Questions To Ask Your Doctor
Once your doctor diagnoses an anal fissure, ask them these important questions:
- Can I expect this fissure to heal on its own?
- How can I treat an anal fissure at home?
- Do I need medication?
- Do I need to make changes to my diet?
- How long should it take for the fissure to heal?
- Am I likely to get more anal fissures?
- Will I need surgery? What are the risks of surgery?
How To Ease Symptoms Of Anal Fissure
Adopting some simple self-help measures can make going to the toilet easier.
This will allow existing fissures to heal, as well as reduce your chances of developing new fissures in the future.
Self-help measures for avoiding constipation include:
- plenty of fibre in your diet, such as fruit and vegetables and wholemeal bread, pasta and rice adults should aim to eat at least 30g of fibre a day
- staying well hydrated by drinking plenty of fluids
- not ignoring the urge to poo this can cause your poo to dry out and become harder to pass
- exercising regularly you should aim to do at least 150 minutes of physical activity every week
You can help soothe the pain by taking simple painkillers, such as paracetamol or ibuprofen, or by soaking your bottom in a warm bath several times a day, particularly after a bowel movement.
Living With Anal Fissures
If you have an anal fissure, take these precautions to avoid making it worse and avoid recurrences:
- Take all medicines as prescribed.
- Get the recommended amount of fiber in your diet. Avoid constipation or large or hard bowel movements.
- Drink enough water to stay well hydrated.
- Maintain a routine bowel habit. Ask your healthcare provider about what this should be for you.
- Avoid spicy foods while you have an anal fissure, because they may make symptoms worse.
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What Does Surgery For An Anal Fissure Involve
Before surgery is considered, your doctor will re-examine you and may conduct other tests to determine why other treatments have failed to heal the fissure.
A fissure may fail to heal because of scarring or muscle spasms of the internal anal sphincter muscle. Surgery usually consists of making a cut to a small portion of the internal anal sphincter muscle to reduce pain and spasms and allow the fissure to heal. Cutting the muscle rarely results in the loss of ability to control bowel movements.
The surgery can usually be performed on an outpatient basis . Pain is relieved after a few days and complete healing takes place in a few weeks.
Medicines And Ointments To Heal A Fissure
The following medicines can provide quick relief from fissure pain and help in anal fissure healing.
These non-surgical measures will help provide relief from pain and bleeding and, potentially, heal acute fissures with virtually no side effects.
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What Are Complications Of Anal Fissures
Complications seen with anal fissures include:
- Pain and discomfort
- Reduced quality of life
- Difficulty with bowel movements, especially because many people avoid going to the bathroom because of the pain and discomfort it causes
- Possible recurrence even after treatment
- Clotting
- Uncontrolled bowel movements and gas.
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Medicines For Treating Anal Fissure
If the home remedies dont work, the next line of treatment to cure anal fissure is using medications. Some medicines that will be effective to manage and control piles symptoms are:
Topical nifedipine and topical nitroglycerin:
Topical nifedipine reduces the internal anal sphincter pressure. Nifedipine is usually prescribed to treat high blood pressure but is best used for fissure treatment when applied directly to the perianal skin.
On the other hand, when nitroglycerin is applied, it increases blood circulation to the affected skin and relaxes the anal sphincter that eventually speeds up healing. Confirm the dosage of these medicines with the doctor before taking them.
These are available as over-the-counter creams, ointments, and anal suppositories that you can buy to help relieve the discomfort caused due to fissure.
Laxatives:
Laxative such as fybogel encourages peristalsis and stimulates the gut to pass the stool. There are different types of laxatives available for use. So, make sure you talk to the doctor before taking them to decide which type of laxative is best for you.
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How To Heal A Fissure Fast
Laser surgery has emerged as a prominent surgery. The superb surgery is satisfying the patients with a perfect healing process. Do you know about laser surgery? How is it beneficial for the healing process?
Laser methods are the perfect treatment of anal fissures. Providing faster healing without any pain and blood is possible with laser treatment.
The non-usage of surgical equipment helps in reducing the anal fissure healing time. The laser beam has been suggested by the doctors at the time of increased severity.
The incision is being done with the laser beam, and there is no use of surgical equipment in the process. The anal fissure healing time is reduced by relaxing the anal sphincter muscles.
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Stages Of Fissure Healing
How long do fissures take to heal?
How do you permanently heal a fissure?
How do you know if a fissure is healing? How to heal anal fissure? How to cure fissure permanently? Do fissures itch when they are healing?
