![]() Stool softeners and increasing water intake may be necessary to promote soft bowel movements and aid in the healing process. The most common treatment for an acute anal fissure consists of making the stool more formed and bulky with a diet high in fiber and utilization of over-the-counter fiber supplementation (totaling 25-35 grams of fiber/day). The majority of anal fissures do not require surgery. Chronic fissures may be more difficult to treat, and may also have an external lump associated with the tear, called a sentinel pile or skin tag, as well as extra tissue just inside the anal canal (hypertrophied papilla). Anal fissures may be acute (recent onset) or chronic (present for a long period of time). ![]() Other, less common, causes include inflammatory conditions and certain anal infections or tumors. Treatments are aimed at interrupting this cycle by relaxing the anal sphincter muscle to promote healing of the fissure. The next bowel movement results in more pain, anal spasm, decreased blood flow to the area, and the cycle continues. ![]() Following a bowel movement, severe anal pain can produce spasm of the anal sphincter muscle, resulting in a decrease in blood flow to the site of the injury, thus impairing healing of the wound. A hard, dry bowel movement is typically responsible, but loose stools and diarrhea can also be the cause. Patients with tight anal sphincter muscles (i.e., increased muscle tone) are more prone to developing anal fissures. What causes an anal fissure?įissures are usually caused by trauma to the inner lining of the anus. Many patients are fearful of having a bowel movement and may try to avoid defecation secondary to the pain. Between bowel movements, patients with anal fissures are often relatively symptom-free. Patients may also notice bright red blood from the anus that can be seen on the toilet paper or on the stool. The typical symptoms of an anal fissure include severe pain during, and especially after, a bowel movement, lasting from several minutes to a few hours. What are the symptoms of an anal fissure? Fissures are quite common in the general population, but are often confused with other causes of pain and bleeding, such as hemorrhoids. Fissures typically cause severe pain and bleeding with bowel movements. An anal fissure (fissure-in-ano) is a small, oval shaped tear in skin that lines the opening of the anus.
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