An anal fissure is a gash in the moist and thin tissue that lines the anal opening. It causes pain and itching and may also bleed during bowel movements. The most common occasion when an anal fissure occurs is when you pass hard stools, which is usual in infants because they pass hardened feces. With the help of treatment, one can get relief from the pain. Let us understand more about the same in this article.

Symptoms of anal fissure
The common signs and symptoms of an anal fissure are:

• Blood while you pass stool
• Discomfort while sitting
• Swelling and pain in the anal section
• Itching in the anal region
• Pain during bowel movements
• A visible crack in the skin around the anus
• Skin tagging near the anal fissure
• Constipation
• Blood stains on toilet tissues and wipes
• Discomfort while urinating or being unable to urinate
• Smelly discharge
• You notice blood on your toilet seat

Causes of anal fissure
An anal fissure may occur due to the following:

• Childbirth
• Anal intercourse
• Passing of large and hard stools
• Constipation during bowel movements
• Long periods of diarrhea
• Tuberculosis
• Anal cancer
• Syphilis
• HIV
• Some inflammatory bowel disease
• Long-term constipation
• Stretching
• When foreign objects are inserted into the anus
• Difficulty in having a proper bowel movement, mainly when the stool is large, dry, or hard

Some other causes include:

• Scarring in the anorectal area
• When there is an underlying medical issue like ulcerative colitis, cancer, sexually transmitted infections, and more.
• When the blood flow to the anorectal area is decreased
• When the spastic muscles become too tight
• Poor bowel habits

Who is more at risk for anal fissures?
An anal fissure can happen to anyone at any time during their lifetime. When people get older, the chances of having this condition decrease. Those who have experienced anal fissures are more likely to have the same in the future.

Complications of anal fissure
Complications associated with anal fissures include-

• Taking a long time to heal – If an anal fissure fails to heal within eight weeks, it is considered chronic, and you might have to get the treatment done.
• If a tear extends to nearby muscles – An anal fissure can get into the ring of muscle that keeps your anus intact. This muscle is also known as the internal anal sphincter. When this happens, anal fissure becomes more challenging to heal. If there is an unhealed cut, it can trigger a cycle of discomfort. You will also be asked to get the surgery done to reduce the pain or remove the fissure.
• Reoccurrence – When you have an anal fissure, there is a high chance that you get another one.

Suggestive treatment options
The main aim behind anal fissure treatment is to reduce the pressure on the anal canal to ease discomfort, reduce the bleeding, and make stools soft. Here are some conservative therapies available for anal fissures-

1. Don’t sit on the toilet seat for too long.
2. Go for a sitz bath, which means you should soak in warm water for around 10 minutes many times a day. This process helps relax the anal muscles.
3. Try stool softeners that can help prevent constipation. Drink more fluids and avoid caffeine-containing products that can cause dehydration. Also, increase your intake of high-fiber foods and fiber supplements.
4. Clean your anorectal area gently.
5. You can use petroleum jelly to lubricate the anorectal area.

These changes in your lifestyle will help heal around 80 to 90% anal fissures within a few weeks. Other measures that you can try include:

1. Use hydrocortisone-containing foams, suppositories, and creams.
2. Go for surgery.
3. Apply creams and ointments.
4. Inject Botox into the anal sphincter.

Tests conducted to detect Anal fissures
The health care provider might suggest the following tests to detect any cut in the anal opening.

• Anoscopy – This includes the examination of the anal canal, anus, and lower rectum.
• Biopsy – This test includes the removal of rectal tissue for microscopic examination.
• Colonoscopy – In this test, the colon is examined.
• Sigmoidoscopy – The lower part of the large intestine is examined in this test.

Sharp pain and small portions of red blood, along with bowel movements, many indicate anal fissures. The frequent cause of anal fissures is repeated trauma to the area. Those having this condition can start with at-home treatments following good wound hygiene. One can avoid the reoccurrence of anal fissures by making lifestyle and dietary changes. With these modifications, one can see the difference in their condition.