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ANAL FISSURE

It is a tear in the skin lining the anus. It usually occurs in posterior part of anus.

Symptoms

  • Pain: severe in acute and mild in chronic type
  • Constipation
  • Bleeding: bright red blood on stool or toilet paper
  • A lump of skin around anus

Causes

  • Passing of hard stool and straining as in constipation
  • Chronic diarrhea
  • Childbirth
  • Crohn's  disease

Diagnosis

  • Per rectal exam and proctoscopy can't be done in acute cases due to pain.

Preventions

 It can be prevented by taking measures to prevent constipation.  High-fiber foods, adequate fluids and regular exercise to avoid strain during bowel movements.

Complications

  • Delayed healing
  • Recurrence
  • Anal fistula, abscess

Treatment

Anal fissures often heal within a few weeks if you take steps to keep your stool soft.

  • Stool softeners: lactulose
  • Sitz bath: Sit in warm water bath where small quantity of paotassium permanganate or table salt is added.
  • Nitroglycerine cream
  • Surgery: for chronic and nonresponsive cases whereby anus is dilated