Chronic Anal Fissure: Symptoms, Causes, and Treatment

Chronic anal fissure is a small tear or cut in the lining of the anal canal that persists over time. It can cause pain, bleeding, and discomfort during bowel movements. This condition is significant as it can affect one's quality of life, causing anxiety and reluctance to pass stools. Chronic anal fissures are common, with a prevalence of about 11 in every 1000 adults. Seeking medical attention is crucial to manage symptoms and prevent complications.

Causes of Chronic Anal Fissure

Chronic Anal Fissure can develop due to various factors. Here are the main contributors:

• Constipation, leading to hard stools that strain the anal canal
• Diarrhea, causing frequent irritation and inflammation in the anal area
• Low-fiber diet, which can result in difficult bowel movements
• Prolonged sitting on the toilet, increasing pressure on the anal region
• Anal trauma from childbirth, anal intercourse, or certain medical procedures

Symptoms of Chronic Anal Fissure

Recognizing the symptoms of Chronic Anal Fissure is crucial as early detection can significantly improve outcomes and quality of life. Symptoms to watch out for include:

• Chronic or recurring pain during or after bowel movements
• Bright red blood on toilet paper or in the toilet bowl
• Itching or irritation around the anal area
• A visible tear or crack in the skin around the anus

Diagnosis of Chronic Anal Fissure

Accurate diagnosis of Chronic Anal Fissure is crucial for effective treatment and symptom management. To diagnose this condition, healthcare providers typically follow a structured diagnostic process that may include:

• Thorough medical history evaluation to understand symptoms and potential risk factors.
• Physical examination, including anorectal inspection, to assess for any visible signs of anal fissures.
• Proctoscopy or anoscopy to visualize the anal canal and confirm the presence of fissures.
• In some cases, additional tests like sigmoidoscopy or colonoscopy may be recommended to rule out underlying conditions.

Treatment Options for Chronic Anal Fissure

Chronic anal fissures can be effectively managed through various treatment approaches tailored to the individual's needs.

Sitz baths

• Sitz baths involve sitting in warm water to soothe the anal area.
• They help relax the sphincter muscles and promote healing.
• The primary objective is to relieve pain and aid in healing.
• Usually done for 10-15 minutes, multiple times a day.

Topical medications

• Topical creams or ointments are applied to the anal fissure.
• They aim to reduce inflammation and promote healing.
• The primary objective is to alleviate pain and aid in the repair of the fissure.
• Application frequency and duration are determined by the healthcare provider.

Botox injections

• Botox is injected into the anal sphincter muscle.
• It helps relax the muscle, improving blood flow to the area.
• The primary objective is to reduce muscle spasm and promote healing.
• Repeat injections may be needed based on individual response.

Prevention and Management of Chronic Anal Fissure

Chronic Anal Fissure can be challenging, but incorporating lifestyle changes and proactive measures can help prevent and manage this condition effectively. Here are some key strategies to consider:

Lifestyle Modifications:

• Eat a high-fiber diet to soften stools and prevent constipation.
• Stay hydrated by drinking plenty of water throughout the day.
• Avoid straining during bowel movements to reduce pressure on the anal canal.
• Incorporate regular physical activity into your routine to promote bowel regularity.

Regular Screenings:

• Consult with a healthcare provider for routine check-ups and screenings.
• Discuss any symptoms or concerns promptly to address them early on.
• Follow up with your healthcare provider as recommended to monitor your condition.

Supportive Care:

• Use over-the-counter creams or ointments to soothe discomfort and promote healing.
• Practice good anal hygiene to keep the area clean and prevent infections.
• Avoid spicy foods and irritants that may aggravate symptoms.

If you’ve been having any symptoms or worries about Chronic Anal Fissure, please reach out to our doctors. They will listen to your concerns, answer your questions and guide you through the next steps.