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Anal Fissure

An anal fissure is a split in the lining of the bowel that occurs just inside the back passage. It is usually caused by the passage of hard stool (related to constipation and straining).

Occasionally a fissure will heal without difficulty but often a cycle of pain and muscular spasm of the anus develops. The combination of anal pain and spasm makes it difficult to open your bowels well creating a vicious cycle of worsening constipation and harder stools leading to more pain and damage when you do open your bowels. This muscular spasm is also thought to reduce blood flow to the area contributing to poor healing of the fissure.

SYMPTOMS
Typical symptoms of a fissure include stinging, tearing or burning pain when passing a bowel motion (stool), often with a small amount of bright bleeding on the stool. The pain may be very severe and throbbing preventing sleep. Constipation often precedes the development of a fissure and the presence of pain with a fissure often compounds the problem of constipation. Anal tags may develop next to long-standing anal fissures and these may predispose to moistness and irritation of the skin outside the anus.

Clinical appearance:
Often the anal region is too painful to allow the doctor to examine the area properly or conduct an internal examination. If an examination is possible, the split in the bowel lining at the anus may be visible by parting the buttocks. Internal examination by sigmoidoscopy or colonoscopy (depending on your age and the external appearance of the anal area) is recommended to exclude other causes of pain and bleeding from the bowel, such as Crohn’s disease.

Facts About Anal Fissure
First Edition 2008

Contents

• What is anal fissure ?
• Symptoms
• Clinical appearance
• Management
• Pain relief

Facts About Anal Fissure is now available to download or read online as an A4 size pdf file.

Anal Fissure (Adobe Acrobat PDF 232K)