Anal fissures

Definition

Small ulcer with a longitudinal lesion inside that is usually located in the anal mucosa near the anal orifice.

How does the disease occur?

Most anal fissures are of unknown origin, although chronic constipation is the factor most frequently associated with the appearance of an anal fissure.

Other possible associated factors are all those that involve irritation or injury to the anal mucosa such as prolonged acid diarrhea, trauma, chemotherapy, colorectal radiation therapy, anorectal surgery, inflammatory bowel diseases such as ulcerative or Crohn's colitis, intestinal tuberculosis, diverticulitis or tumors.

Symptoms of the disease

The anal fissure, depending on its size and location, can be asymptomatic.

When it is symptomatic, it can manifest itself in the form of:

Diagnosis of the disease

The diagnosis of anal fissure is made by the proctologist or general surgeon in the office of the medical center or hospital.

The diagnosis is based mainly on:

Treatment of the disease

The first treatment option for anal fissure is conservative treatment by:

Hygienic-dietetic measures such as: avoiding constipation with a diet rich in fiber or with the intake of increased stool volume. Sitz baths with warm water for 10-15 minutes after each bowel movement.

Pharmacological treatment such as: application of topical treatments based on ointments or creams that contain local anesthetics or anti-inflammatory drugs to treat pain. Local application of nitroglycerin ointments or local injections with botulinum toxin that relax the muscles of the anal sphincter, favoring the passage of stool and the healing of the fissure.

When the above measures fail or a long-standing fissure is treated, the only possible treatment is surgical treatment aimed at facilitating the relaxation of the anal sphincter or reducing its contraction to promote healing of the anal fissure.

Disease prevention

Hygienic dietary measures such as a correct diet, regular physical exercise, avoiding constipation and the consumption of spicy or toxic substances such as tobacco, increasing the intake of fluids that hydrate the stool and facilitate its expulsion and avoid the abuse of laxatives; They contribute to the healing of the fissure and to prevent its reappearance.

Glycerin suppositories can help pass unhydrated hard stools during periods of constipation.

Patients with disease that favors the formation of anal fissures should undergo regular medical supervision.

• Acute and severe anal pain with bowel movements (which can last from minutes to several hours) and slight bleeding at the end of the bowel movement.
  • Appropriate physical examination of the patient
  • Assessment of the symptoms that they present and their history of disease
  • Result of the complementary studies that are carried out, generally an anal inspection by rectal examination; an anoscopy or endoanal ultrasound to visualize the lesions.
  • Carrying out other complementary studies based on the findings found after the correct assessment of the patient to diagnose possible associated diseases.