Anal fissures

Anal fissures's disease overview

What is

What is anal fissure?

anal fissure is a condition where the anal mucosa causes pain, which often occurs after trying to push hard stool. This is one of the typical pathologies that often cause anal burning pain and bleeding when bowing.

Anal fissures often occur in middle age, but also the cause of anal bleeding in teenagers. Most cases will cure within a few weeks with improving constipation, but a few anal fissures will become chronic and need surgical treatment.

Anal fissures can lead to many complications such as:

  • Chronic anal fissures: The anal fissure is not healed after 6 weeks will become chronic.

    • Rehabilitation anal fissures.

  • cracks spread into the anal sphincter: making it difficult for healing to heal with medication or surgery.

    • Causes of Anal fissures's disease

    Causes of anal fissures include:

  • Inflammation of the rectal anus: inflammatory cells produce yeasts that decompose glue, reduce the endurance of the organization, when there is stretch, the crack is easy to appear, Especially when snake feces pass will tear the anal mucosa to create an ulcerative
  • Inflammation of muscle fibrosis in the anus: The anal sphincter mass, increasing tone, very strong spasm, the spasm of the sphincter is the basic factor that makes the drive The ulcer does not heal
  • Anemia at the site of the ulcer is not healed and called anemia ulcer
  • Trauma: hard stool or too large stool, after hemorrhoid surgery, anal narrowing, after pushing
  • Mechanical factors
  • HIV, anus - colon, syphilis
  • Crohn's disease or other colitis, anal-rectal cancer

    • Other causes such as constipation and having to push many times when bowel movements, prolonged diarrhea, anal sex.

    Symptoms of Anal fissures's disease

    Anal fissures and hemorrhoids are two different diseases, it is easy to confuse with each other because both of these conditions can cause rectal bleeding.

    signs of anal fissures usually include:

  • intense anal pain and burning sensation during and after bowel movements, burning pain can last up to several hours. Pain makes patients very afraid of defecation, insomnia, pale, affecting the whole body and spirit.

    • Pain through 3 stages:

  • When defecation is starting to go through the anus.
  • All pain after a few minutes.
  • Pain increased intensely, then suddenly all the pain.
  • There is a bright red blood with stool or toilet paper.
  • Itching, discomfort around the anus.
  • Can see a tear on the skin around the anus.

    • often have excess skin and anal papillae near the cracking position.

    People at risk for Anal fissures's disease

    Risk factors leading to anal fissures are:

  • Diets with many processed foods, foods with high saturated fat, low fiber
  • Lack of movement
  • Children: Many children have anal fissures in the first years of life without the cause
  • Elderly: Many elderly people may have anal fissures due to blood reduction, the consequences of reducing rectal perfusion
  • Constipation: Pushing sometimes on bowel movements and too hard stool
    • postpartum: Anal fissures often occur with women during the postpartum period, possibly due to a diet that is too abstinence that causes constipation
  • Crohn's disease

    • Prevention of Anal fissures's disease

  • There is a habit of defecation regularly, every day according to a specific time.
  • When the patient has constipation, it is not allowed to use the strength to push, should use warm salt water to indent the stool.
  • After defecation must be clean, can be cleaned with water, then wipe dry with clean cloth. Do not use fragrant paper or to get wet anus can lead to anal inflammation.
  • There is an appropriate diet:

    • Eat plenty of fiber from green vegetables, especially to eat foods such as radish, taro, sweet potatoes, ...

    Limit greasy food, hot spicy foods such as pepper, chili, ...

    Limit drinking alcohol and coffee. No smoking.

    Supplement the necessary water content, making sure to drink 2 liters of water/day. You can drink vegetable juice, fruit juice, ... to stimulate intestinal motility to soften stool to go to bowel.

  • When signs of anal inflammation or ulcerative colitis should be treated promptly to avoid severe infections causing ulcers and anal leakage.

    • There is a exercise regime, daily activities scientifically.

    Diagnostic measures for Anal fissures's disease

    Clinical

    anal examination: Putting fingers into the anus is difficult due to spasm of sphincter, sometimes sclerosis. Sometimes just light the anus and tell the patient to immediately see the lower edge of the ulcer or a tufts of fibrous hemorrhoids (gate hemorrhoids), the skin signals the location of the ulcer. Observe can help distinguish new or old ulcers.

    It is necessary to distinguish anal fissures from the pain of the same bone, rectal pain, inflammation around the anus, Morgani cavity and especially the sores of sexually transmitted diseases (especially homosexuality).

    Test

    to determine the cause and eliminate other combined diseases such as ulcers, colorectal cancer, ...

  • Rectal endoscopy: usually performed in patients under 50 years old, no risk factors for small intestine or colon cancer.

    • colonoscopy: Performed for patients over 50 years old, allowing the entire colon survey.

  • Measure anal pressure: to evaluate the anal muscle tone, as well as measure the sensitivity and function of the rectum.

    • Anal fissures's disease treatments

    What should

    anal fissure?

    Anal fissures usually heal for a few weeks if the patient keeps the stool soft and the treatment of constipation or diarrhea. However, if the crack is not healed for 6 to 8 weeks, the patient needs to be treated with medicine or even surgery.Non -surgical treatment:

  • Change lifestyle: Add more fiber to diet, drink plenty of water, exercise regularly
  • Soak the anus: Soak in warm water for 10-20 minutes many times a day, especially after going to the boweled to help relax the sphincter to help heal. Do not use soap because it can cause anal irritation.

    • Use fecal softening drugs.

  • Ice cream: anusol-hc, zinc oxide, .... Helps reduce discomfort from mild cracks.
  • Calcium channel blockers: nifedipin and diltiazem, drink or crush into gel and apply on cracks contribute to sphincter dilation.
    • Surgery:

    If medical treatment has not decreased by symptoms, patients need surgery. Only 20% of patients with anal fissures need surgery.

    Surgical methods often used to treat anal fissures include:

  • Analectric: Preventing anal holes from being narrowed and done with anesthesia. In the procedure, the anus is gradually exposed.
  • Cut off the crack and sew it again
  • Surgery to open muscles in
  • Coordinate to remove cracks and open muscles in
  • Open the sphincter with chemicals: Using nitroglycerin or botulinum A causes temporary paralysis in the anal fissure. Side effects: headache.  

    • Indications:

  • New anal fissures: Anal oysters.

    • Old anal fissures: Cut off crack or open sphincter with surgery or chemicals.

    See also:

  • Anal fissures
  • Is anal fissures hemorrhoids?
  • Anal fissure after birth: Mothers' suffering

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