An anal fissure is a tear in the anal skin. Such a tear is noticeable by pain during bowel movements as well as blood in the stool or on the toilet paper. Cause are often problems with defecation. Too hard a chair and the associated strong pressing can cause injury to the sensitive skin in the anal canal. Acute anal fissures can usually be treated well with ointments or creams. In contrast, a chronic fissure may require surgery.
Causes of anal fissure
The skin in the anal canal - also known as Anoderm - is very sensitive. If the skin breaks and forms an oblong tear, it is called an anal fissure. Which causes are responsible for the formation of such a fissure, has not yet been clarified. However, the consistency of the stool seems to play an important role.
Thus, the emergence of an anal fissure by strong pressing during bowel movements - such as constipation - be favored. Likewise, persistent diarrhea and hemorrhoids can have a negative effect on the anal skin. If the fissure occurs as a result of a chronic intestinal disease such as Crohn's disease or ulcerative colitis, it is called a secondary anal fissure.
Blood and pain as symptoms
If an anal fissure is present, it often manifests itself as a strong, burning or stinging pain during bowel movements. Likewise, itching, burning or oozing in the anal area may indicate such a fissure. On the toilet paper or in the chair is also often found bright red blood.
As a result of the pain during bowel movements, a moderate bowel movement may occur. As a result, the chair only hardens and the wound is additionally irritated. If the sphincter muscles of the anus become tense due to the pain, the pain can increase even further. In addition, the anal skin is poorly supplied with blood through the cramped muscles.
It is important, therefore, that those affected maintain their toilet rhythm as possible and break the pain cycle.
Acute and chronic anal fissure
In the case of anal fissures, a distinction is made between an acute and a chronic variant. Acute fissures usually heal again within a few days.
However, if the anal fissure does not heal, the injury can become chronic. Typical of a chronic fissure is that forms a thickened skin fold at the anus (outpost fold). Likewise, fibroids - benign connective tissue nodules - and scarred marginal ridges can develop around the ulcer.
Which doctor helps with an anal fissure?
If you have blood in your stool, you should always consult a doctor to rule out a serious condition. If you suspect an anal fissure, it is best to first consult your family doctor - he will probably refer you to a proctologist. This is a specialist in diseases of the rectum.
The proctologist will conduct an examination of the external anal area. If there is an anal fissure, he can often recognize this without further investigation. If this is not the case, he must clear the anus from the inside. This usually only happens after a local anesthetic, since the examination can otherwise be associated with pain. If a reflection of the rectum must be performed, this is also done only under anesthesia.
Treat anal fissure with ointments and creams
An acute anal fissure can often be treated by regulation of bowel movements. Make sure you drink a lot and eat enough fiber. These are among others in fruits, vegetables and whole grains. Likewise, regular exercise helps to boost digestion.
Locally anesthetizing ointments or suppositories can help against the pain of bowel movements. Under certain circumstances, the doctor can inject a narcotic directly into the area of the anal fissure. The local anesthesia can interrupt the pain circulation and promote healing.
For acute as well as chronic anal fissures, ointments are also suitable for therapy, which better bleed through the sphincter and relax the cramped muscles. They usually contain active substances from the group of calcium antagonists or nitro preparations. Due to the effect of the preparations, the fissures often heal without further treatment.
Home remedy for an anal fissure
If you have an anal fissure, you should always consult a specialist and do not spend too much time trying to alleviate the problems yourself with home remedies. We recommend only warm sitz baths. Due to the warmth of the water, the sphincter can relax and blockages can be prevented.
Also for the relaxation of the sphincter may contribute a so-called Analdehner. By regularly stretching the sphincter with the small plastic cone, the tension of the muscles diminishes over time.
Operation as a last resort
However, an anal fissure can not always be treated with home remedies, ointments and creams - in some cases an operation is necessary. This is usually the case when the outpost crease or fibroma are strong. Likewise, surgery must be performed if an anal fistula has formed.
In an outpost fold or scarred tissue, the physician attempts to remove the affected tissue as flatly as possible (fissurectomy). While the sphincter was often severed in the past, this form of surgery is hardly performed today. As a result, fecal incontinence may occur at an advanced age.
After surgery, it usually takes several weeks for the wound to heal. During this time, it is particularly important to keep the stool soft with enough fluid and fiber. The wound healing can be supported by ointment dressings and sitz baths.
Prevent an anal fissure
The best way to prevent anal fissure is to have a healthy and balanced diet. Take enough liquid every day: Ideally, it should be between 1.5 and 2 liters of water daily.
Also, make sure your diet is high in fiber by targeting whole grains, fruits and vegetables. In this way, you keep your chair soft and can thus avoid strong pressing during bowel movements.