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Between bowel movements, patients with anal fissures are often relatively symptom-free. Your surgeon will go over benefits and side-effects of each of these with you. Treatment strategies are aimed at interrupting this cycle to promote healing of the fissure. Topical anesthetics, such as lidocaine, can be used for anal pain and warm tub baths sitz baths for minutes several times a day especially after bowel movements are soothing and promote relaxation of the anal muscles, helping the healing process. These non-operative measures will help achieve resolution of pain and bleeding and, potentially, heal greater than half of acute fissures with virtually no side effects. Your colon and rectal surgeon will discuss these risks with you to determine the appropriate treatment for your particular situation. Other medications may be prescribed, when a patient has a more chronic-type fissure, that promote relaxation of the anal sphincter muscles. The typical symptoms of an anal fissure include pain and bleeding with bowel movements. Patients undergoing sphincterotomy have much improved quality of life as compared to patients with persistent anal fissures. Fissures are usually caused by trauma to the inner lining of the anus. Fissures located elsewhere off to the side should raise suspicion for other diseases see below and will need to be examined further.

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WHAT IS AN ANAL FISSURE? An anal fissure (fissure-in-ano) is a small, oval shaped tear in skin that lines the opening of the anus. Fissures typically cause.

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Description: Anal fissures can occur at any age and have equal gender distribution. A hard, dry bowel movement is typically responsible, but loose stools and diarrhea can also be the cause. Injections are performed as an outpatient, same-day surgery procedure and, occasionally, can be performed in the office setting. Persistent symptoms, however, need careful evaluation since other conditions other than an anal fissure can cause similar symptoms. Chronic fissures may be more difficult to treat and may also have an external lump associated with the tear, called a sentinel pile or skin tag, as well as extra tissue just inside the anal canal, referred to as a hypertrophied papilla. Many patients are fearful of having a bowel movement and may try to avoid defecation secondary to the pain. Treatment strategies are aimed at interrupting this cycle to promote healing of the fissure. Topical anesthetics, such as lidocaine, can be used for anal pain and warm tub baths sitz baths for minutes several times a day especially after bowel movements are soothing and promote relaxation of the anal muscles, helping the healing process. This delay in diagnosis may lead to an acute fissure becoming a chronic one and, thus, more difficult to treat. These non-operative measures will help achieve resolution of pain and bleeding and, potentially, heal greater than half of acute fissures with virtually no side effects. Narcotic pain medications are not recommended for anal fissures, as they promote constipation.
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