An anal fissure, or an anal fissure, is a rupture of the mucous membrane of the rectum of different depths. There are anal fissures in those people who lead a sedentary life or suffer from chronic constipation.
Anal cracks are diagnosed in 18% of patients who are handling discomfort in the rectal area. They are more common in women of reproductive age.
The anal fissure itself, the symptoms and treatment of which we consider, may be an independent phenomenon that has arisen as a result of the influence of various traumatic factors. However, much more often, painful defects of the rectal mucosa and epithelium in the anus are associated with various concomitant diseases( abnormalities in the gastrointestinal tract, peptic ulcer of the stomach or duodenum, internal and external hemorrhoids).
Causes of anal fissure are usually associated with injuries to the rectum or other diseases, such as hemorrhoids, constipation. The appearance of a mucosal defect in the anus area is promoted by the
same factors as in hemorrhoids:
- Trauma of the anal canal of the anal canal , which occurs when passing through a hard dry stool during constipation. Prolonged stretching of the anal canal leads to traumatic damage to its posterior wall, especially in men. This zone of the anal canal has anatomical prerequisites for the formation of cracks, since the muscles of anal pulp converge here. In women, the weak point of the anal canal is its anterior part, where the vulva, vagina and crotch center converge. Therefore, cracks in the anterior part of the anal canal are more common in women. On the side walls of the anal canal, cracks occur rarely.
- Diseases of the digestive system - various colitis, gastritis, peptic ulcer, hemorrhoids can lead to the formation of cracks in the anus. As statistics show, the anus crack is present in 95% of patients suffering from inflammation of the hemorrhoids.
- Cardiovascular system and associated diseases( congestion in the pelvic and rectal regions, thrombophlebitis, obliterating atherosclerosis, aneurysms, vasculitis, etc.).
- Chronic diseases of the upper gastrointestinal tract ( gastritis, cholecystitis, gastric ulcer, duodenal ulcer).
- Pregnancy and childbirth - the pressure of the growing uterus on the internal organs, including the large intestine, leads to problems with defecation, as a result of which the future mother may have anal fissures. It is not uncommon for this pathology and in young mothers - the appearance of cracks in the anus is facilitated by the perineal ruptures obtained during labor.
Do not hope that the newly formed defect of the mucosa will heal by itself, especially if the patient does not change anything in his way of life and nutrition. Moreover, an acute crack( acute it is considered the first 4 weeks of its existence) can go into a chronic one, which lasts for months and takes the patient out of a state of physical and mental balance.
If a person in time turned to a specialist, then to treat the crack in the anus at home ointments or candles are prescribed, and only in the neglected case they offer a surgical operation. Microcracks can be several millimeters, and deep ones reach two centimeters.
Symptoms of an anal fissure
When an anal fissure occurs, the most important and primary symptom is pain and minor bleeding( see photo).Unpleasant sensations persist after defecation, with itching and burning. Over time, spasm of the sphincter can join them. Such signs are observed at any stage of the disease.
However, if the acute wound can heal in a few weeks without special treatment, then the chronic crack does not close very long. Pain with prolonged stays in a sitting position, constant discomfort causes fear of defecation. As a consequence, constipation appears, which only worsens a person's condition. The patient becomes irritable, there are violations of sleep.
Anal fissure in children
Children suffer from cracks to a lesser extent than adults, but similar symptoms can occur even in the baby. If a child is confronted with the disease, it is very important to begin treatment in a timely manner so that the crack does not go into chronic form, and does not provoke a lot of complications.
Do not treat a child at home. Folk remedies can only relieve symptoms, unlike medications.
Over time, the acute form of the disease can flow into the chronic stage, especially when improper care of the wound or use of incorrect medicines. Most often, a fissure of the anus in women after labor is acquired, which is also explained by regular changes in the body of the newly-born mother.
Pain in chronic form brings suffering not only during defecation or after a long sitting, but also at any forced uncomfortable position, walking. To the itching, discomfort and bleeding added panic fear of the toilet.
The patient increasingly resorts to laxative drugs, enemas, suppositories, thereby aggravating the process. Possible development of insomnia and increased irritability.
Complications of anal fissures include:
- Acute paraproctitis( if infection occurs through a defect in the mucous membrane of the rectum in the surrounding fatty tissue).
- Severe pain. As a rule, pronounced pain syndrome with anal fissures is explained by an anal sphincter spasm.
- Colitis( inflammatory disease of the inner shell of the large intestine)
- Prostatitis( inflammatory lesions of the prostate gland)
- Excessive bleeding
- Fistulas of the rectum
The proctologist can easily detect an anal fissure even at the stage of routine examination,mucous membranes are broken If the chronic rectal fissure is located inside, a finger examination is performed
So the proctologist can determine its size, feel the edges.yes, there are problems with palpation, then the rectomomanoscope is inserted into the anus, this device allows you to examine the rectum at a depth of twenty centimeters. If necessary, colonoscopy, irrigoscopy is prescribed
How to treat an anal fissure
If the cause of this problem is any disease,then its treatment is necessary, since cracks in the anus can not be cured without eliminating the cause of their appearance.
In addition, when starting anal fissure treatment, it should be clearly realized that no funds will be effective enough if the patient suffers from constipation. Solid feces will injure the anus, so the wound will be difficult to heal, and new cracks can appear periodically. Therefore, all patients need to follow a diet recommended for constipation.
The choice of a way to combat such ailment in a particular case is determined by the proctologist after a preliminary examination, depending on the clinical manifestations and the nature of the disease.
