Anal fissure definition and facts
- Anal fissures are cracks or tears in the anus and anal canal. They may be acute
or chronic.
- Anal fissures are caused primarily by trauma, but several non-traumatic diseases
are associated with anal fissures and should be suspected if fissures occur in unusual
locations.
- The primary symptom of anal fissures is pain during and following bowel movements.
Other symptoms that may occur are:
- bleeding,
- itching, and a
- malodorous discharge.
- Anal fissures are diagnosed and evaluated by visual inspection of the anus and anal
canal.
- Anal fissures are initially treated conservatively with home remedies and OTC products
by:
- adding bulk to the stool,
- softening the stool,
- consuming a high fiber diet,
- utilizing sitz baths.
- Prescription drugs used to treat anal fissures that fail to heal with less conservative
treatment include:
- ointments containing anesthetics,
- steroids,
- nitroglycerin, and
- calcium channel blocking drugs (CCBs).
What are anal fissures?
An anal fissure is a cut or tear occurring in the anus (the opening through which
stool passes out of the body) that extends upwards into the anal canal. Fissures
are a common condition of the anus and anal canal and are responsible for 6% to
15% of the visits to a colon and rectal (colorectal) surgeon. They affect men and
women equally and both the young and the old. Fissures usually cause pain during
bowel movements that often is severe. Anal fissure is the most common cause of rectal
bleeding in infancy.
Anal fissures occur in the specialized tissue that lines the anus and anal canal,
called anoderm. At a line just inside the anus (referred to as the anal verge or
intersphincteric groove) the skin (dermis) of the inner buttocks changes to anoderm.
Unlike skin, anoderm has no hairs, sweat glands, or sebaceous (oil) glands and contains
a larger number of sensory nerves that sense light touch and pain. (The abundance
of nerves explains why anal fissures are so painful.) The hairless, gland-less,
extremely sensitive anoderm continues for the entire length of the anal canal until
it meets the demarcating line for the rectum, called the dentate line. (The rectum
is the distal 15 cm of the colon that lies just above the anal canal and just below
the sigmoid colon.)