Piles, Fissure, Fistula

 

Introduction

Anal fissures are tears in the skin and muscle tissue of the anus. They can be caused by trauma to the area, such as from straining, or by a medical condition like Crohn’s disease or hemorrhoids. Anal fissures may also appear as a result of passing hard bowel movements. Fissures can cause pain and bleeding, but they usually pass without treatment within a couple weeks. However, if you have chronic anal fissures (those that recur after healing), they may require more aggressive treatment to rule out other conditions and prevent further complications.

What are anal fissures?

Anal fissures are small tears or cracks in the lining of the anus. They can be caused by constipation, diarrhea, or anal intercourse. When you have an anal fissure it can cause pain and bleeding when you have a bowel movement. You may notice blood on your toilet paper after going to the bathroom as well as some itching around your anus (the area between your butt cheeks).

Anal fissures usually heal within 6-8 weeks without treatment but if they don't go away after six weeks then see a doctor because something else might be wrong with your body besides just an anal fissure such as hemorrhoids (swollen veins around your anus that look like small grape clusters).

Symptoms of anal fissures:

The symptoms of anal fissures may include:

• Painful bowel movements. You'll feel pain, burning and stinging during a bowel movement. It's not uncommon for a person to experience the pain even before he or she passes stool. The pain can last several minutes after the bowel movement is finished as well.
• Blood on the toilet paper or in the stool, especially following a bowel movement. This is one of the most common signs that you have an anal fissure and not hemorrhoids (piles). Usually, piles are soft and bleed only when they're pressed against hard surfaces like toilet seats or flooring when you walk around barefoot. But with an anal fissure, there'll be bleeding even if you don't apply any pressure on your anus while sitting on a chair or lying down in bed — this happens because blood flows out of small tears in your anus walls due to severe stretching caused by passing stool through very narrow passages leading from rectum to anus exit point called sphincter muscles which normally keeps food inside your body until it has been digested fully

Causes of fissure:

Fissure can be caused by the passage of hard stools, constipation and excessive straining during bowel movements. It may also be a result of poor diet that lacks fiber or vitamins. A fissure is often accompanied by bleeding or bright red blood in the stool which is usually painful.

Diagnosis of anal fissures:

• Examination of the anus
• Examination of the rectum
• Examination of the lower gastrointestinal tract
• Examination of the blood
• Examination of the stool
• Examination of the patient (physical examination)

Treatment of anal fissures:

Treatment of anal fissures:

Laser treatment - the use of an excimer laser or carbon dioxide (CO2) laser on the internal sphincter muscle to cause scarring, which strengthens it and reduces spasms.

Sclerotherapy - injecting chemicals (usually sodium tetradecyl sulfate) into the internal sphincter muscle to scar and strengthen it.

Surgery - removing a small part of the rectum (anoscopy). Surgery is used only if other treatments have failed, because there may be no further problems for several years after surgery.

A surgical treatment is needed to treat the chronic and recurrent cases of anal fissures.

If you've been experiencing chronic or recurrent anal fissures, surgery is the best treatment option. Surgery is not always necessary and it's not always successful. It should be considered only after all other treatments have been exhausted and when the symptoms are severe enough that quality of life is significantly compromised. A surgical treatment for anal fissures can include:

• Hemorrhoidectomy: During this procedure, a surgeon will make an incision in your anus and remove any internal or external hemorrhoids that have developed because of chronic stretching due to constipation or straining during bowel movements.
• Sclerotherapy: This procedure involves injecting a chemical solution such as polyvinyl alcohol into the affected area to shrink the tissue around it so that it heals properly without further tearing or bleeding.

Conclusion

The treatment of anal fissure should be based on a careful evaluation of the patient’s symptoms, past medical history and clinical findings. Treatment options include rest from aggravating activities such as constipation, soaps in the bath or excessive wiping during bowel movements. You can also use over-the-counter medication for pain relief (e.g., ibuprofen).