Here is what you need to know about an anal fissure
A tear in the tissue lining of the anal canal is termed as an anal fissure. The tear and break in the tissue lining can cause severe pain resulting in bleeding when a person is having a bowel moment. A person suffering from anal fissure experiences blood in stools. An anal fissure can be both acute and chronic and can occur at any age. An acute anal fissure doesn’t need medical intervention and heals quickly as they are superficial. However, a chronic anal fissure does not heal for more than a month and tends to have deeper cuts, requiring medical attention.

Causes
There are a plethora of causes that can lead to anal fissure. Some of the common causes include:

• Chronic constipation and diarrhea can often tear the skin in and around the anal area.
• Straining during childbirth or bowel movements can also lead to episodes of an acute or chronic anal fissure.
• An anal fissure could also be the result of decreased blood flow to the anorectal area and overly tight or spastic anal sphincter muscles.
• It could also be a result of inflammatory bowel disease (IBD), such as the Crohn’s disease.

In some rare cases, an anal fissure may develop due to anal cancer, HIV, tuberculosis, syphilis, and herpes.

Symptoms
The primary symptoms of an anal fissure include anal itching and anal pain. Apart from this, a person suffering from an anal fissure also experiences localized pain during bowel movements. Blood in the stools can also be noticed in cases of chronic anal fissure.

Diagnosis
A doctor usually diagnoses anal fissure by simply examining the anal area. However, they will perform a thorough rectal examination to confirm the diagnosis. The rectal examination involves inserting an anoscope inside the rectum to see the extent of the tear. The thin medical instrument allows the doctor to inspect the anal canal. Anoscopy also helps to identify the causes of anal and rectal pain, such as hemorrhoids. In some cases of rectal pain, the patient needs an endoscopy to better evaluate the symptoms.

Treatment
Most cases of an acute anal fissure don’t require extensive treatment. However, a person experiencing chronic cases of anal fissure may find relief and encourage healing through the use of a sitz bath. A sitz bath is a warm, shallow bath to cleanse the perineum (the space between vulva and scrotum). It also provides relief from itching and pain in the genital area. Apart from this, over-the-counter (OTC) stool softeners, drinking more fluids, taking fiber supplements, and eating more fibrous fruits and vegetables may also be helpful. Some doctors also recommend applying nitroglycerin ointment promoting blood flow in the anorectal area and other creams to soothe the inflammation in the area. Applying topical pain relievers to the anus also eases the discomfort.

Another possible treatment for an anal fissure is the use of botox injections in the anal sphincter. Botox injections are inserted near the anal area to prevent spasms and temporarily paralyze the muscle, and this allows the anal fissure to heal and prevents new fissure from forming.

If the symptoms are not relieved within two weeks of the treatment, it is recommended to see a specialist for further evaluation so that he or she may diagnose the condition correctly and recommend other treatment options.