Anal Fissures

Anal fissures are small tears or cuts in the lining of the anal canal

Symptoms
  • Pain and discomfort during and after bowel movements: This is the most common symptom of anal fissures. The pain may be sharp or burning, and may last for several minutes or even hours after a bowel movement
  • I tching and burning around the anus due to inflammation
  • Bleeding
  • Discharge: In some cases, anal fissures can cause a discharge of pus or mucus from the anus.
  • Constipation: Chronic constipation can increase the risk of developing anal fissures, and in turn, anal fissures can cause constipation due to the fear of pain during bowel movements
  • Spasm of the anal sphincter muscle: This can cause a tight, painful sensation around the anus, especially during bowel movements.
Causes 

Anal fissures can be acute or chronic. They can occur when the anal canal is stretched too much, such as during: 

  • Bowel movements
  • Anal sex.


Treatments

Topical treatments:

0.2% nitroglycerin ointment

0.3% nifedipine ointment.

These medications help to relax the anal sphincter muscle and promote healing.

Oral medications: 
If topical treatments are not effective

Calcium channel blockers (e.g. nifedipine) or selective serotonin reuptake inhibitors (SSRIs) to help reduce anal sphincter spasm and promote healing.

Laxatives:

Help prevent constipation, which can worsen anal fissures.

Bulk-forming agents (e.g. psyllium husk) or osmotic laxatives (e.g. lactulose).

Surgery:

In severe or chronic cases of anal fissures, surgery may be necessary such as lateral internal sphincterotomy or botulinum toxin injection.