What is an Anal Fissure?

An anal fissure is a small tear in the inner lining of the anus, which typically causes severe pain and bleeding during defecation. This condition often occurs as a result of constipation, diarrhea, or excessive straining. Early diagnosis and treatment are crucial in preventing the progression of the disease.

What is an Anal Fissure?

An anal fissure is a tear in the delicate and moist inner lining of the anus. It generally occurs during the passage of hard or large stools. Acute anal fissures are superficial and may heal quickly, while chronic anal fissures are deeper and require treatment. This condition manifests with symptoms such as the sensation of glass cutting during defecation, pain, and sometimes bleeding.

In chronic anal fissures, prominent skin tags and hypertrophic papillomas may develop around the fissure, which can complicate the treatment process.

Which Age Groups are Affected by Anal Fissures?

Anal fissures can occur in any age group, but they are more common in two particular age groups:

• Infants and Young Children: Frequent defecation issues during the toilet training process can lead to anal fissures.
• Adults: Individuals aged 20-40, especially those suffering from constipation, pregnancy, or defecation difficulties, are more likely to experience anal fissures.

Which Diseases Can Be Confused with Anal Fissures?

Anal fissures can be confused with other diseases that have similar symptoms. These conditions include:

• Hemorrhoids (Piles): Bleeding and pain may lead to confusion with anal fissures.
• Anal Fistulas and Abscesses
• Crohn’s Disease and Ulcerative Colitis
• Rectal Polyps
• Anal Condyloma and Tuberculosis

A thorough examination by an experienced physician can easily differentiate these conditions from anal fissures.

Symptoms of Anal Fissures

A thorough examination by an experienced physician can easily differentiate these conditions The most common symptoms are as follows:

• A sensation of glass cutting during defecation
• Pain and swelling around the anus
• Bleeding or mild spotting
• Difficulty defecating and itching around the anus
• Prolonged pain and burning sensation

As these symptoms can be similar to other anal conditions, it is important to consult a healthcare professional for an accurate diagnosis.

Causes of Anal Fissures

The primary causes of anal fissures include:

• Constipation: Hard stools can cause tears in the sensitive tissue of the anus.
• Diarrhea: Frequent defecation can cause irritation in the anal area.
• Childbirth: Pressure during vaginal delivery can lead to anal fissures.
• Trauma: Medical procedures such as colonoscopy or enemas can cause injury to the area.
• Poor Diet: A diet lacking in fiber leads to hard stools.
• Other Factors: Inflammatory conditions such as Crohn’s disease, ulcerative colitis, and tuberculosis.

How is an Anal Fissure Diagnosed?

The diagnosis is typically made through a physical examination by an experienced surgeon. During the examination, the following are observed:

• Location and Depth of the Fissure: It is most commonly found in the posterior midline.
• Skin Tag: Chronic fissures may result in the formation of prominent skin tags.

In some cases, a more detailed examination under anesthesia may be required for a definitive diagnosis. Since fissures can be confused with conditions like Crohn’s disease or anal cancer, it is essential for the doctor to conduct a thorough evaluation.

Diet for Patients with Anal Fissures

To prevent constipation, a fiber-rich diet is recommended. Suggested foods include:

• Whole-grain breads and bulgur
• Fresh fruits and vegetables
• Legumes and fatty seeds
• Consuming 2-2.5 liters of water daily

Spicy foods and alcoholic beverages should be avoided, as they can exacerbate irritation in the affected area.

Which Sports Should Be Avoided During the Treatment of Anal Fissures?

During the treatment of anal fissures, activities that strain the area should be avoided. Sports to avoid include:

• Cycling and horseback riding
• Pilates and weightlifting
• Intense cardio exercises

Beneficial activities include swimming in warm water and spa treatments.

Botox Treatment for Anal Fissures

Botox injections are becoming increasingly popular for the treatment of anal fissures. The advantages of Botox include:

• No need for general anesthesia.
• Patients can return to their daily activities immediately after the procedure.
• Minimal side effects and a high success rate.

Botox injections are an effective option, especially for patients who wish to avoid surgery.

Which Surgical Method Should Be Preferred for Anal Fissure Surgery?

The most commonly preferred method for treating chronic anal fissures is lateral internal sphincterotomy. The characteristics of this surgical procedure include:

• High success rate (94-100%)
• Low risk of complications
• Outpatient procedure option

Alternatively, flap surgery or advancing flap techniques may be used. However, these methods require a longer recovery time compared to sphincterotomy.

Can Anal Fissures Become Cancerous?

Anal fissures do not turn into cancer. However, anal cancers can present with similar symptoms to those of anal fissures, so it is crucial to consult a doctor for a definitive diagnosis.

Anal fissures can be managed with the right treatment and lifestyle changes. If you notice symptoms like pain or bleeding in the anal area, it is important to seek early diagnosis and treatment from a healthcare professional.