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Anal fissure is the second most common disease of the end digestive tract (after hemorrhoids). Currently, anal fissure is the most common cause of rectal bleeding and one of the most common causes of anal pain. What are the causes and symptoms of an anal fissure? What is the treatment?

Anal fissureis a long, narrow and shallow rupture of the mucosa of the final section of the anal canal (the so-called anoderm), which occurs when the anal mucosa exceeds the stretching capacity.

Fresh cracks that form suddenly are calledsharp anal fissure . If it is not treated, or the disease recurs frequently, it may developchronic anal fissure . Then the skin fold thickens (so-called sentinel lump) and perianal warts (so-called sentinel warts) appear.

The disease is usually diagnosed in people between the ages of 20 and 40.

Anal fissure - causes and risk factors

  • prolonged constipation;
  • difficult bowel movements due to too hard, compacted stool;
  • persistent diarrhea;
  • infection of the anal glands;
  • frequent anal sex;
  • large number of deliveries;
  • prolonged delivery, high birth weight of the child, childbirth with the use of auxiliary devices (this may result in ischemia of the tissues in this area);
  • diseases such as chronic ulcerative colitis, Crohn's disease;

Anal fissure - symptoms

  • pain in the anal area, most often pain occurs during bowel movements and lasts half an hour after it. It is described as strong, sharp, burning or stinging;
  • rectal bleeding - usually during bowel movements, usually small, but sometimes very heavy, with fresh blood. Then the traces of blood are on the stool, toilet paper, underwear;
  • strong pressure on the stool;
  • anal itching;
  • anal burning;
Important

Anal fissure - when to see a doctor immediately?

Rectal bleeding requires immediate consultation. It can be evidence not only of an anal fissure, but also of othersserious diseases, e.g. anal cancer.

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Anal fissure - diagnosis

In order to diagnose an anal fissure, it is best to go to a proctologist (a doctor dealing with diseases of the large intestine and rectum). The doctor examines the anus first - in some cases the fissure may be visible after opening the buttocks (usually it is located at the back of the anus, less often - e.g. in pregnant women and after childbirth - at the anterior wall of the anus).

Also performsper rectum . In the case of an acute anal fissure, the patient feels shooting pain, and in the case of chronic fissure, the sentinel lump and warts are additionally visible.

Then the diagnosis should be extended to endoscopic examinations, e.g. rectoscopy or sigmoidoscopy. In the course of diagnostics, other diseases that are manifested by pain or bleeding from the anus, including cancerous ones, should be excluded.

Anal fissure - treatment

The therapy consists of:

  • high-residual diet - it should be introduced permanently, because returning to the old eating habits in a short time leads to the relapse of the disease;
  • drugs that soften and relax the stool;
  • anti-inflammatory drugs;
  • agents reducing the tone of the sphincters (e.g. local botox injections, the use of nitric oxide ointment, nitroglycerin ointment);
  • sit-ups in warm water;

When treatment is unsuccessful (this is very rare), surgery may be necessary to perform partial lateral incision of the internal sphincter with or without a slit resection or, less commonly, local resection of the slit.

The main complications of surgical treatment are most often temporary fecal incontinence, and above all gas incontinence.

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Category:

Gastrology