An anal fissure is a small tear in the thin, moist tissue (mucosa) that lines the anus.
Anal fissures can occur at any age, but are more common in infants and middle-aged adults.
CAUSES
1. Chronic constipation.
2. Prolonged diarrhoea.
3. Overly tight or spastic anal muscles.
4. Scarring in the anorectal area.
5. An underlying medical problem, such as crohn’s disease ,ulcerative colitis ,Anal Cancer,Leukemia; infectious diseases (such as tuberculosis); and sexually transmitted diseases (such as syphilis, gonorrhea, Chlamydia , chancroid, HIV).
6. Anal sex, anal stretching due to childbirth.
7. Insertion of foreign objects into the anus.
SYMPTOMS
1. Pain in anus during and after passage of stool.
2. Bright red blood on the stool or toilet paper after a bowel movement. 3. A small lump or skin tag on the skin near the anal fissure.
DIAGNOSIS
Based on
1. Case history
2. Rectal examination
3. Proctoscopy
4. Sigmoidoscopy
1. Nitric acid- Splinter like pain in anus . Hard stool with bright red bleeding.
2. Ratanhia- Pain as if anus is full of broken glasses.Burning pains long after passage of stool.
3. Paeonia-Painful and itching fissures oozing offensive moisture. 4. Sulphur- Great heat and burning in anus with fissures. 5. Aesculus- Anus raw and sore as if full of small sticks.
GENERAL MANAGEMENT
1. High Fibre diet- salad and fruits (Cucumber, tomatoes, apple,pear,guava ).
2. Adequate hydration.
3. Soaking in a warm bath (also called a sitz bath), 10 to 20 minutes several times a day, to help relax the anal muscles.
4. Optimal physical activity.
5. Avoid Caffeine, spicy food.
