Anal Fissures

Overview

An anal fissure is a tear inside the anal canal. It is a very common condition in infants with 8 out of 10 likely to have a fissure within the first year of life.

Causes

In both infants and adults anal fissures are typically caused by straining during a bowel movement especially after a period of constipation when a large hard stool is forced through the lining of the anal canal. Women who have recently given birth and people with Crohn's disease are at a higher risk. It is easy to get into a cycle as the anal fissure makes for a painful bowel movement and therefore the individual becomes constipated and the cycle repeats itself.

Symptoms

  • sharp or burning pain during or following a bowel movement
  • blood on the stool or toilet tissue
  • rectal itching

Treatment

Most anal fissures require no medical treatment and heal on their own within a few days. Stool softeners petroleum jelly an over-the-counter anesthetic ointment and/or a warm sitz bath may help. (A sitz bath is a type of bath in which only the hips and buttocks are soaked in water in an effort to promote healing.) Adults often find that what works for babies works for them; that is using "baby wipes" and a thicker zinc protective cream such as zincofax or penaten.

If your condition doesn't improve see your doctor. He or she may recommend a local injection of botox. The botox has a short term effect on the nerve supply to the affected part of the anus and so it is less likely to move and this speeds healing. For chronic fissures minor surgery may be required to relax the sphincter a muscle that closes the opening of the anus.

Prevention

You may be able to prevent anal fissures by maintaining good hygiene. Always change your baby's diaper promptly and keep the area around the bum dry. Adults should add fibre to their diet and avoid foods that tend to cause constipation. Drinking plenty of water allows the fibre to expand and will also help to keep stools soft.