What is an anal fissure?
An anal fissure is a small tear in the lining of the anus. It may cause pain, bleeding or itching.
What causes an anal fissure?
A hard, dry bowel movement may cause a tear in the anal lining, resulting in a fissure. Other causes of a fissure include diarrhea, inflammation of the anorectal area or spasms of the anal musculature.
Will a fissure heal up by itself?
About 50% of anal fissures heal, either by themselves or with the use of a medicated cream or ointment. Stool softeners and sitz baths (soaking the anal area in plain warm water for 15-20 minutes) may also be helpful.
What can be done if a fissure doesn't heal?
A persistent anal fissure should be re-examined to see whether a definite reason exists for lack of healing. Such reasons may include scarring or muscle spasm of the internal anal muscle. Those which continue to cause pain or bleeding can be corrected by surgery.
What does surgery involve?
This usually consists of a procedure which cuts a portion of the internal anal muscle. This does not interfere with the ability to control bowel movements. The procedure usually can be performed in an outpatient setting without requiring an overnight hospital stay.
When would I be able to return to work after surgery?
There is minimal discomfort for a few days which can be easily controlled with mild pain medication. Many people miss only a day or two of work.
How long will it take to heal after surgery?
Complete healing usually occurs in a few weeks with pain often disappearing after two to four days.
Will the problem come back again?
More than 95% of patients who require surgery for this problem have no further trouble from anal fissures.
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