What is an Anal Fissure:
A fissure is “a long, deep crack in something” in the dictionary. When this crack is in the anal region it is referred to as an Anal Fissure/ Fissure-in-Ano or merely a fissure.
Anal fissures primarily affect men and women between the ages of 20 and 40, but they can develop in anyone under the right conditions. In addition to discussing the signs and risk factors of anal fissures, this post will address some frequently asked questions, such as how long does treatment for fissures take, what happens if a fissure goes untreated, and does an anal fissure heal on its own.
THE SYMPTOMS OF ANAL FISSURE
ANAL FISSURE SYMPTOMS
Severe pain is the most common complaint and symptom of anal fissure patients, especially during and right after a bowel movement. A patient may notice a skin tag, a lump of skin, or a visible tear in the perianal skin if they are able to look at the area. After cleaning the area, patients might also notice bright pink blood streaks. These factors contribute to the confusion between anal fissure and hemorrhoids.
Anal fistulae, a condition characterized by tunneling and infection in the glands within the anus, is sometimes mistaken for anal fissure. Anal fistulae can develop from anal fissures or abscesses that do not heal properly. For this reason, it’s critical to minimize your fissure episodes and make sure they heal correctly.
ANAL FISSURE RISK FACTORS
Anal fissure development is more likely to occur due to a multitude of factors. Constipation, straining during bowel movements, consuming insufficient amounts of fiber, unusually hard or abrasive stool, inflammatory bowel disease, persistent diarrhea, and childbirth are a few of these.
AT-HOME TREATMENT OPTIONS FOR ANAL FISSURE
ANAL FISSURE – HOME REMEDIES
Is it possible for anal fissures to heal themselves? While it is true that some anal fissures are too severe to heal on their own without the help of an experienced proctologist for fissure, we would love to tell you that this is possible 100% of the time. If you have a mild anal fissure, you can try at-home treatments like:
EATING MORE FIBER
Fiber will not only help you pass your stools more easily, but it will also help you go less frequently. By avoiding forceful defecation, you can protect the anal canal and encourage the fissure’s healing. A dietary fiber supplement such as isabagol husk may also be beneficial if you are having trouble increasing the amount of fiber in your diet.
STAYING HYDRATED BY TAKING SUFFICIENT LIQUIDS
A lack of fluid in the body is frequently the cause of a hard stool. Therefore, it is advised to consume a sufficient amount of fluids. It could be in any form—milk, buttermilk, coconut water, fruit juice, or water.
EXERCISING REGULARLY FOR AT LEAST 30 MINUTES EACH DAY
Our digestive system and entire body remain active when we exercise regularly. This promotes healthy digestion, nutrient absorption, and easy bowel movements. Therefore, make it a point to exercise every day and stay active all day.
STOOL SOFTENERS
If the urge to strain during bowel movements is not reduced by fiber, you might consider using a stool softener. These medications will facilitate easier passage by increasing the amount of water excreted in your stool. This less strain on the anal opening might speed up the healing of your anal fissure.
CHANGE THE WAY YOU CLEAN
Not only is toilet paper rough on the vulnerable skin around the perianal folds, but it is also extremely poor at cleaning that area. Cleaning with water is the best option if you have recurrent anal fissures. It could involve using a hand or bidet to wash the perianal area with water.
RELIEVING SPASMS OF SPHINCTER MUSCLES IN THE ANAL REGION
The primary cause of the anal fissure’s inability to heal is pain in the anal region, which causes the sphincter muscles to spasm and reduce the amount of space available for stool passage. This spasm impedes the healing process in two ways: first, by reducing the amount of space available for stool passage, it causes additional frictional damage in the fissure, deepening the cut injury. Second, it interferes with this area’s blood supply, delaying healing.
Therefore, the sphincter muscle spasms must be relieved in order to allow the anal fissure to heal.
HOW TO RELIEVE SPASMS IN THE ANUS
- Sitz Bath for Anal Fissure: It involves sitting in warm water with hips submerged in it for 10-15 minutes. Some antiseptic solution may be added to the water. The warmth of the water will soothe the pain and help reduce spasms in the sphincter muscles of the anal region.
- Use of anesthetic/soothing gel/ointment in the anal area: Anesthetic/soothing gel/ointment should be applied inside the anal area following a warm water sitz bath. The key point to remember in this case is that gel or ointment needs to be applied inside the anal region because the cut injury is located there. Applying cream to the anal opening alone won’t be beneficial.
The application of anesthetic, calming gel, or ointment inside the anal area should only be done with gloved fingers. It will make sure that gel or ointment is applied correctly at the Fissure site and assist in reducing sphincter muscle spasms.
- Taking pain relievers: Sphincter muscle spasm and pain in the anal area can also be relieved by taking pain reliever medications.
HOW MUCH TIME FISSURE TAKE TO HEAL
The most important aspect to keep in mind is that healing anal fissures at home is a gradual process. You are managing an open wound in one of the body’s most sensitive areas. You may be wondering how long anal fissures usually last. The average time it takes for a fissure to heal is five to six weeks, though this is dependent on the individual patient.
SURGICAL TREATMENT OF ANAL FISSURE
Before we talk about the surgical treatment of anal fissure, let me make one thing clear: in 80–90% of cases, anal fissure can be easily treated with appropriate constipation management and the application of healing ointment. No surgery is required in these cases.
