A fissure-in-ano or anal fissure is a small tear in the lining of the anus, caused by straining the membranes of the anus further than they can comfortably stretch. This condition is extremely common, and there are a number of treatment options available for patients who develop it. In most cases, treatment at home is enough to clear up the problem. In patients who develop chronic fissures, it may be necessary to take some medications to promote more rapid healing.
When a fissure-in-ano develops, the patient usually experiences painful defecation, sometimes with a sharp twinging sensation. Blood or clear fluid may appear and spot toilet paper, and some patients find that their rectums become extremely itchy. In some cases, a hemorrhoid develops along with the fissure-in-ano, and the patient may experience additional discomfort and swelling around the anus.
Soaking the area in warm water, using a tool like a sitz bath, is usually recommended to soothe the anus and help the patient feel more comfortable. Some patients add salts or other preparations to the water. In addition, adding fiber to the diet and taking stool softeners will make defecation more comfortable and give the anus a chance to heal by reducing stress on the tissue when people use the bathroom. These treatments are often sufficient to resolve the fissure-in-ano at home within three to five days.
If painful defecation persists or patients start to notice new symptoms, they should seek treatment from a doctor. A general practitioner can often manage care, starting with a patient interview and an examination. The doctor may recommend continuing the conservative treatment and giving it a few more days, or consider adding more aggressive treatment options including medications. In cases where a fissure-in-ano becomes inflamed or infected, it may lead to an abscess, and this could require surgical intervention to drain and clean the abscess.
People can reduce their risks of developing this condition by eating a balanced diet high in fiber to regulate bowel movements and keep the intestinal tract healthy. If a patient develops constipation or has difficulty defecating, making dietary changes or seeing a doctor to discuss the use of stool softeners and other treatments can be a good idea. In addition to preventing anal fissures, such measures will also be beneficial for gastrointestinal health. Even with these measures, it is still possible to develop a fissure-in-ano, but the tear will usually be very mild and highly responsive to treatment.