Anal Fissure
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An anal fissure is a small tear or wound in the skin lining the anal canal. It is a common condition and can be very painful.
Common symptoms
The most characteristic symptom is intense, sharp pain during and especially after bowel movements, which may last for several hours. Other symptoms include:
- Bright red anal bleeding, usually noticed on toilet paper or on the stool.
- Burning or itching in the anal area.
- A small skin tag (sentinel hemorrhoid, fibroma, or skin “tag”) near the fissure if it becomes chronic.
Causes
The most common causes are related to trauma in the anal canal:
- Passage of hard or large stools.
- Chronic constipation and straining during bowel movements.
- Persistent diarrhea.
- Childbirth.
- In less common cases, it may be associated with such conditions as Crohn's disease.
Treatment
Initial treatment focuses on relieving symptoms and allowing the fissure to heal naturally. Acute (recent) fissures usually respond well to non-surgical treatments.
Hygienic-dietary measures.
Stool softeners and a high-fiber diet (fruits, vegetables, whole grains) to prevent constipation and reduce straining.
Specific creams or ointments with agents that relax the anal sphincter muscle.
Healing agents such as hyaluronic acid or Centella asiatica.
If a fissure does not heal after several weeks, it is considered chronic and may require additional treatments:
Botulinum toxin injections.
Surgery, performing a controlled section of a portion of the anal sphincter under local anesthesia.
It is important not to confuse an anal fissure with hemorrhoids or other conditions, so consulting a proctologist is recommended if symptoms persist.
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An accurate diagnosis is key to determining the most appropriate treatment in each case.
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