A fissure that fails to respond to conservative measures should be re-examined. Persistent hard or loose bowel movements, scarring, or spasm of the internal anal muscle all contribute to delayed healing.
Petroleum jelly, zinc oxide, 1% hydrocortisone cream, and products like Preparation H can help soothe the area. Instead of toilet paper, use alcohol-free baby wipes that are gentler on the area. Sitz baths can help heal fissures and make you feel better.
Too much pressure, tight anal sphincter muscles, and poor blood supply to your anus may lead to their development and poor healing. Anal fissures don't usually give way to more serious problems.
The management of anal fissures
Advise the patient to increase dietary fibre and fluid intake to keep bowel motions soft. The importance of correct anal hygiene and the need to keep the anal area dry should be emphasised. Regular sitz baths (sitting in warm water up to the hips) can help to relax the sphincter.
Anal fissures often heal within a few weeks with appropriate home treatment. Take steps to keep your stool soft, such as increasing your intake of fiber and fluids. Soak in warm water for 10 to 20 minutes several times a day, especially after bowel movements. This can help relax the sphincter and promote healing.
Surgery If your fissure does not heal in four weeks or you have had your fissure for a long time you may need surgery. The surgeon will cut the fissure open in a procedure called a sphincterotomy. This will hurt initially but the fissure will be gone and probably won't come back.
Do fissures ever fully heal? Most acute anal fissures heal within a few weeks, similar to other minor wounds or cuts. Even 35% of chronic anal fissures heal, even temporarily. However, it is not uncommon for a fully healed fissure to recur after another injury or hard bowel movement.
Once a fissure develops, the internal anal sphincter typically goes into spasm, causing further separation of the tear, constricting blood flow to the area, impairing healing, and causing pain.
The exposed internal sphincter muscle beneath the tear goes into spasm. This causes severe pain. The spasm also pulls the edges of the fissure apart, making it difficult for your wound to heal. The spasm then leads to further tearing of the mucosa when you have bowel movements.
Engaging in 30 minutes of moderate physical activity, such as walking and exercising most days of the week, helps with anal fissures. Exercise regulars the bowel movements and increases the blood flow to most parts of your body, so it promotes the healing of an anal fissure.
Most anal fissures heal by themselves within six to eight weeks. There are a number of ways to help the fissure heal and to relieve your pain and discomfort. These include the following. Gradually increase the fibre in your diet up to 30g per day by including plenty of wholegrain foods, fruit and vegetables.
Fissures are usually caused by trauma to the inner lining of the anus from a bowel movement or other stretching of the anal canal. This can be due to a hard, dry bowel movement or loose, frequent bowel movements. Patients with a tight anal sphincter muscle are more likely to develop anal fissures.
Most anal fissures are idiopathic and are located in the posterior midline. However, some fissures may be associated with systemic diseases, infections or malignancy [1, 2]. Squamous cell carcinoma of the anus (SCCA) commonly presents with bleeding and anal pain [3].
An anal fissure that fails to heal within eight weeks is considered chronic and may need further treatment. Recurrence. Once you've experienced an anal fissure, you are prone to having another one.
Anusol Cream is a medicine which is used to relieve the swelling, itch and irritation of internal and external piles (haemorrhoids) and other minor ano-rectal conditions such as anal itching and fissures. It can be used post-operatively following ano-rectal surgery.
Drink plenty of water.
Hydration helps you avoid constipation. Take an over-the-counter stool softener to avoid hard, dry bowel movements. Keeping things flowing through your body can help you avoid fissures.
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.
Correct sleeping position for fissure
Our surgical gastroenterologists suggest wearing clean cotton undergarments and loose-fitting pyjamas when going to sleep. HOD also advises you to sleep on your stomach to reduce anal fissure pain and place a pillow under your hips.