Anal Fissure
Anal fissure – also called an anorectal fissure, is a linear split or tear in the lining of the lower anal canal. Most anal fissures happen when a large, hard stool overstretches the anal opening and tears the delicate anoderm. Less often, anal fissures develop because of prolonged diarrhoea, inflammatory bowel disease or sexually transmitted diseases involving the anorectal area. Short term anal fissures are usually superficial and shallow, but chronic long term anal fissures may extend deeper through the anoderm to expose the surface of underlying muscle.
ANAL FISSURE CAUSES
Anal fissures are usually caused by trauma that stretches the anal canal, such as after passage of large or hard bowel movement or explosive diarrhoea.
Less commonly, fissures are caused by foreign body insertion or anal intercourse. Anal fissures can also occur in patients who have other medical conditions such as Crohn’s disease (an inflammatory disease of the intestines). As a result, part of the evaluation may include testing for these conditions.
Symptoms of Anal Fissure
ØRectal pain, usually described as burning, cutting, or tearing
ØPain with bowel movements; spasm of the anus is very suspicious for an anal fissure.
ØBloody stools-Typically, bright-red blood appears on the surface of stools. Blood usually is not mixed into stool. Occasionally, blood is found on toilet paper after wiping. Some Patient may report no bleeding.
ØMucous discharge-a pus like discharge
ØAnal Pruritus – itching in anus
ØA patient with an anal fistula may complain of recurrent malodorous perianal drainage, pruritus, recurrent abscesses, fever, or perianal pain due to an occluded tract.
ØPain occasionally resolves spontaneously with reopening of a tract or formation of a new outflow tract.
ØPain occurs with sitting, moving, defecating, and even coughing.
ØPain usually is throbbing in quality and is constant throughout the day.