Signs indicating a fissure is healing:
About 9 out of 10 short-term fissures heal with home treatmentincluding using stool softeners or fiber supplements and taking regular sits baths. And about 4 out of 10 long-term anal fissures will heal after home treatment is used.
But not all fissures will heal with just home treatment. If a fissure lasts more than 8 to 12 weeks, you may need prescription medicines. These may include nitroglycerin cream, high blood pressure medicines in pill or gel form, or injections of botulinum toxin .
If medicines don’t stop your symptoms, you may need to consider surgery. The most commonly used surgery is lateral internal sphincterotomy. In this procedure, a doctor cuts into part of the internal sphincter to relax the spasm that is causing the fissure.
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What are the Symptoms and Signs of Anal Fissures?
. Severe pain during a bowel movement followed by continuing pain is the classic symptom of an anal fissure.
. There is a vicious cycle of constipation causing pain, which makes the anal sphincter muscles go into spasm.
. This causes more pain and spasms, which makes having a bowel movement more difficult and worsens the constipation.
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Who Is At Risk For An Anal Fissure
Certain factors raise the risk for anal fissures, including:
- Constipation with straining to pass hard stool
- Eating a low-fiber diet
- Intense diarrhea
- Any inflammatory condition of the anal area.
Anal fissures may also result from inflammatory bowel disease, surgery or other medical treatments that affect bowel movements or the anus.
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Follow Proper Bathroom Hygiene
People suffering from anal fissure should make sure that they follow the below-mentioned hygienic measures-
- After every bowel movement, clean the anal area gently and dry it properly.
- Every time you have the urge to pass stools, dont ignore it. Controlling the urge results in constipation which makes the fissure worse.
- Do not apply soap or take bubble baths as it can irritate the skin in the anal canal.
- Avoid excessive straining or sitting on the toilet for too long as it puts extra pressure in the anal area.
Diagnosis Of Anal Fissure
Your GP will usually be able to diagnose an anal fissure by asking about your symptoms and examining you. Theyll ask you to describe your symptoms and how long youve had them. They may also ask you about your health in general and your medical history.
Your doctor will examine you by asking you to lie on your side with your knees bent towards your chest. Theyll then gently part your buttocks to examine the area and see if theres a fissure.
If theres any uncertainty about whats causing your symptoms or if initial treatments dont help, your GP may refer you to see a colorectal surgeon. This is a surgeon who specialises in conditions affecting your bowel and back passage.
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Dietary Fiber And Home Remedies
A high-fiber diet can help keep your stools regular and easily passable. This is a key factor in preventing future anal fissures.
A daily fiber intake of 2535 grams is suitable for most adults. Alongside an increase in dietary fiber, its essential to drink plenty of fluids per day. This helps to soften stools, makes them easier to pass, and helps promote good wound healing.
You may wish to take fiber supplements to increase your daily intake.
How Long Does A Fissure In The Anus Take To Heal And Heal
A fissure in the anus can occur for many different reasons and, basically, its duration will depend on the correction of the cause for which it appeared .
You can use creams, ointments, increase your fiber intake and even resort to surgery, but if you do not correct the reason why the anus has been injured, it is very difficult for everything to really return to normal.
Lets see what causes an anal fissure and how long it might take to heal.
Pay attention if you have one or more factors that can cause it, as this will directly affect its resolution. If you take steps that can reverse the cause, you will improve faster than you thought, even if the fissure is chronic.
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When To See A Gp
See a GP if you think you have an anal fissure.
Do not let embarrassment stop you seeking help. Anal fissures are a common problem GPs are used to dealing with.
Most anal fissures get better without treatment, but a GP will want to rule out other conditions with similar symptoms, such as piles .
They can also tell you about self-help measures and treatments that can relieve your symptoms and reduce the risk of fissures coming back.
How Is It Diagnosed
A doctor can diagnose an anal fissure based on your symptoms and a physical examination. The examination may include:
- Looking at the fissure by gently separating the buttocks.
- A digital rectal examination. The doctor inserts a gloved finger into the anal canal.
- Anoscopy. This involves using a short, lighted scope to look into the anal canal.
The doctor may wait until the fissure has started to heal before doing a rectal examination or anoscopy. If an examination needs to be done right away, medicine can be used to numb the area.
During an examination, a doctor can also find out whether another condition may be causing the fissure. Having several fissures or having one or more in an area of the anus where fissures usually don’t occur can be a sign of a more serious problem, such as inflammatory bowel disease or a weakened immune system.
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What To Do If You Have A Fissure
First, a doctor will want to rule out other conditions with similar symptoms, as well as abscesses, infections, inflamed skin tags or hemorrhoids or other more serious concerns, Dr. Zutshi says.
