Anal fissures are small tears in the skin in the anus area and are very uncomfortable. It is usually characterized by pain and bleeding during defecation. This condition can be both acute and chronic and can cause long-term discomfort if left untreated.

What is Anal Fissure?

Anal fissures are cracks in the sensitive skin covering the outside of the anus. It is often caused by hard or large stools. However, in some cases, another underlying disease can trigger this condition.

Symptoms of Anal Fissure

• Severe Pain: It is felt especially during and after defecation.
• Bleeding Bright red blood in the stool.
• Itching and Irritation: Itching and discomfort around the anus.
• Visible Tear A visible tear around the anus.

Causes of Anal Fissure

• Constipation Hard stools can strain the anal area and cause a fissure.
• Diarrhea Continuous defecation can cause irritation in the anal area.
• Trauma Childbirth or a direct blow to the anus area can trigger fissure formation.
• Bowel Diseases: Inflammatory bowel diseases such as Crohn’s disease.
• Contraction: Excessive contraction of the anal sphincter muscle can reduce blood circulation in the area, making healing difficult.

Types of Anal Fissure

1. Acute Fissure: It is short-term and usually lasts less than 6 weeks. It responds quickly to treatment.
2. Chronic Fissure: These are long-standing fissures and usually require surgical intervention.

Diagnosis of Anal Fissure

The diagnosis is usually made by a doctor’s examination. The doctor evaluates the fissure by listening to the patient’s medical history and performing a physical examination. If necessary, additional tests may be performed to rule out another underlying disease.

Anal Fissure Treatment Options

1. Lifestyle Changes:
   • Fiber: Include more fruits, vegetables and whole grains in your diet.
   • Drink plenty of water: Helps soften the stool.
   • Hot Sitting Baths: Provides relaxation by relaxing the muscles around the anus.
2. Medical Treatment:
   • Topical Creams: Creams containing nitrates or calcium channel blockers relax the sphincter muscle.
   • Painkillers Used to relieve temporary pain.
   • Laxatives: May be recommended to prevent constipation.
3. Botulinum Toxin (Botox):
   • It helps to temporarily relax the sphincter muscle and accelerates healing.
4. Surgical Treatment:
   • Lateral Internal Sphincterotomy: It is an effective method used in chronic fissures. The sphincter muscle is slightly cut and the pressure is reduced.

Anal Fissure Prevention Methods

• Adopt a diet high in fiber to prevent constipation.
• Drink plenty of water to keep the stool soft.
• Organize your toilet habits; avoid sitting for long periods of time.
• Stimulate bowel movements by exercising regularly.

Anal Fissure and Complications

Left untreated, anal fissures can lead to serious complications:

• Chronicization: Acute fissures have an increased risk of becoming chronic.
• Anal Fistula A fissure can lead to an infection around the anus.
• Decreased Quality of Life: Persistent pain and discomfort can affect the patient’s daily activities.

Anal fissure can be controlled with early diagnosis and treatment. While medical treatment is usually sufficient in acute cases, surgical intervention may be required in chronic cases. If you have complaints, you can determine the most appropriate treatment method by consulting a health specialist.