Further evaluation may be required if there is concern that another medical condition may have contributed to the development of the fissure. If the diagnosis is unclear, a sigmoidoscopy or colonoscopy is usually recommended, especially if there has been rectal bleeding.
Colonoscopy will allow the operator to examine the anus and rectum in detail and seek out early cancers that can also present like fissures or bleed like hemorrhoids sometimes.
Anal Fissures and Colon Cancer
People with colon cancer may develop anal fissures, but anal fissures don't cause colon cancer or increase your risk of getting colon cancer. Even if your anal fissure heals completely, it can come back after you have a hard bowel movement. This doesn't mean you have colon cancer.
Doctors usually perform a procedure called lateral internal sphincterotomy (LIS), which involves cutting a small portion of the anal sphincter muscle to reduce spasm and pain, and promote healing. Studies have found that for chronic fissure, surgery is much more effective than any medical treatment.
Most people will fully heal within 2 to 4 weeks.
Living with anal fissures
Get the recommended amount of fiber in your diet. Avoid constipation or large or hard bowel movements. Drink enough water to stay well hydrated. Maintain a routine bowel habit.
It usually isn't a serious condition, and most people can treat it at home. However, recurring anal fissures or ones that don't readily heal can be cause for concern.
A fissure that fails to respond to conservative measures should be re-examined. Persistent hard or loose bowel movements, scarring, or spasm of the internal anal muscle all contribute to delayed healing.
Anal fissures usually heal within a few weeks without the need for treatment. But they can easily come back if they're caused by constipation that remains untreated. In some people, symptoms from anal fissures last 6 weeks or more (chronic anal fissures).
The spasms can cause pain and slow down the healing. Bowel movements can also keep the fissures from getting better. An anal fissure is considered acute if it recently happened or if you've had it less than 6 weeks. It's considered chronic if it's been more than 6 weeks or it comes back often.
At chronic stage, the only permanent treatment solution for fissure is undergoing surgery. Laser surgery for fissure is exactly what you need!
An acute fissure appears as a superficial laceration with well demarcated edges (like a paper cut). Chronic fissures are wider and deeper than acute fissures, and have raised edges that may be swollen. Sphincter muscle fibres may be visible at the base of a chronic fissure.
Fissures are usually caused by trauma to the inner lining of the anus from a bowel movement or other stretching of the anal canal. This can be due to a hard, dry bowel movement or loose, frequent bowel movements. Patients with a tight anal sphincter muscle are more likely to develop anal fissures.
Chronic anal fissures typically occur in the midline, with visible sphincter fibers at the fissure base, anal papillae, sentinel piles, and indurated margins. Anal fissures are a common cause of anal pain during and for one to two hours after defecation.
The pain and discomfort of an anal fissure usually gets worse when a person has a bowel movement. The pain tends to linger a long time afterward. There may be bleeding from the tear as well. Constipation may also occur as the condition gets worse.
“Anal fissure operation is a small procedure that can greatly improve your condition” emphasizes Dr. Amarchand.
Signs that a fissure has become chronic can include: Painful bowel movements without bleeding. Itching and irritation of the skin around the anus. A skin tag at the end of a fissure.
This medication is used to treat minor pain, itching, swelling, and discomfort caused by hemorrhoids and other problems of the anal area (such as anal fissures, itching).
Petroleum jelly, zinc oxide, 1% hydrocortisone cream, and products like Preparation H can help soothe the area. Instead of toilet paper, use alcohol-free baby wipes that are gentler on the area. Sitz baths can help heal fissures and make you feel better.
Yes, probably. You should expect some pain and discomfort in your bottom (anus) after anal fissure surgery. The pain is usually worst during the first seven days after the operation and should get much better after this first week.
Post-treatment VAS for acute fissure was significantly lower at 6 weeks. Patients with acute fissure achieved significantly better healing than chronic fissure. Healing declined from 100% when symptoms were < one month to 33.3% when symptoms >6 months.
On the face of it, it may seem like not much, however, if you have a hole in your gastrointestinal (GI) tract, you could develop an infection and that could lead to sepsis.
Once a fissure develops, these symptoms can occur after every bowel movement; the rectal pain can be severe and can last several minutes to hours. Bleeding is usually of a small volume, though it is often bright red. However, the bleeding may discolor the toilet bowl, giving it the appearance of heavy bleeding.