The most common reason for these fissures is constipation or diarrhea. However, these fissures can become chronic if untreated and damage the anal sphincter muscle tissues. In this case, it is important to relax your anal sphincter and maintain regular bowel movements. In this article, we will explain what anal fissures are, the causes, how they are treated, and some diet tips for managing them. Read on. Anal fissures cause great discomfort and are often accompanied by pain and bleeding while passing stools. The ring of muscle at the end of your anus, also called the anal sphincter, may experience spasms due to such fissures. The common causes of anal fissures are discussed below.
What Causes An Anal Fissure?
Anal fissures may be caused by:
Passing hard or large stools during a bowel movement Constipation that causes one to strain during a bowel movement Anal intercourse Childbirth Chronic cases of diarrhea
The less common causes of anal fissures include:
Inflammatory bowel diseases like Crohn’s disease Anal cancer Syphilis HIV Tuberculosis
Some factors may put an individual at a higher risk of developing anal fissures.
Risk Factors
The risk factors for anal fissures are:
Childbirth – Anal fissures are quite common in women after giving birth. Constipation Age – While anal fissures may occur at any age, they are more common in middle-aged adults and infants.
Individuals affected by anal fissures tend to exhibit the following signs and symptoms.
Signs And Symptoms Of Anal Fissures
The signs and symptoms associated with anal fissures are:
Pain during bowel movements, which may vary in severity Pain that lasts up to several hours after passing stool Blood spots in the stool (or toilet paper) after a bowel movement A noticeable crack in the skin around the anus Presence of a small skin tag on the skin near the anal fissure
If you experience any of these symptoms, it is best to get yourself diagnosed to rule out other possibilities.
How Are Anal Fissures Diagnosed?
To diagnose anal fissures, your doctor may ask about your medical history. This may be followed by a physical examination that includes a gentle examination of the anal region. The fissure or tear is usually visible and can be easily diagnosed with a physical examination. If an underlying condition is suspected, your doctor may suggest other diagnostic tests like anoscopy, flexible sigmoidoscopy, or colonoscopy. An acute fissure looks like a fresh paper cut, whereas a chronic anal fissure is a deeper tear that may be accompanied by internal/external fleshy growths. Anal fissures are considered to be chronic if they last for more than eight weeks. Once diagnosed, you can discuss the available treatment options with your doctor.
Over-The-Counter Treatment For Anal Fissures
An anal fissure can ease within a few weeks if you make a few changes that will help in keeping your stool soft. Over-the-counter (OTC) treatments are also available for treating the symptoms of anal fissures. They include:
Topical application of nitroglycerine (Rectiv) externally to enhance blood flow to the fissure and promote healing. Topical use of anesthetic creams like lidocaine hydrochloride (Xylocaine). Botox (Botulinum toxin type A) injection to relax spasms by paralyzing the anal sphincter muscle. Blood pressure medications like oral diltiazem (Cardizem) or nifedipine (Procardia) to relax the anal sphincter.
Those with a chronic anal fissure that does not respond to OTC treatments may require surgery. A procedure called lateral internal sphincterotomy (LIS), which involves making a small incision to remove a portion of the anal sphincter muscle, is one of the most commonly used surgeries for chronic fissures. While surgery is the best option to treat chronic fissures, acute fissures can be easily managed and treated with the help of some natural remedies.
Home Remedies For Managing Anal Fissures
1. Coconut Oil
The emollient properties of coconut oil can help in keeping the affected area lubricated (1). This makes the passing of stool easier and also promotes the healing of the fissure. 1-2 teaspoons of virgin coconut oil You may do this 1-2 times daily.
2. Olive Oil, Honey, And Beeswax
A mixture of olive oil, honey, and beeswax was observed to help manage the symptoms of itchiness and pain associated with anal fissures (2).
1 teaspoon of honey 1 teaspoon of olive oil 1 teaspoon of beeswax
You may do this 1-2 times daily.
3. Aloe Vera
The soothing and wound-healing properties of aloe vera can help in alleviating pain and bleeding associated with anal fissures. It can also speed up the healing of the fissure (3). 1 teaspoon of aloe vera gel You may do this 2-3 times daily.
4. Warm Sitz Bath
A warm sitz bath can help in alleviating inflammation and the burning sensation that often accompany an anal fissure (4). Warm water (as required) You can do this 1-2 times daily.
5. Flaxseed
Flaxseed can treat the symptoms of constipation (5). This makes it a great option to ease bowel movements and the symptoms of anal fissures. ½ – 1 tablespoon of powdered flaxseed You may do this once daily. Along with these remedies, following a proper diet also helps treat anal fissures and prevents their recurrence.
What Should You Eat To Prevent Anal Fissures?
A fiber-rich and laxative diet can help ease acute anal fissures that are caused by constipation. Raw fruits, vegetables, and whole-grain bread are associated with a decreased risk of anal fissures. Consuming white bread, bacon, sausages, and sauces thickened with roux is associated with an increased risk of anal fissures (6). High-fiber fruits like pear, grape, plum, and apple with the peel on can also be used to manage the symptoms of constipation due to their high-fiber content (7). What happens if a fissure goes untreated? If left untreated, an anal fissure may lead to infection and pus formation in it. Is Vaseline good for fissures? You may apply Vaseline to soothe the area. However, consult a doctor to get a prescription for a medicated ointment specifically formulated for fissures. Which is more painful: piles or fissures? Though both are painful, piles are only noticeably painful in the initial stage. Anal fissures are painful right from the beginning and as long as they last. Does itching mean the fissure is healing? Itching does not necessarily mean the fissure is healing because you may experience itching even if it is not in the healing stage. Can I use hemorrhoid cream for fissures? Yes, you can use hemorrhoid cream for fissures. However, it is best to consult a doctor before you start using it. Does Preparation H work on fissures? Yes, Preparation H may help heal the wound and soothe the skin. Can wiping cause fissures? Yes, excessive wiping can result in fissures. It can tear the lining of the lower rectum and cause fissures.
