Fissures result from the stretching of your anal mucosa beyond its normal capacity. This often happens when stools are hard due to constipation. Once the tear happens, it leads to repeated injury. The exposed internal sphincter muscle beneath the tear goes into spasm.
Causes and Risk Factors
Passing a hard stool or prolonged episode of diarrhea. Lack of fiber in the diet and/or water with that fiber. Food that creates a rough passage through the digestive system, such as popcorn, nuts or tortilla chips.
Do not use over-the-counter ointments or creams without talking to your doctor. Some of these preparations may not help. Use baby wipes or medicated pads, such as Preparation H or Tucks, instead of toilet paper to clean after a bowel movement. These products do not irritate the anus.
See your health care provider if you have pain during bowel movements or notice blood on stools or toilet paper after a bowel movement.
Most people will fully heal within 2 to 4 weeks.
WILL THE PROBLEM RETURN? Fissures can recur easily, and it is quite common for a fully healed fissure to recur after a hard bowel movement or other injury. Even when the pain and bleeding have subsided, it is very important to continue good bowel habits and a diet high in fiber as a sustained lifestyle change.
Walking promotes overall good health. It lowers the chances of formation of hard stools and stimulates and promotes blood flow which is helpful if you have a fissure.
In addition, stress and psychological disturbances may have a role in the development of chronic anal fissures through causing sympathetic dysfunction manifesting as a tonic pressure rise in the pressure of the anal canal [8]. Stress may be implicated in the formation and development of chronic anal fissures.
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.
Numbing cream can also make bowel movements less painful. 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.
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).
How do you know if a fissure is healing? You'll start to notice your symptoms improving as your fissure is healing. Your pain should lessen and if you had any bleeding, this should stop too. You should have a follow-up appointment with your doctor after six to eight weeks.
Itching. Itching can also be another sign that the anal fissure is healing. The skin typically itches as it heals. Inflammatory cells flood the wound site to eliminate bacteria and other infections.
The symptoms of a fissure and a hemorrhoid can be similar. Either can cause pain, itching and bleeding. However, if you are in pain and don't feel an external lump, the condition is more likely to be a fissure. If you notice that you are leaking mucus from your anus, the problem is probably a hemorrhoid.
The pain may make it hard for you to have a bowel movement, causing constipation (having fewer bowel movements than usual). They can also cause bleeding from your anus. Anal fissures don't cause colon cancer or increase your risk of getting colon cancer.
Some people get fissures once in awhile and others can become chronic, lasting for years. The pain of a fissure may cause people to avoid having a bowel movement leading to chronic constipation.
Piles are mostly painless and unnoticeable. Fissures cause a lot of pain.
Some of the home remedies you might want to try to treat anal fissures also may help to prevent them in the future. Drinking more water and choosing foods with more fiber and water content will help to make your stools softer. Passing stools more easily will reduce the discomfort that comes with fissures.
Over-wiping with rough and dry toilet paper can lead to itching, pain, and bleeding. In fact, improper wiping is the leading cause of America's most common bum-related injury – anal fissures (aka anal tears). Other common problems include UTI's and hemorrhoids.
Sitting can be painful for people with anal fissures, and also they should not strain during bowel movements.