Next, in conjunction with the lifestyle changes outlined above, treatment for a fissure usually starts conservatively with simple at-home fixes and conservative medical therapy.
At home: A sitz bath soaking in warm, but not hot, water several times a day works wonders for many patients. The pain many people feel before or right after a bowel movement comes from muscle spasms brought on by the anal fissure. Warm baths help those muscles relax, which in turn helps the fissure heal over time.
Medical management: Medical therapy targets the muscles, too. A doctor may offer a specific ointment that relaxes the anal muscles so the fissure can heal, minus the spasms. A numbing agent such as lidocaine is an option, too. However, it may add to the burning and irritation.
Surgical options: When conservative treatments dont work, there are two simple outpatient surgical options. One is a Botox injection into the anal muscles. This basically paralyzes the muscle to prevent spasms and allow the fissure to heal. The other option is sphincterotomy, a strategic cut to the muscle that also relieves spasms. Both come with a healing time of around two weeks.
Can Anal Fissures Be Prevented
For fissures in infants:
- Treat constipation, if that is found to be the cause.
For fissures in adults:
- Keep the anorectal area dry.
- Wipe the area with soft materials, a moistened cloth, or cotton pad. Avoid rough and scented toilet paper.
- Promptly treat all occurrences of constipation and diarrhea.
- Avoid irritating the rectum.
Last reviewed by a Cleveland Clinic medical professional on 02/22/2019.
References
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Avoid Constipation And Keep The Stools Soft
- Eat plenty of fibre which is found in fruit, vegetables, cereals, wholemeal bread, etc.
- Have lots to drink. Adults should aim to drink at least two litres of fluid per day. You will pass much of the fluid as urine. However, some is passed out in the gut and softens the stools. Most sorts of drink will do however, alcoholic drinks can lead to lack of fluid in the body and may not be so good.
- Fibre supplements and laxatives. If a high-fibre diet is not helping, you can take fibre supplements such as ispaghula, methylcellulose, bran or sterculia. Methylcellulose also helps to soften stools directly, which makes them easier to pass. You can buy these at pharmacies or obtain them on prescription. A laxative such as lactulose or a macrogol laxative may sometimes be suggested.
- Toileting. Don’t ignore the feeling of needing to pass stools. Some people suppress this feeling and put off going to the toilet until later. This may result in bigger and harder stools forming that are more difficult to pass later.
- Avoid painkillers that contain codeine, such as co-codamol, as they are a common cause of constipation. Paracetamol is preferable to ease the discomfort of a fissure.
See separate leaflets called Constipation in Adults, Constipation in Children and Fibre and Fibre Supplements for more details.
Surgical Treatment For Anal Fissures
If you have a chronic anal fissure, you may need to see a rectal surgeon. The first option may be to inject your anal sphincter with a medication called Botox to relax the muscle and prevent spasms. This treatment is 50 to 80 percent successful. If all else fails, a surgical procedure may be needed to cut the anal sphincter muscle, called a sphincterotomy. Although this procedure is rarely needed, it is successful over 90 percent of the time.
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Original Researchdoes The Duration Of Symptoms Of Anal Fissure Impact Its Response To Conservative Treatment A Prospective Cohort Study
60 patients with anal fissure were treated conservatively and were evaluated at 6 weeks.
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Mean pre-treatment VAS for acute fissure was significantly higher than chronic fissure.
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Post-treatment VAS for acute fissure was significantly lower at 6 weeks.
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Patients with acute fissure achieved significantly better healing than chronic fissure.
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Healing declined from 100% when symptoms were < one month to 33.3% when symptoms > 6 months.
Are Anal Fissures Dangerous
It cannot be said that anal fissures are dangerous in themselves, but they can be really annoying for the sufferer.
These types of injuries warn that your body is out of balance. You can pay attention to that warning and correct the habits that have generated that problem or just attend to the fissure as an isolated event that has nothing to do with your habits.
When you only see the fissure and you dont see your body as a whole, two things can happen:
- That the fissure heals with treatment, but later other disorders related to your imbalance appear, for example, you continue with constipation and after a few years diverticula appear in the colon.
- That the fissure does not heal and worsens, affecting the muscle layer and becoming chronic.
Of course, you should pay attention to whether an anal fissure becomes chronic, does not heal, bleeds frequently and, even worse, if it does not hurt, because it can also be a case of anal cancer . Although it is rare, it must be diagnosed early to make treatment easier and more effective. That is the only case in which a fissure can be dangerous .
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