The anal channel cracks are treated in the following ways:
- The medical method is the use of medications to achieve an analgesic effect and healing of a crack in the passageway. The course of treatment depends on the degree of the disease, is carried out by the patient independently at home.
- The minimally invasive method of is laser removal of a crack in a hospital.
- The surgical method of is also performed in the hospital, performing laser and sphincterotomy removal.
Begin, of course, with the conservative. It can include such activities:
- Take warm baths 2-3 times a day for 10-20 minutes. Thanks to this procedure, the muscles of the anus relax.
- Treatment of the anal area with petroleum jelly.
- Prevention of constipation. To do this, you need to consume more fluids, fruits, vegetables or after consulting a doctor to take a laxative.
If these measures do not bring the desired effect or need to be obtained more quickly, you can resort to the use of ointments and suppositories.
Candles and ointments from cracks in the anus
As medicamental agents, special candles or ointments from cracks in the anus are most often prescribed. They can remove the spasm of the internal anal sphincter.
- Ichthyol suppositories;
- Glycerin Suppositories;
- Candles with Calendula;
- Betiol with belladonna;
They usually contain some kind of analgesic, which alleviates pain in the anus.
Wound healing and anti-inflammatory suppositories:
- Relief( contain shark liver oil that has anti-inflammatory, hemostatic and analgesic effects);
- Propolis. To prepare the medicine, you should grate it on a fine grater, mix with butter, warm to dissolve. After the preparation of the liquid solution, the preparation merges into the candle shaped candles;
- Methyluracil. Suppositories with this component have a good wound healing effect;
- Natalside is an anti-inflammatory drug for the treatment of anal fissures, which does not contain hormonal components. Can be used during pregnancy;
- Posterizan. This preparation contains inactivated bacteria of the intestine, as well as the products of their vital activity. The drug increases the immune defense and has an anti-inflammatory effect;
- Hepatrombin T - rectal suppositories for stopping rectal intestinal bleeding with analgesic and anti-inflammatory action;
Witch hazel( homeopathic remedy on a plant basis).
They help to cure rectal fissures and prevent the appearance of complications.
Elimination of constipation and softening of the stool
Making the stools softer and the stools daily, one of the main reasons for the crack around the anus can be eliminated. Medications that ease defecation are divided into the following groups.
- Means, increasing the volume of intestinal contents of : plant based on agar or psyllium( Naturolax, Mukofalk, Fiberlex), based on cellulose( Fiberal, Fibercon).
- Polyhydric alcohols : Dufalac, Normase, Lactulose( a standard that does not irritate the intestines), Sorbitol, Macrogol, Lactiol( see all laxatives).
- Softening ( Vaseline and Sea Buckthorn Oil, Norgalax).At home, if there are problems with the anal sphincter, counter microclysters are used 10 minutes before emptying( 100 ml of pasteurized sunflower oil and 200 ml of boiled water at room temperature).
Some folk remedies can be used to treat an anal fissure at home. They will help to remove the inflammation, and reduce the intensity of pain.
- To relieve pain, use a candle made from ordinary potatoes. It is cut out in the form of a suppository from a tuber, inserted into the anal canal, held overnight. Then it comes out when the bowels are empty. To enhance its therapeutic effect, you can dab before use in honey or oil, for example, sea buckthorn. The course is 10 candles.
- If the crack goes deep into the anal canal, you can use curative microclysters. For example, mix 30 ml of sea buckthorn oil and infusions of chamomile flowers, gently in a warm form inject the mixture into the anus with a syringe and hold until enough patience. The procedure should be done before bedtime for 2 weeks.
- Candles. For their preparation you will need cones of hops( 8 pieces), unsalted lard( 0.5 kg), St. John's Wort( 3/4 glass of grass), 1.5 cups of boiling water. Hops and St. John's wort must be boiled, insist for 3 hours, wrapped in a warm cloth. Infusion to infuse.
Sitting baths are also very effective. They help to immediately remove local swelling, pain and help in healing the wound. For such trays you need infusions of herbs. The basis is taken all the same: chamomile, sporish, calendula, St. John's wort, oak bark, immortelle. The water must be warm at the same time, and the duration of the procedure is at least 20 minutes.
Proper nutrition and diet
The diet for an anus in the fissure should promote a regular stool, make the stool masses soft and not cause stagnation of blood in the rectum.
- It is recommended that a person drink 1.5 - 2 liters of water every day, which also makes the stools softer. A daily intake of fermented milk products gives a lax effect.
- It is necessary to refuse bread from white flour, as it slugs the intestine, as well as from spicy seasonings, smoked and pickled products, alcohol, especially high fortress.
- It is desirable that the basis of the ration is vegetables and fruits. They contain coarse fiber( dietary fiber), which helps digestion.
Surgical treatment of
In some cases, extensive and difficult to heal anal fissures require surgical intervention for effective treatment. Several effects are used. The most common operations are called lateral internal sphincterotomy.
During this procedure, the doctor makes a tiny incision and separates certain layers of the sphincter muscles. This allows you to prevent muscle spasms, which leads to complete elimination of tension during bowel emptying. The method of suturing the walls and excising the mucous membranes, which are affected by scarring and sclerosing, is also used.
How long does it take to treat an anal fissure?
The duration of anal fissure treatment in adults depends on the severity of the disease and the chosen therapy regimen.
Non-surgical treatment of a crack using diet, hygiene procedures and medications at home can help alleviate the symptoms of the disease in a few days and lead to complete recovery in 4-8 weeks.
The complexity of the surgical treatment of the anal fissure and the length of the postoperative recovery period depend on the degree of development of the disease and the type of surgery performed.