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This is a cut (ulcer or laceration) inside the anus. The usual cause is Trauma to the anus because of a strained bowel movement, a hard bowel movement, or high internal sphincter tone (the area that allows stool to pass stays too tense to allow proper passage).
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- Severe tearing pain during a bowel movement
- Throbbing pain in anus following a bowel movement
- Blood on toilet paper or around the bowel movement
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- Constipation
- Straining
- High internal sphincter tone (explained above)
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- Visual inspection by physician
- Tests:
- Anoscope
- Flexible sigmoidoscopy
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- Sitz baths (baths in a warm tub of water)
- Fiber supplements
- Stool softeners
- Topical anesthetics (Mesalamine suppositories)
- Topical nitroglycerin ointment (at 10% of the strength used for angina) -- relaxes the internal sphincter
- Partial lateral internal sphincterotomy or excision of the fissure
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- Thrombosed external hemorrhoid
- Solitary rectal fissure
- Cancer of the anus
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