Bleeding and pain (burning) while defecating or after defecating is often confused with hemorrhoids, but may correspond to the more characteristic symptoms of an anal fissure. This condition is largely unknown because it is a taboo subject that can generate embarrassment, however, it occurs in people of all ages, including children in early childhood, women who have given birth but mainly to people who suffer from constipation.
Here we explain how to identify a anal fissure and what are the risk factors you need to keep in mind to prevent it and/or consult in case you are suffering from it.
Anal fissure: what is it and how to detect it?
It is a small wound or tear in the mucosa of the anal canal. And although small, these injuries can cause disproportionate pain and significant discomfort, because the skin around the anus is exceptionally sensitive and full of nerve endings. Therefore, when it occurs, any movement or strain in the affected area can trigger a sharp, stabbing burning sensation.
These are the symptoms that will suggest an anal fissure:
- Rectal bleeding: the presence of bright red blood on toilet paper or in the stool is one of the most common signs. Often this bleeding is mild but can be alarming.
- Intense pain with bowel movement (anal muscle spasms)Involuntary spasms of the anal sphincter muscles may occur, which can worsen the pain and make the process of defecation even more uncomfortable.
- Itching, anal irritation and wet sensationAs a consequence of the fissure, there may be constant itching or irritation due to secretions in the area that generate perianal moisture.
- Sensation of incomplete evacuation: it is possible to feel that you have not had a complete bowel movement after going to the toilet, due to pain and muscle spasms.
Have you ever experienced any of these? The first thing you need to keep in mind is that you should not self-medicate. Anal fissures are presented in a primary way by some local traumatic phenomenon (large and hard stools, constipation, diarrhea, sex toys, excessive cleaning, etc.) but also by diseases that can cause them in a secondary way (Crohn's disease, cancer, tuberculosis, fungal infections or sexually transmitted infections, etc.); so it is essential to consult a specialist in coloproctology to have an accurate diagnosis.
However, in order to prevent this type of injury, it is essential to know the risk factors associated with this condition, which are as follows:
- Tension during chronic evacuation, often caused by constipation.
- Vaginal delivery due to the trauma that can occur during the procedure.
- Some intestinal diseases, if not properly managed, e.g., Crohn's disease.
- Cleaning the anal area excessively or forcefully.
- If you have had an anal fissure in the past, you have an increased risk of developing another one.
Types of anal fissure and how to treat it
As we mentioned before, self-medication is not recommended, since there are two types of anal fissure and each one has its own established treatment.
Acute anal fissure is a single episode of short duration (less than 6 weeks), which can be treated with conservative measures, such as changes in diet rich in fiber and abundant liquids, analgesic creams, warm sitz baths, and usually heal on their own in a short period of time. While the chronic anal fissurepersists for more than 6 weeks and may last for months or years. Its treatment is more complex, as it includes options such as specific topical creams, botulinum toxin injections and surgery.
In the Institute of Coloproctology ICO we are specialized in the diagnosis and treatment of anorectal diseases, so we are at your disposal to provide guidance and relief if you suspect you have an anal fissure. We will perform the necessary studies and based on the results, we will give you the appropriate management that will allow you to recover your quality of life.
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