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Also known as an anal ulcer, an anal fissure is a small tear in the lining of the anus. It may occur for several reasons such as when passing hard or large stools. At Clemenceau Medical Centre Hospital, our General & Colorectal Surgeons are highly trained and equipped with the latest technology, placing them among the best anal fissure treatment doctors in Dubai. 

Symptoms of Anal Fissure 

Common symptoms of an annal fissure include: 

  • A visible crack in the skin of the anus 
  • A skin tag on the skin near the anal fissure 
  • Bright red blood on the stool or paper after a bowel movement 
  • Mild or sometimes severe pain during bowel movements 

Causes of Anal Fissure 

Some of the common causes of annal fissures include, but are not limited to: 

  • Passing large or hard stools 
  • Childbirth 
  • Chronic diarrhea 

Risk Factors of Anal Fissure 

The following are factors that may increase an individual’s risk of developing an anal fissure: 

  • Childbirth: Anal fissures are very common in women after they have a natural birth 
  • Constipation: Straining during bowel movement and passing hard stool increases the risk of tearing in the lining of the anus 
  • Age: As much as anal fissures can occur at any age; they are most common in infants and middle-aged adults 
  • Crohn’s disease: This is an inflammatory bowel disease that causes chronic inflammation of the intestinal tract. This may make the lining of the anal canal more vulnerable to tearing 

Diagnosis of Anal Fissure 

To diagnose an anal fissure, the doctor will most likely ask the patient about his/her medical history and perform a physical exam which will include a gentle inspection of the anal region. 

Because the tear is often visible, usually this exam is all that is needed to diagnose an anal fissure. 

Complications of Anal Fissure’s if Left Untreated 

Common complications of an anal fissure that is left untreated may include: 

  • Recurrence: An individual who has experienced an anal fissure is more prone to having another one 
  • Failure to heal: In most cases, an anal fissure that persists for more than eight weeks is considered chronic and may need further treatment 
  • A tear extending to surrounding muscles: An anal fissure may extend into the ring of muscle that holds an individual’s anus closed (internal anal sphincter). This will make it more difficult for the anal fissure to heal. 

Treatment of Anal Fissure 

If an individual takes steps to keep his/her stool soft by either increasing intake of fiber and fluids, soaking in warm water for 10 to 20 minutes several times a day, and many other measures, anal fissures often heal within a few weeks. However, if symptoms persist, an individual will likely need further treatment 

Non-surgical Treatment of Anal Fissure 

To treat an anal fissure conservatively, the doctor may recommend the following: 

  • Injection therapy – This paralyzes the anal sphincter muscle and relaxes spasms 
  • Externally applied ointment – This helps increase blood flow to the fissure and promotes healing and helps relax the anal sphincter 
  • Blood pressure medications – These include medications such as oral nifedipine (Procardia), which helps relax the anal sphincter 

Surgery for Anal Fissure 

For a chronic anal fissure, especially one that is resistant to other treatments, or if the patient’s symptoms are severe, the doctor may recommend surgery.  

A procedure called lateral internal sphincterotomy (LIS) is normally performed. The procedure involves cutting a small portion of the anal sphincter muscle so as to reduce spasms and pain and speed up the healing process. 

Prevention of Anal Fissure 

An individual may be able to prevent an anal fissure mostly by taking measures to prevent constipation or diarrhea. One should eat high-fiber foods, drink fluids and exercise more frequently.

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