Therefore, you should seek medical attention right away if your anal fissure is not improving with non-surgical treatment for anal fissure or with home remedies for anal fissure, or if you suddenly develop symptoms of infection (fever, chills, nausea, vomiting, or some discharge from the fissure). Your proctologist will probably suggest surgically repairing your fissure while controlling any infection. An operation known as a lateral internal sphincterotomy (LIS) is performed.
What is lateral internal sphincterotomy (LIS):
This treatment involves making an incision in the internal sphincter to relieve sphincter muscle spasms. It allows them to relax better, which promotes healing.
Lateral internal sphincterotomy (LIS) complications:
However, due to potential complications like anal incontinence following the procedure, surgery for an anal fissure is not advised. About half of the patients having fissure surgery report having short- or long-term difficulty controlling their gas or stools.
WHY FISSURE TAKES TIME TO HEAL
Patients frequently inquire in our practice at Piles To Smiles about the duration of healing for an anal fissure, which is simply a cut injury. The following are some explanations for the anal fissure’s delayed healing:
- Bandaging and trauma protection are not feasible: Healing of wounds greatly depends on bandaging and trauma protection. In the Anal Fissure, these are not feasible. While the trauma can be reduced by treating constipation, it cannot be totally prevented because soft stools also rub against cuts, though mildly, which will undoubtedly slow down the healing process.
- Reduced blood supply to the fissure: The sphincter muscle spasms caused by the fissure result in a reduction in blood supply to this area. An adequate blood supply is necessary for a wound to heal, thus it will take longer for an anal fissure to heal.
- Difficulty in the application of healing ointment: Application of healing ointment can be challenging in anal fissures because the cut injury is deep inside the anal passage, making it necessary to apply the cream inside. Applying cream outside won’t help. However, it is not very convenient to insert your finger inside and apply the ointment because of the sphincter muscle spasm. Using an applicator to apply ointment won’t help much because it cannot ensure that the ointment will be applied correctly.
- Higher risk of infection: The anal fissure cut is always vulnerable to infection due to the presence of stool. Anal fissure infections always cause a delay in healing.
HOW TO KNOW IF A FISSURE IS HEALING
Reduction of pain, stoppage of bleeding, and closure of the wound are some indications that an anal fissure is healing.
What happens if a fissure goes untreated?
Serious complications can result from untreated anal fissures, such as:
- Infection: The fissure can become infected and result in pus formation.
- Fistula: The fissure can grow deeper and turn into a fistula, which is an abnormal connection between the anal canal and the skin outside.
- Anal stenosis: A persistent constriction of the anus.
- Fecal impaction: There is a higher chance of experiencing fecal impaction.
- Constipation: Severe constipation is more likely to occur.
ANAL FISSURE DIAGNOSIS & TREATMENT AT PILES TO SMILES
Make an appointment with Piles To Smiles, the best proctologist in Delhi NCR, if you fear you may have an anal fissure. Our doctors can assist you in developing a plan of action that will allow you to heal more quickly without the need for surgery for an Anal Fissure. Because the freshly healed skin will probably be weaker for a while, the fissure may recur more easily. This is especially likely to happen if the underlying cause of the fissure is not properly addressed. Therefore, the only way to treat Fissure permanently is to address its underlying cause.
We have the best fissure surgeon on staff who can help you to the best of their ability in the unlikely event that surgery becomes necessary. At Piles To Smiles, we only recommend fissure surgery when it is absolutely necessary, that is, when there is no other course of action.
Frequently asked questions
- Using methods to maintain a soft stool can help you, heal fissures more quickly. These include taking more fiber and water, as well as stool softener if needed.
- After bowel movements, taking a Sitz bath or spending ten to twenty minutes submerged in warm water can help reduce discomfort and accelerate healing.
- Applying a calming or healing ointment deep within the anal passage helps reduce sphincter muscle spasm, which promotes the healing of the fissure by boosting blood flow to the area.
Itching may indicate that an anal fissure is healing, but it shouldn’t hurt as much as it did during the worst of the fissure.
With the healing of the fissure, the pain should subside or go away entirely.
Fissures can undoubtedly heal fully with the right care, which includes managing bowel movements and application of healing ointment at the location of the fissure.
Surgery is not usually necessary for anal fissures. Treatment for chronic anal fissures is usually more difficult, though.
Patients with complicated or chronic fissures that worsen with time and persist despite medication and lifestyle modifications may benefit from surgery, according to the best proctologist in Delhi NCR.
Anal fissures frequently result in a vicious circle. An acute injury causes the internal anal sphincter to hurt and spasm. This reduces the space available for feces to pass, further irritating the lining of the anal passage. Reduced blood flow and inadequate healing result from this. As long as this cycle is continued, fissures will persist.
Additionally, fissures frequently recur when the underlying causes continue. Constipation and underlying medical conditions like Crohn’s disease are two examples.
In addition, as previously mentioned, healing ointment must be applied over the the cut. Applying the ointment deeply enough to cause the fissure to heal is not very convenient, though, because of sphincter muscle spasm. Therefore, healing of the fissure will not occur until this spasm is relieved.
