An anal fissure is a longitudinal tear of the perianal skin distal to the dentate line , often due to increased anal sphincter tone. Anal fissures are classified according to etiology e. They are typically very painful and may present with bright red blood per rectum hematochezia. Anal fissures are a clinical diagnosis based on history and examination findings. Management is primarily conservative, and includes stool softeners, analgesia , and possible local muscle relaxation; because of the risk of incontinence, surgical intervention is a last resort.
Chronic Anal Fissures - Clinical Evidence Handbook - American Family Physician
Author disclosure: Richard L. Nelson has received fees from the American College of Physicians for web-based education modules. He is also the author of references cited in this review. Chronic anal fissures typically occur in the midline, with visible sphincter fibers at the fissure base, anal papillae, sentinel piles, and indurated margins. Anal fissures are a common cause of anal pain during and for one to two hours after defecation.
Chronic Anal Fissures
An anal fissure is a small tear in the thin, moist tissue mucosa that lines the anus. An anal fissure may occur when you pass hard or large stools during a bowel movement. Anal fissures typically cause pain and bleeding with bowel movements. You also may experience spasms in the ring of muscle at the end of your anus anal sphincter.
In most cases, anal fissures are a result of hard stools or constipation, as well as injury. Anal fissures can be acute lasting less than six weeks or chronic more than six weeks. A small percentage of these may occur at the anterior midline. The diagnosis of an anal fissure is primarily clinical. Several treatment options exist, including medical management and surgical options.