What is an anal fissure?
A crack/tear in the anal canal is called an anal fissure. Although usually small they are often associated with considerable discomfort (bleeding, pain, burning, itching). Maximum pain is usually related to bowel movement. If bleeding occurs, it is usually in small quantities of fresh pink blood, which always stops immediately after bowel movement. Anal fissures are common with both children and adults. Although anal fissures can be very uncomfortable, it is not a serious or dangerous condition.
What causes anal fissures?
The most common cause is constipation and prolonged diarrhea. Stress can be related to anal fissures. Often no obvious cause is detected.
In the presence of a fissure, the sphincter reacts by contracting (spasms), which may aggravate the pain further.
How is anal fissures treated?
Warm sitz baths with bathing oils for 20-30 minutes 1 time daily for 14 days is considered beneficial. Use a bathtub or a tub. The bath warms up and relaxes the muscles. Baths also soften and clean the surroundings of the anus and enhances blood flow in tissues and thus increases healing.
Treatment with cream / gel for up to 2 months may be necessary. It is important that the cream or gel is introduced 1-2 cm into the anal canal 2 times daily. You will receive a prescription following the examination.
Stool adjustments. The stool should be soft and easy to get rid of. Drink rich amounts of fluids, use fiber supplements and exercise daily (read more about constipation on this homepage). Mild laxatives available over the counter at pharmacies can be used as needed.
Avoid painkillers with codeine (It worsens constipation).
What if the treatment doesn’t work?
During treatment, the symptoms will usually disappear gradually. If the symptoms reappear immediately after ended treatment, the treatment has not been effective. Pause for a few weeks and possibly try the above treatment again.
If the above treatment does not get fissures to heal, it may be necessary to proceed to Botox injection or a small incision into the sphincter - (both treatments takes place at a hospital).
Anal fissure prevention?
The only effective preventive measure is to avoid constipation (high fluid intake + high fiber diet + daily exercise). You can get more information about stool adjustments and proper diet on this homepage and the homepage of the Danish Food Administration (danish language) www.altomkost.dk.