A fissure refers to a cut or tear that occurs around the anus region, and it is characterized by pain during bowel movements especially the rectum. The pain can be more severe and is coupled with itchiness and bleeding. The fissures appear along the specialized tissues that line the anal canal referred to as anoderm.
Globally, fissures are approximately responsible for 6% to 15% of rectal surgeon visits. It is the predominant cause of rectal bleeding in infancy, and common causes of anal fissures include long bouts of constipation, childbirth and straining bowel movement
Anal fissure often heals naturally within a few weeks just like other small skin cuts and tears. However, they can recur easily. There are various approaches to healing fissures which are broadly classified into self-help and medicated remedies.
Self-help remedies include the following;
Drinking enough water
It is pretty simple, but it makes tremendous change and improvement in the overall body health. Water is crucial to making the body hydrated. The common approach of ensuring consumption of adequate water is observing “The 8×8 Rule” meaning, drinking at least eight ounces of water eight times a day. If you unable to drink water which I understand can be difficult to drink, including myself. I could never really drink 8 glasses of water and I tried. If you can, then you should, but if you can’t, then drink your favourite juice or beverage. Avoid alcohol, but the point is get liquids into your body.
Your body takes about 2 months to get used to the liquids you are taking, so keep taking as much liquid each day and avoid stool softners as they are in theory not good for your body and it is not good to take unnecessary medication anyway.
Using soft toilet paper after a bowel movement
Use of soft toilet paper to wipe after a bowel movement is a great way to ease the pain as compared to using abrasive ones. The softer the toilet paper, the better for the fissure as it ensures minimal disturbance to the healing fissures.
Increasing fibre intake
Minimal intake of fibre may lead to constipation which is a major cause of anal fissures. This leads to strenuous bowel movements due to the unnecessary excessive force exerted around the anus. Dietary fibre is found in high quantities in foods such as fruits, wholegrain, and vegetables. These foods have the ability to relieve and prevent constipation. The following table illustrates the recommended daily fibre intake.
|Age 50 years and below||Age 51 and older|
|Men||38 grams||30 grams|
|Women||25 grams||21 grams|
Exercise is vital in promoting cardiovascular health which in turn helps the heart in pumping sufficient blood to various body organs. Walking, stretching, yoga and canoeing are good in healing anal fissures as they promote good blood flow to the anal area since it does not get as much blood supply compared to other areas. However, biking, sports that require a lot of running, heavy weight lifting and all other exercises that cause straining should be avoided.
Using Glyceryl trinitrate
This is an ointment applied to the anal canal twice a day. This medication is recommended especially if the symptoms do not improve within two weeks. It works by increasing blood supply to the fissure and expanding blood vessels around the anus. This helps in reducing pressure around anal canal and helping it heal faster. The ointment should be applied for at least six weeks. It is documented that acute fissures will heal using Glyceryl trinitrate treatment and around seven in every ten chronic fissures respond to the ointment if used correctly.
Botulinum toxin injections
This medication is relatively new and used in cases where others have not helped. Botulinum is poisonous but safe when used in small doses. The medication helps by paralyzing the sphincter muscle after injection which prevents spasming hence reducing pain and allowing the fissure to heal. Although it is not very clear how effective the medication is for anal fissures, research has shown it was helpful in more than half the people it was administered to.
The Lateral sphincterotomy procedure involves reduction of tension around the anal canal by making a small cut in the sphincter. This helps in healing and reduces the probability of developing more fissures. The operation is done under a general anesthetic on a day patient basis
This remedy is one of the most successful treatments of anal fissures with an excellent track record of success, and most patients heal within two to four weeks
Advancement anal flaps
This procedure is recommended in treating chronic anal fissures that are mostly caused by injury to the anal canal or pregnancy. It involves transferring a healthy tissue from another body part and using it to repair the fissure. This helps in improving blood circulation to the fissure.
Calcium channel blockers
They are majorly used in the treatment of high blood pressure. However, once applied directly to the anal canal has proved helpful in treating people with anal fissures. This medication works by relaxing the sphincter muscle hence increasing the blood supply to the affected region.
There are side effects that are associated with the use of Calcium channel blockers which can include dizziness, headaches, and itchiness especially the area applied. The side effects are expected to disappear once the body gets used to the medication.
Stephanie Hill is the Chief Editor of Healthy Fixation and blogs regularly on various blogs and health and fitness topics. Stephanie provides personal advice on the latest health news and recommendations on health related issues and products.