Anal fissure disease

Anal fissure is the 3rd most common disease visited in the anal department. Anal fissures are common in young and middle-aged people, but they still occur in children and the elderly, but with a lower frequency.

Symptoms The main symptom of an anal fissure is anal pain during bowel movements and persists after a bowel movement.
Pain nature: A sharp pain like a cut or tear when stool passes through the anus, sometimes a burning pain and lasts many hours after a bowel movement. Bleeding may or may not be present, light red blood is usually not much. There is a mass of skin in the anus in the posterior midline, sometimes patients complain of pain in this mass. Discharge in the anus: usually little and only see the fluid in the underwear, anal itching due to the irritation of this secretion. Constipation is a common symptom in patients with anal fissures. Sometimes anal pain is accompanied by painful urination, painful urination, or urinary retention.
Acute anal fissures usually heal after medical treatment, but sometimes the lesions do not heal completely. If acute anal fissures do not heal after medical treatment, secondary lesions will appear. The first is swelling of the lower end of the fissure forming an edematous lesion known as a sentinel pile.
Inflammatory mass at the lower end of the fissure formed by infection causes lymphedema to cause pain and inflammation of this mass. Then, this inflammatory mass will fibrosis and form fibrous excess skin. After many months, the non-healing fissure produces a deep ulceration of the inner sphincter, fibrosis, resulting in spasm of the internal sphincter and fibrosis of this irritated muscle. Any stage can cause pus formation in the ulcer, leading to a sphincter or perianal abscess and to a low anal fistula with the external fistula opening in the posterior midline. of the anus.
To date, the exact cause of anal fissures has not been determined. But the recognized causative factor is trauma to the anal canal with the cause of passing hard and large stools. Inflammatory bowel disease, especially Crohn's disease, is a documented cause of anal fissures. History of anal surgery such as hemorrhoidectomy or procedures such as hemorrhoid ligation with rubber rings, sclerotherapy, infrared photocoagulation... are also recorded causing anal fissure complications. Cases of anal fissures in the middle anterior anal canal were recorded in women after vaginal delivery.

Treatment methods Non-invasive treatment is anti-constipation with faeces, laxatives, soaking the anus with warm water to help relax the sphincter, or applying local anesthetic to the anal canal, avoiding the skin. around the anus, which can cause dermatitis. Instrumental treatment is an anal dilatation under anesthesia to help the sphincter relax, Botulinum Toxin A injection into the internal sphincter with the aim of relaxing the sphincter. Surgery applied in the treatment of chronic anal fissures.
Treatment of anal fissures is not complicated, but it is necessary to intervene early so that the patient can soon return to a normal lifestyle and avoid a more severe disease. Therefore, visit a specialist clinic as soon as you have the above symptoms.