An anal fissure is a tear or open sore (ulcer) that develops in the lining of the large intestine, near the anus. Anal fissures are quite common, with around 1 in every 10 people affected at some point in their life. They affect both sexes equally and people of all ages can get them. But children and young adults between 10 and 30 years of age are more likely to get anal fissures.[5]
Anal fissure symptoms
The most common symptoms of anal fissures are:
• Sharp excruciating burning pain on defecation.
• Minute bleeding resulting in bright red spot on feces and toilet paper
Most people delay treatment because of embracement resulting in complications but a timely visit to a GP results in early recovery on conservative management.
Diagnosing anal fissures
Anal fissure are solely diagnose on clinical history and examination. History includes inquiry about sign and symptoms as well as bowl habits and inquiry about general health. Examination is done slightly separating the buttocks and ulcer can be visualized around anal rim under proper illumination. Digital rectal examination procedure in which your doctor will insert a gloved finger in the anus to examine in inside of the anal canal and rectum. However it is avoided because of excruciating pain that patient experience an deserve only of complicated cases and preferably done under local anesthesia to reduce pain during examination
What causes anal fissures?
Anal fissures are caused by damage to the anal canal lining resulting in tear and painful ulcer development most cases are caused by long standing constipation. As constipated person passes hard compact stool it can damage the anal canal lining.
Other possible causes of anal fissures include:
• persistent diarrhea
• inflammatory bowel disease (IBD), such as Crohn's disease and ulcerative colitis ( long standing inflammatory conditions of the bowel)
• pregnancy and childbirth
• occasionally, a sexually transmitted infection (STI), such as syphilis or herpes, which can infect and damage the anal canal
• having unusually tight anal sphincter muscles, which can increase the tension in your anal canal, making it more susceptible to tearing
In many cases, no clear cause can be identified.
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