An anal fissure is a cut or tear in the lining of the anus. The crack in the skin causes severe pain and discomfort. When this cut starts to fill back, when the pain and discomfort go away, This is the sign of fissure healing.
About 90% of the anal fissure heal with home remedy while 40% of the long-term anal fissure heal after surgical treatment. Essentially, if the anal fissure does not heal after more than 4-5 weeks with home remedies or any medication, you need to consult a doctor.
You may have to go through the complete process that includes – knowing the cause of fissure, diagnosis or tests to know the underlying causes if any, what are your symptoms of anal fissure and what is the possible course of treatment for anal fissure in your case. Let us go through the stages of fissure healing in this blog to understand how to heal fissure fast.
What happens in anal fissure?
Anal fissure is a common anorectal problem where there is a tear in the anus from where the feces are excreted. A lot of people go through this problem but are embarrassed to discuss it with the doctor and sometimes the condition is misattributed with piles. Therefore, the reported number of anal fissure cases are less.
Stages of fissure healing involve softening the stool, avoiding constipation and practicing good hygiene. Both men and women are susceptible to anal fissure at any age, usually young adults.
There are two types of anal fissure:
Acute anal fissure
It goes away within 4-5 week with or without treatment. It is common and appears in the anus with visible edges.
Chronic anal fissure
It does not go away on its own or with home remedies even after weeks. Chronic fissure needs surgical treatment as without treatment it may persist for years.
Anal fissure can also be divided into primary and secondary fissure. Fissure due to an injury such as childbirth or constipation is primary. While fissure caused due to underlying conditions such as Crohn’s disease or ulcerative colitis is secondary fissure.
What causes anal fissure?
Anal fissure can occur due to trauma to the anal canal or anal penetration. The bowel area gets stretched while passing stool which further hinders the healing. Injury can be due to :
Straining during bowel movement or chronic constipation
Anal fissure is primarily due to constipation. Factors contributing to constipation can be:
- Low fiber diet
- Insufficient water or liquid intake
- Strong medication or painkillers
- Ignoring the urge to defecate
- Sedentary lifestyle
- Depression or stress
- Excess spicy or junk food
Excessive pressure during childbirth
Postpartum anal fissure is very common. During pregnancy, women often experience constipation due to baby weight that puts excessive pressure on the rectum.
Other causes might be:
- Inflammatory Bowel Disease (IBD) such as Crohn’s disease
- Reduced blood flow to the anorectal region
- Tight anal sphincter muscle
- History of anal surgery
- Intercourse or entrance of foreign object into the anus
There are very less chances that anal fissure can be due to:
- Anal Cancer
Once you get a tear, bowel movements afterwards results in more pain, more anal spasm, continuously reducing blood flow to the affected area can interrupt the healing of fissure.
What are the symptoms of anal fissure?
Pain due to anal fissure is quite severe. The symptoms of anal fissure are:
- Sharp pain and burning during bowel movement that may last for several hours
- Itching in the anal region
- Blood in stool
Some less common symptoms are:
- A sentinel pile that develops at the edge of the anus
- Anal sphincter muscles go into spasm due to pain and make condition worse
- Abscess or boil near the anal region can also cause fissure
How much time does it take for fissure to heal?
To heal fissure fast, some people opt for surgery which helps them recover in a week’s time. They can get back to their daily routine in a week. Whereas people who opt for home remedies or over-the-counter medicines for fissure, it may take 5-6 weeks to heal a fissure.
What is the method to diagnose anal fissure?
A doctor examines the area around the anus. However, he/she may perform a rectal examination to confirm the diagnosis.
The doctor may use an endoscope in case of chronic fissure to look for the underlying causes. Otherwise, the tests may include:
- Anoscopy: The doctor inserts a thin, flexible tube with a light and camera attached at one end into the anal canal.
- Sigmoidoscopy: The test is similar to anoscopy but also includes examining the lower colon.
- Colonoscopy: This is similar to the above procedure but also examines the entire colon. The procedure checks for the underlying causes such as IBD.
Anal fissure is often misunderstood for hemorrhoids or piles due to several common symptoms. This may result in some undetected and untreated conditions. Therefore, expert advice is important in such cases.
Who all are at risk of anal fissure?
A fissure can affect anyone. Usually, it is most common among infants, young children and adults. In old age, the blood flow to the anorectal area is often poor, which results in anal fissure. Pregnant females and new moms are also under high risk of getting anal fissure due to excessive straining during their last few weeks of pregnancy and childbirth.
