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Anal Fissures

more about Anal Fissures




Normal

Abnormal
  • This is a cut (ulcer or Laceration) inside the anus.  The usual cause is trauma to the anus because of a strained bowel movement, hard bowel movement, or high internal sphincter tone (the area that allows stool to pass stays tense, obstructing proper passage).

  • Severe tearing pain during a bowel movement
  • Throbbing pain in anus following a bowel movement
  • Blood on toilet paper or around the bowel movement

  • Constipation
  • Constant irritation from stool in diapers of babies or constant wiping in all others
  • Scratching due to infections (e.g., pinworm) or skin conditions (e.g., dry skin, Eczema)
  • Straining
  • High internal sphincter tone (explained above)

  • Visual inspection by physician

  • Sitz baths
  • Fiber supplements
  • Stool softeners
  • Topical anesthetics (Mesalamine suppositories)
  • Topical nitroglycerin Ointment (this is at 10% the strength used for angina) -- relaxes the internal sphincter
  • Botulism toxin injection -- also relaxes the internal sphincter
  • Partial lateral internal sphincterotomy -- the sphincter is partially cut in order to relax it


  • Tests That May Be Done
    1. Anoscope
    2. Flexible Sigmoidoscopy





more about Anal Fissures


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