Anal fissures usually heal within a few weeks but those that have not healed after 4–6 weeks are called chronic fissures.
An acute anal fissure typically heals within 6 weeks with conservative treatment. Some disappear when constipation is treated. Anal fissures that last for 6 weeks or more are called chronic anal fissures. These fail conservative treatment and need a more aggressive, surgical approach.
The most common symptoms of anal fissures are: a sharp pain when you poo, often followed by a deep burning pain that may last several hours. bleeding when you poo – most people notice a small amount of bright red blood either in their poo or on the toilet paper.
And about 4 out of 10 long-term anal fissures will heal after home treatment is used. But not all fissures will heal with just home treatment. If a fissure lasts more than 8 to 12 weeks, you may need prescription medicines.
Anal fissures are common, and not normally dangerous, but they can hurt a lot. Most anal fissures heal in a few days to weeks with a little self-care. But some anal fissures are more complicated and may resist healing. If you have a chronic fissure, don't hesitate to seek medical treatment.
In general, surgery is considered a last resort for the treatment of chronic anal fissures and is typically only recommended after conservative treatments have failed to provide relief. It may also be recommended when chronic anal fissures have persisted for longer than 8-12 weeks.
If someone has a chronic fissure, it is thought that the reason it has not healed is that the ring muscle (sphincter) that goes around the anus (back passage) has become so tense that the flow of blood to the lining of the anus is reduced.
Some of the possible complications of an anal fissure include: Chronic anal fissure – the tear fails to heal. Over time, this can cause extensive scar tissue at the site of the fissure (sentinel pile). Anal fistulas – abnormal 'tunnels' join the anal canal to surrounding organs, usually other parts of the bowel.
Chronic fissures typically have a cyclical history of intermittent healing and recurrence, but about 35% will eventually heal, at least temporarily, without intervention.
Primary anal fissures are most commonly located at the posterior midline and less commonly at the anterior midline. Secondary, or atypical, anal fissures are caused by another disease process such as Crohn disease and can occur at locations other than the midline.
Chronic anal fissures can be simply and effectively treated medically without the risk of incontinence associated with sphincterotomy. Topical nifedipine and botulinum toxin injections are an excellent combination, associated with a low recurrence rate and minimal side effects.
Some fissures can be minimally symptomatic, but most patients present with severe pain, bleeding, or itching. The pain can be localized to the anus but can radiate to the buttocks, upper posterior thighs, or lower back. Often the pain is triggered by a bowel movement, can last for hours, and can be severe.
To heal a fissure fast, some people opt for surgery which helps them recover in a week's time. They can get back to their daily routine in a week. Whereas people who opt for home remedies or over-the-counter medicines for fissure, it may take 5-6 weeks to heal a fissure.
Some people get fissures once in awhile and others can become chronic, lasting for years.
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.
Some signs that an anal fissure is healing include pain reduction, cessation of bleeding, and wound closure.
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. At the proximal end of a chronic anal fissure may be hypertrophied anal papillae, while at the distal margin may be a skin tag (sentinel pile).
Indications: Surgery may be indicated for chronic anal fissures that last longer than 6 weeks without healing.
Most anal fissures are idiopathic and are located in the posterior midline. However, some fissures may be associated with systemic diseases, infections or malignancy [1, 2]. Squamous cell carcinoma of the anus (SCCA) commonly presents with bleeding and anal pain [3].
It is possible by consuming stool softeners and a high fiber diet. Exercising regularly also helps in a great deal. Hydration is important, therefore it is important to drink adequate fluids. Apart from these, there are a few things one must avoid in order to heal annal fissures.
Anal fissures and fistulas are often mistaken as the same anal disorders. However, the fissure is a term that means a tear in the skin. Whereas, fistula refers to tube-like passages between organs.
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.
Piles are mainly the swollen blood vessels while fissures are kind of cracks and fistulas are an opening of a cavity. Piles are mostly painless and unnoticeable. Fissures cause a lot of pain. In the case of fistulas, pus is discharged out of the anal area.