A Family Doctor's Tale -ANAL FISSURE

DOC I HAVE ANAL FISSURE

An anal fissure is a tear in the anus usually caused by constipation and straining at stools.

There may be a skin tag covering the fissure.

Children and pregnant women are more prone to it.

However treatment is effective with antibiotic creams and proper diet with more fruits and vegetables.


Anal fissure is a superficial linear tear at the edge of the anus.



Anal fissure occur after a tear in the posterior midline of the anus caused by the passage of hard large stools and constipation.

The tear is covered by a sentinel skin tag at the lower end(sentinel pile).

The tear may occur at any age but are more common in young children and pregnant women.

Sometime the tear may occur at the anterior midline of the anus.



Symptoms:

1.Pain during and after passing motions

2.Serous discharge from tear

3.Itch (pruritis ani)

4.blood streak on stools

Signs:

1.sentinel skin tag covering a posterior midline tear of the anus

2.spasm of the anal sphincter

3.perianal infection

Diagnosis of Anal fissure is by:


1.Digital examination of the anus

2.Proctoscopy to exclude piles

3.Sigmoidoscopy may be required in adults.

Treatment of Anal fissure is by:


1.Stool softener

2.low residue diet

3.Avoid constipation -take more fruits and water

4.Give painkiller if necessary

5.Apply anti-itch cream

6.Use antibiotic cream if there is evidence of perianal infection

Prognosis is usually good.

Prevention is usually by:

avoid straining at stools

regular bowel habits

stool softeners

more fruits and vegetables