People with a persistent or history of Inflammatory Bowel Diseases or IBD are also at a high risk of developing anal fissure. In this condition, the inflammation in the inner side of the intestinal lining makes the skin and tissues around the anal area much more susceptible to developing fissure.
Patients with frequent complaints of constipation are likely to develop fissure at some point.
How to heal anal fissure?
Stages of healing fissure depend on the severity starting from home remedies, over-the-counter medicines and ointments and finally surgery when nothing works.
Home remedies to heal a fissure
Short term anal fissure can be treated with home remedies. There are various measures that you can do at home to heal anal fissure fast. They include:
- First thing you have to do is prevent constipation to get out of the vicious circle. To prevent constipation you can :
- Drink plenty of water or liquid
- Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fiber
- Exercise regularly for blood flow to the affected area
- Talk to the doctor and take laxatives or supplements if necessary
- Go to the washroom when you feel the urge to defecate
- Sitz bath can be very relaxing to aid pain and itching. Sit in warm water for 15-20 minutes after every bowel movement.
- Use over-the-counter medicines and ointments carefully and as prescribed by the doctor.
- Follow washroom hygiene properly.
Medicines and Ointments to heal a fissure
To heal anal fissure fast, there are some medicines in the market that provide relief from pain.
It is a prescription ointment which you can apply before going to the toilet. This is used for short term as it may cause skin irritation.
It helps in treating itching, swelling and pain in the anal regions. Consult a doctor before use because it has side-effects such as skin thinning.
You can talk to the doctor and take a painkiller for pain relief. Avoid opioids as they cause constipation.
Stool softeners or laxatives
Anal fissure can heal fast if the stools you pass are soft enough. Fiber-rich fruits and vegetables are best stool softeners or else talk to the doctor for supplements.
Calcium Channel Blocker (CCBs)
It is majorly associated with the healing of chronic fissure in a lot of cases. The ointment includes diltiazem and nifedipine that help in muscle relaxation. The side-effect of this medicine is that patients notice a drop in their blood pressure.
These non-surgical measures will help provide relief from pain and bleeding and, potentially, heal acute fissure with virtually no side effects.
But doctors recommend surgery to heal chronic fissures for which he/she will be explaining the benefits and side-effects of each of the treatments for anal fissure.
Surgery to heal fissure fast
When a patient does not respond to home remedies or medication, surgery becomes necessary.
Botulinum toxin or botox, when injected into the anal sphincter, temporarily paralyzes muscles for up to three months. This may be done without anesthesia. Botox treatment may result in temporary, mild anal leakage of gas or feces.
Lateral internal sphincterotomy
This procedure aims to relax the anal sphincter. The surgeon makes a cut in the muscle to loosen the anal muscles. Thus the blood supply is improved resulting in quick healing. The recovery time varies from person to person in sphincterotomy.
The laser surgery for anal fissure is done under local anesthesia. The procedure uses the diode laser which vaporizes the pathological tissue of anal fissure. The laser removal of the fissure is a very effective and efficient process. It is the most modern technique to treat anal fissure. Laser surgery is the perfect alternative for the other conventional methods to heal fissure fast. Advantages are:
- Less operation time
- Daycare or outpatient procedure
- Go back to a normal routine within a day or two
- Great surgical precision
- Faster recovery
- Significantly less postoperative pain
- Less recurrence rates
- Anal sphincter is well preserved (no chances of incontinence/ fecal leak)
Complications of anal fissure may include
- Chronic anal fissure: If the crack does not heal over time then it can cause extensive scar tissue around the fissure.
- Incontinence: This may be post-surgery consequences to treat chronic fissure.
- Anal fistulas: If anal fissure is left untreated or the treatment is not effective, it can complicate the condition and develop anal fistula.
- Anal stenosis: In this condition, the anal canal narrows abnormally either due to spasm of the anal sphincter or contraction of the resultant scar tissue.
How can you prevent anal fissure?
There are different stages of anal fissure but there are ways to prevent it. Hence, you can reduce the risk of getting anal fissure by taking the following measures:
- Keep the anal area clean and dry
- Cleaning the area gently with warm water and non-scented soap
- Eat fiber-rich food
- Drink enough water
- Treat diarrhea immediately
Pristyn Care doctors are dedicated to ensuring high-quality patient care by advancing the prevention and management of disorders and diseases of the colon, rectum and anus. Moreover, for any medical assistance regarding fissure healing, you can call us or make an online consultation for help. We have some of the highly experienced and acclaimed surgeons who can precisely take care of such conditions.
Therefore, if you have any query, or need more clarification, feel free to contact us. We are always happy to assist you.