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If you suffer from a chronic fissure, you may opt for surgery to fix it.

Anal pain can appear suddenly and is always an unwelcome guest. Although many people will assume pain from the anal or rectal area is a hemorrhoid, this is not always the case. Another common cause of anal pain is an anal fissure. A fissure is a tear in the opening of the anus.

  • Pain or bleeding may be the first symptom you notice, and this can be accompanied by intense itching.
  • After a bowel movement, the pain may linger for minutes or hours.

Fissures cause the anal sphincter to spasm, which increases the pain. There are both acute and chronic anal fissures. An acute fissure will resolve in a short time period if you follow your doctor's recommendations. A chronic fissure is one that lasts six weeks or more.

What Causes an Anal Fissure?

There are two main causes of anal fissures. The most common is constipation, especially if the constipation is an ongoing problem. The constant strain that your rectum is under to push feces out can cause the opening to tear. Sometimes, people fear having a bowel movement because of their constipation, which leads to waiting too long and becoming more backed up. Fissures can also be caused by constant diarrhea. Diarrhea can eat away at the lining of your rectum, causing a small tear. Digestive illnesses such as Crohn's disease or irritable bowel syndrome can also cause anal fissures.

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Treatment for Anal Fissures

Acute anal fissures are those that last less than six weeks. If the root cause of the fissure is constipation, increasing your water and fiber intake can give your rectum a break and help the fissure heal on its own. A medicated healing ointment such as lidocaine or hydrocortisone may also be applied. Warm baths can also help the fissure to heal. Prescription ointments that contain nitroglycerine or calcium channel blockers may be used.

A chronic fissure, or one that has lasted more than six weeks, may require more aggressive treatment. First, the underlying cause must be addressed. Then a stronger prescription ointment may be utilized. Lastly, surgery may be indicated.

Anal Fissures Surgery

A chronic fissure that is not healing may warrant surgery. Surgery is not usually the first treatment but is used after other treatment methods have failed to bring relief. There are a couple different options for surgery. One is an injection of a liquid similar to Botox into the anal sphincter. This numbs the area and prevents the sphincter from going into painful spasms.

Another option is to cut away a small portion of the sphincter. While this does not necessarily cure the fissure, it will give you relief. The likelihood of the fissure returning after this procedure is slim.

If you are having pain and/or bleeding after a bowel movement, see your healthcare provider for the correct diagnosis before trying to treat yourself.

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