Anal Fissures

These are tears that occur in the lining of the anus, most commonly as a result of constipation and the passage of very hard stools. Other causes include diarrhea and inflammation of the anal tissue. What symptoms might I notice?

Anal fissures can cause significant pain during and after bowel movements. Bright red blood with wiping is common. How are anal fissures treated?

Treatment involves treating the underlying cause, taking stool softeners when appropriate, soaking in warm Sitz baths 3-4 times daily, increasing dietary fiber, and using creams to alleviate discomfort.

Medications such as externally applied nitroglycerin are sometimes used to increase blood flow to the fissure to promote healing and to help relax the anal sphincter. The anal sphincter is the muscle that controls the release of stool from your body. When this muscle contracts too much, stool can be hard to pass. On the other hand, when it contracts too little incontinence can result.

Nitroglycerin is generally considered the medical treatment of choice when other conservative measures fail. It is very important if prescribed NOT to touch the cream with your bare hands. Instead, use a q-tip. Touching the nitroglycerine can result in a significant drop in your blood pressure and subsequent fainting.

Surgery may be required to fix the fissure if all else fails. How can I avoid anal fissures?

Avoid constipation. Increase the fiber in your diet to help bulk your stools and make them easier to pass. Drink plenty of fluids. Avoid inserting anything into your anus.

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