...

What is an Anal Fissure?

An anal fissure is a small tear in the tissue that lines the anal canal. Stool is eliminated from the body via the anus. The opening and closing of the anus (back passage) are controlled by a small ring of muscle at the end of the anus called the anal sphincter.

Anal fissures can be categorised based on:

  • Duration-
    • Acute: Lasts less than 8 weeks
    • Chronic: Lasts more than 8 weeks
  • Underlying Cause-
    • Primary: Not caused by an underlying medical condition
    • Secondary: Caused by an underlying medical condition, like Crohn’s Disease

What are the Symptoms of Anal Fissures?

Anal fissure symptoms include:

  • Sharp or searing pain during bowel movements.
  • Persistent burning pain after bowel movements, sometimes lasting for hours.
  • A sensation of passing broken glass during bowel movements.
  • Bright red blood in the toilet bowl.
  • Bright red blood on the toilet paper.
  • A skin tag or lump near the anus.

When Should You Seek Medical Help?

If you think you might have an anal fissure, you should consult your doctor. Although many anal fissures can heal by themselves, it is crucial to eliminate the possibility of underlying conditions. Treatment can also help ease anal fissure symptoms during the healing process. Anal fissures tend to recur in affected patients, and timely treatment can reduce the probability of recurrence.

Anal fissures are more common than you think, affecting around 10% of the population at some point in their lives. There is no need to feel embarrassed for seeking treatment on time. Our team is experienced and places the utmost importance on your comfort and good health.

What Causes Anal Fissures?

Anal fissures can be caused by:
  • Chronic constipation and bearing down during bowel movements
  • Chronic diarrhoea
  • Passing large or dry stools
  • Pregnancy and childbirth
  • Aggressive or excessive wiping of the anus
  • Anal injuries
  • Anal intercourse
Some underlying conditions include:
  • Crohn’s disease
  • Ulcerative colitis
  • Rectal cancer
  • STIs like HIV and syphilis

It is not always possible to pinpoint a particular cause.

How is an Anal Fissure Diagnosed?

The doctor will have a detailed discussion regarding your symptoms and medical history and might ask questions like:

  • What are the major symptoms you have been experiencing?
  • When did the symptoms begin?
  • What is the severity or intensity of your symptoms?
  • Have you noticed any lifestyle changes that ease or worsen your symptoms?
  • Do you suffer from chronic constipation or diarrhoea?
  • Have you received official diagnoses for any other medical conditions?

Several methods can be employed for diagnosis.

The most common method is a physical exam. The doctor will gently inspect the affected area, ensuring minimal discomfort or pain. Anal fissures are visible externally in most cases. A digital rectal examination is typically not required for diagnosis.

If the doctor suspects the presence of a more serious underlying condition, they may suggest further testing to identify the root cause.

Treatment Options for Anal Fissures

Treatment options for anal fissures include lifestyle changes, non-surgical treatment, and surgeries in some cases.

1. Anal Fissure Treatment Using Lifestyle Changes:

Many cases can be treated with lifestyle changes that lead to easier and healthier bowel movements and relax the affected area. Some highly recommended lifestyle changes you can immediately make are:

  • Adding more high-fibre foods to your diet
  • Increasing daily fluid intake
  • Regularly exercising
  • Use a sitz bath (a shallow, warm bath) to soak the affected area multiple times a day, especially following bowel movements
  • Not holding a stool when you feel the urge to use the toilet
  • Not using unnecessary pressure during bowel movements

2. Anal Fissure Treatment Using Non-Surgical Options - Ointments, Creams & More

If these methods do not result  in significant improvement, you will be presented with non-surgical anal fissure treatment options like:

    • Topical medication like Ointments and creams can help ease your anal fissure symptoms.
      • Glyceryl Trinitrate (GTN)
      • Diltiazem Cream

       

      These medications improve blood flow to the affected area and speed up healing. However, these can be accompanied by side effects. You may also be prescribed an anaesthetic numbing cream, like lidocaine, for pain management.

    • Oral medication:  The doctor may prescribe laxatives to promote easier, smoother bowel movements. Oral painkillers can also be prescribed for pain mitigation.
    • Botox Treatment: Botox treatment, administered under local or general anaesthetic, can relax the anal sphincter muscle, promoting healing by reducing spasms.
  • Injectables: If topical and oral medications are not effective, muscle relaxant injections are used to paralyse the anal sphincter. This allows the fissure to heal without being aggravated by sphincter spasms

If the fissure does not heal after 8 weeks, surgery might be required.

3. Surgery for Anal Fissures

If lifestyle changes and non-surgical treatment options are not successful, your doctor may recommend surgery. Surgery is considered the most effective anal fissure treatment, with 90% of patients reporting positive long-term results. However, as with all surgeries, this comes with the risk of potential complications.

Surgical techniques like lateral sphincterotomy are employed to remove anal fissures. The recovery time is in the range of 2-4 weeks, and the recurrence rate of anal fissures post-surgery is from 1 to 5 percent. In rare cases, surgeries may result in temporary or permanent incontinence, where the patient loses control over flatulence (passing wind) and/or bowel movements.

Why Choose the Leicester Bowel Clinic?

Book a consultation with us to get treatment for your condition..

At Leicester Bowel Clinic, we focus on bowel health and conditions, digestive issues, and cancer care. Our clinic offers minimally invasive procedures for bowel problems, ensuring effective results and patient comfort. We aim to provide personalised care for our patients and offer the latest treatments for hernias, bowel conditions and rectal disorders.

Want to book an appointment?

Connect with
us now

Book a consultation
Request a call back

Pricing

Consultations start at

£200

Request a call back by filling out the contact form to the right.

We look forward to assisting you!

request a call back

Our Locations

Leicester Bowel Clinic at Spire Hospital

  • Wednesdays evenings (Mr Runau) from 6:00 pm until 9:00 pm at: Spire Leicester Hospital Gartree Road Leicester LE2 2FF
  • To arrange an appointment directly with the Spire Leicester Hospital, please call the booking line on 0116 2653685

*Free on-site parking is available.

Frequently Asked Questions

01. How long do anal fissures last?

Anal fissures can be acute or chronic. Fissures that do not heal within 8 weeks are referred to as acute anal fissures, whereas those that last longer than 8 weeks are referred to as chronic anal fissures. While non-surgical treatment can treat acute fissures, surgery is the preferred treatment method for chronic anal fissures.

02. How do you know if you have an anal fissure?

Severe pain and bleeding bowel movements are the most common symptoms of an anal fissure. It is important to get yourself examined by a doctor if you suspect you may have an anal fissure. This helps rule out other critical conditions that also present with similar symptoms.

03. What is the best treatment for an anal fissure?

The treatment option with the lowest chance of fissure recurrence is surgery. For mild and acute cases, lifestyle modifications and dietary changes may suffice. Other non-surgical treatments, like creams and ointments, can also be helpful. To treat advanced cases, surgery is preferred. It is important to speak with a doctor to determine the severity of your condition and choose a suitable treatment plan.

Related Blog

{"cpt":"blog","style":"1","columns":"3","show":6,"from_category":["anal-fissure"],"order":"DESC","orderby":"none"}