended steps for diet & exercise
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A dedicated Medi-Pal is assigned to take care of the entire process. This includes booking your appointments, scheduling the surgery, handling your documentation including claiming insurance, discharge, and post-op recovery
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Post procedure care and follow-ups
Our engagement doesn't end after your surgery. It continue until you go back to your normal life. Free diet and exercise consultations during your recovery phase are offered to ensure a quick recovery
With so many options, are you wondering what the right choice for your condition is? While you can opt for either an open surgery or a laser surgery, numerous studies have shown that laser surgeries are far more effective. Be it the duration of the procedure, post-operative pain or recovery time, laser surgeries always outrank open surgeries and are therefore, a better choice. Here is a quick comparison that will help you decide your course of action.
1. Long waiting lines
2. Lack of personalized attention
3. Excessive billing/hidden charges
4. Running around for your treatment
Frequently asked questions
- Non-invasive way of treatment
- Day procedure which is completed within 30 minutes
- Patient can go home on the same day of the procedure
- No risk of complications
- Faster healing and recovery