Anal fissure refers to a tear in the lining (anal mucosa) of the anus. An anal fissure is a tear or split in the lining of the anus (anal mucosa). It can cause pain when you pass bowel movements and bright red blood from your anus.
This problem affects approximately eight in ten babies under one year old. As we age, our susceptibility to anal fissures decreases. Constipation and trauma (such as difficult childbirth) are common causes.
About half of cases can be healed by themselves if they are treated properly and avoid constipation. If the pressure from passing bowel movements constantly opens the fissure, it can make healing difficult. Surgery is an option.
Anal Fissure symptoms
Anal fissure symptoms may include:
- Anal pain
- Pain when passing a movement and for some time afterwards
- Bright red blood from anus
- Blood on the stool’s surface
- Toilet paper stained with blood
Role of the anus
The Anus allows bowel continence. This is voluntary control of the passage and movement of bowel movements. Peristalsis is a process whereby waste is moved down the length of the large intestine through waves of muscular contractions. The rectum is temporary storage for the waste after it has been removed from excess water. The rectum connects to the anus. This is a tube that contains a muscular ring (sphincter). It can be opened at will to permit the expulsion (poo) of faeces. The anal mucosa is the membranous lining in the anus. An anal fissure refers to a tear in anal mucosa.
Anal fissure: Causes
The following are some of the possible causes:
- Chronic constipation
- Passing a hard, dry stool
- After passing a motion, excessive or rough wiping of your anus diarrhoea
- Inflammation of the anus or rectum
- Crohn’s Disease
- Scratching (for example, as a reaction to pinworm disease) anal injury
- Cancer of the rectum
Can Anal Fissure Cause Cancer?
Anal fissures are often thought to cause cancer. However, it is almost never true. Anal fissures are a simple condition that is just a cut in anal area. Although there are many symptoms associated with anal fissures, they do not cause long-term health problems. However, anal fissures can recur regardless of how well they are treated.
Anal Fissure Complications
Anal fissures don’t usually cause more serious diseases like bowel cancer. However, cancer of the anus can mimic an anal fissure. Anal fissures can lead to complications such as:
- Chronic anal fissure: The tear does not heal. This can lead to scar tissue (sentinel pile) at the fissure site.
- Anal fistulas are abnormal ‘tunnels’ that connect the anal canal with surrounding organs.
- Anal stenosis is when the anal canal becomes abnormally narrowed due to contraction of scar tissue or spasms of the anal valve.