Causes of an anal fissure;
1. Passing large or hard stools
2. Constipation and straining during bowel movements
3. Chronic diarrhoea
4. Anal intercourse
However, there are also some less common causes of fissures like inflammatory bowel disease, anal infections, tumours, anal cancer, HIV, tuberculosis, syphilis etc.
Treatment of an anal fissure
However, not being a very serious medical issue, an anal fissure does not last for months if steps are been taken to keep the stool soft or avoid having constipation. This is done by drinking lots of water at the same time, soaking in warm water for 10 to 20 minutes several times a day, especially after bowel movements, can help to relax the sphincter and promote healing.
After applying all these remedies if the symptoms persist then one can opt for the medical treatment.
1. Application of Ointments
Applying anaesthetic creams likelidocaine hydrochloride (Xylocaine) can provide relief from pain and anal irritation.
2. Application of Nitroglycerin
This is one of the most effective medical treatment as it is usually opted when all other treatment fails. It aids to increase the blood flow to the fissure and promote healing that in turn helps in relaxing the anal sphincter.
3. Application of Botulinum toxin type A (Botox) injection
These injections are used to paralyze the anal sphincter muscle and relax spasms in order to reduce the pain.
Sometimes an anal fissure, get worse and demands for a surgical treatment. The surgery is usually opted to relax the anal sphincter muscle in order to reduce the pain and spasms, allowing the fissure to heal. Lateral Internal Sphincterotomy (LIS) is a surgical procedure which is considered very effective and is usually performed by cutting a small portion of the anal sphincter muscle to reduce spasm and pain and promote healing.
It generally takes 6 to 10 weeks for proper healing of the patient who has gone through any medical or surgical treatment. At the same time, it is important to maintain good bowel habits and eat a high-fibre diet for avoiding hard stool. The continued hard or lose bowel movements will scar, or spasm the internal anal muscle which can delay the healing process. Fissures can often come back whenever there is a hard bowel movement or trauma to the anal canal.
Anal fissure and colon cancer
Anal fissures not being a much serious medical issue does not increase the risk of colon cancer nor cause it. In fact, people suffering from colon cancer may develop anal fissures. However, more serious conditions can cause similar symptoms.