Anal Fissure Complications

Anal fissures are a split or tear in the membrane lining of the anus, also called the anal mucosa. Anal fissures are not hemorrhoids; though do have some of the same symptoms. An anal fissure may tear into the internal anus sphincter which causes spasms of the sphincter and delays the healing process.

Causes

• The causes of an anal fissure are constipation, passing a large, dry stool, diarrhea, anus injury, or cancer. Anal fissures may present themselves during pregnancy and after childbirth, as constipation is common. Diarrhea causes inflammation of the anus, making it vulnerable to a fissure.

Symptoms

• Anal fissures are painful while passing a bowel movement, causing blood to appear on the external portion of the feces. Blood may also be present on toilet paper or seen in the toilet following a bowel movement. The anus and rectum will be painful until the fissure heals.

Complications

• While rare, complications are possible with an anal fissure. A chronic anal fissure is a tear that will not heal, causing a build up of scar tissue at the fissure location. Anal fistulas are tunnels that develop and join the anal wall to other parts of the bowel. Anal stenosis is when the anal cavity is abnormally narrowed from anal spasms of the sphincter or scar tissue contractions. Complications of anal fissures require a surgical procedure which cuts a portion of the anus sphincter to reduce spasms. In some cases, the fissure may be removed. Surgery is generally done as outpatient and rarely causes a loss of bowel control.

Treatment

• Most fissures will heal properly; however care must be taken to aid in the healing process. During healing, action must be taken to avoid constipation. Eat a diet high in fiber and bulk to keep bowel movement regular. Laxatives can be taken if constipation is present. Drink plenty of water, normally eight 8-oz. glasses daily. Cleanse the anal area gently with mild soap on a regular basis. A Sitz bath will relieve pain in the anal region and consists of a warm bath with or without a medication added. Applying a topical cream will numb the pain and reduce inflammation.

Prevention

• The easiest way to prevent anal fissures is by preventing constipation. Eat a healthy diet that is high in fiber and water. If constipation is common, include a daily fiber supplement in the diet. Do not strain during bowel movements as this puts unnecessary pressure on the anus and sphincter. Gently wash the rectum and anus after bowel movements to keep it clean and moist. A person with a previous anal fissure is more likely to get one in the future.