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Anal fissure

What is an anal fissure?

A chronically inflamed tear of the anal skin and mucosa inflamed forming a constantly newly ruptured not healing narrow ulcer. These tears are noticed especially at the back (coccyx ward) of the anus. In consequence, the result is a high pressure of the sphincter which sits under the mucous membrane. The reason that the wound does not heal is due to poor blood circulation, which in turn is based on an elevated resting pressure on the sphincter. A skin fold is often formed outwardly of the fissure.
Fissures can also be caused by manipulations or infections Here the right treatment must be found. Therefore, it is advisable not to conceal such things.

Mainly sharp, burning pain during stool is complaint. Occasionally, the pain is felt very strongly, even without a bowel movement and leads to very painful anal cramps. The cramps prevent the fissure to heal further.  During bowel movements the ulcer can be ruptured and bleeding may be caused. Sometimes an itching may occur.

It is recommended to start a conservative treatment with a drug to lower the pressure on the sphincter. In an anal dilatation the ulcer will be stretched.  This refreshes the tissue and it should built new clean scar tissue in the non-healing crack. In addition, local anesthetic ointments are applied and it is taken care of too soft stools.
Alternatively, there is the possibility of a complete removal of the fissure. In this surgical procedure the fewest recurrences and the lowest risk of incontinence is to be expected. The operation can be done outpatient using local anesthesia or in a short stay in hospital.

After surgery, you will usually be released from hospital after the first bowel movement. The anal hygiene should not be performed by wiping, but by clean rinsing of the anus. The stool should be formed soft, not too hard or too thin to avoid pain and a new disease cycle.