> Anal Fissures
Anal fissures are abnormal cracks or tears in the anus skin that often
extends internally from the anal opening into the anal cavity, under
the trunk (between the legs) and towards the genetalia. A study of
the human anatomy reveals that this part of the anal wall is relatively.
Anal fissures or tears usually result in rectal bleeding and pain,
particularly after defecation.
Since most anal fissures are the result of stretching of the anal
mucosa beyond its limit, they will sometimes heal on their own when
the stretching is minimized. However this may not always be the
case; spasms of the internal sphincter muscle may cause chronic
tearing or fissures. Spasms can not only tear the walls and mucosa,
but actually prevent blood from reaching the area and therefore
inhibits the mucosa from its ability to heal itself. The resulting
ulcer must be addressed by a physician or surgeon for it to heal
Anal fissures are common in women after childbirth. Further, they
may also be caused by anal intercourse and difficult bowel movement
due to constipation. Children who suffer from constipation are also
at risk of anal fissures. Congenital anal fissure, although fairly
uncommon, can be found among newborns as well, usually due to an
anomaly or illness while in the womb that causes fistulas or other
It is important to note that other inflammatory diseases such as
IBD may cause anal fissures as well. If anal fissures persist, it
is recommended you see a physician for a proper diagnosis.
Anal fissures have well defined symptoms. For example, bright red
bleeding after defecation is an indicator that you may have an anal
fissure. Pain is usually associated with any activity that puts
any stress or pressure on or around the anus. In most cases, the
pain will be noticeable enough that one will be able to ascertain
the cause (for example, bleeding and pain immediately following
constipation or child birth). More than 90% of anal fissures will
heal on their own, however some may persist.
In some cases, anal fissures are accompanied by irritation or itchiness
around the anal cavity. Because of this symptom, many people misdiagnose
an anal fissure with a more common affliction, hemorrhoids. Although
hemorrhoids and anal fissures are completely different, their symptoms
are so similar that this confusion is to be expected. A couple ways
of determining whether you have a hemorrhoid or an anal fissure
are as follows: hemorrhoids can be external or internal –
if you have a bump or lesion just outside the anus which is bleeding
and causing pain, you probably have a hemorrhoid. Hemorrhoids also
tend to be painful throughout the day where anal fissure pain usually
decreases until stress if put on the anal cavity (a bowel movement
for example). If you are unsure whether you have an internal hemorrhoid
or anal fissure, it is best to see a physician for a proper diagnosis.
How to Prevent Anal Fissures
To help prevent the onset of an anal fissure, it is important to
respond to your body in sickness (such as constipation and diarrhea).
Here are a few examples:
• Take care of constipation. Always ingest fiber-rich food
in your daily diet, and also include fruits such as banana which
have laxative properties;
• Treat diarrhea as quickly as possible;
• If you have frequent constipation, lubricate the anal wall
daily with a water based lubricant;;
• Use a dampened wipe instead of abrasive toilet paper;
• Although anal sex is an uncommon cause of anal fissures,
it is important to refrain from this activity if you have had anal
Anal Fissure Treatment
As far as the treatment of anal fissure is concerned, there are
several theories, some of which contradict each other. While one
group of experts are of the opinion that anal fissures should be
rectified by surgery, another strongly opposes it by quoting examples
where surgery has resulted in several after effects that include
fecal incontinence where the patient involuntarily passes stool.
To counteract the issue, Italian researchers in 1998 initiated injecting
botulinum toxin into the anal sphincter with the idea that it will
promote healing by way of relieving spasms through relaxation of
the muscle. This of course only addresses fissures caused by muscle
From a surgical standpoint, sphincterotomy is often recommended
for anal fissure treatment where conservative measures do not yield
satisfactory result. The invasive procedure includes excising a
part of the sphincter that has lost its elasticity and repairing
the rest of it for proper functioning. “Tailored lateral sphincterotomy”
selects the height of the sphincter to be divided with the aim of
preserving more of the sphincter in the patient.
As with most inflammations and ailments, doctors tend to prescribe
corticosteroids, or steroidal creams, to reduce inflammation and
induce healing. There are many such creams available over the counter
and through prescription. The problem with steroidal drugs is that
we are seeing more and more people who are allergic to steroids
and the list of side effects for steroidal prescriptions are getting
longer each day (including the onset of brittle bones or osteoporosis).
As with most ailments, natural therapy is becoming more and more
popular. This is because natural remedies are almost always safe,
can have ‘side-benefits’ instead of ‘side-effects’
have high success rates (this is naturally contested by pharmaceutical
companies!) and is relatively cheaper than prescription or surgery
routes. Examples of natural remedies include witch hazel, chamomile,
aloe vera, tea tree and other herbs with high vitamin E content.
With natural healing becoming more popular, there is no need to
become an expert – natural remedies for almost all ailments
are now available on the internet or in health stores. In most cases
natural remedies will remove the need for surgery or prescription
It is important to be in tune with your body and to investigate
any abnormalities. Diagnosing your own ailments correctly is not
only important for the sake of your well being, but also helps you
listen to your body and understand when it fighting other ailments.
However, it can never be stressed enough that a second opinion,
especially from your physician, is always recommended. Your doctor
can tell you what your particular ailment is, and suggest treatment.
If you are not satisfied with a prescription and want to explore
natural methods, speak to your doctor about this. At least you will
have a proper diagnosis of the problem on which to work from.
Mayo Foundation for Medical Education and Research:
US National Institue of Health: