What’s an anal fissure?
Anal fissures, like most other anal problems, are often misunderstood as hemorrhoids. An anal fissure is a tear in the thin outer lining of the anus while hemorrhoids are engorged blood vessels located within the lower rectum and the anus. Although the two conditions seem similar, they generally have different causes and also anal fissure have different medicine. Hemorrhoids are caused by repeated pressure in the anal and rectal veins, whereas anal fissures usually occur as a result of trauma to the anal canal. Any wear or tear or scratch of the anal lining is an anal fissure.
The signs and symptoms of an anal fissure include
- Severe pain during and after bowel movements
- Bright red blood on stool or toilet paper after bowel movements
- A visible crack in the surrounding skin of the anus
- Irritation or itching in the anal area
- A small lump in the skin around the anus
There are two types of fissures: acute and chronic. Acute fissures only require a bit of self-care and heal quickly (within 4 to 6 weeks) while chronic fissures persist beyond 8-12 weeks. Chronic fissures are also associated with raised edges, exposed internal sphincter muscle, scar tissue formation and an external skin lump associated with the tear.
Causes of anal fissures
Anal fissures are thought to initially start as an acute tear that may be due to: constipation and straining, trauma during child birth, anal intercourse, foreign objects, and persistent diarrhea. This anal tear causes a lot of pain resulting in spasms of the anal sphincter muscle. These spasms reduce the blood flow to the site of injury thus hindering healing and recovery. Subsequent bowel movements cause more pain, which incites more anal spasms and the vicious cycle continues. Anal fissures are also associated with inflammatory bowel diseases (Crohn’s disease and ulcerative colitis), sexually transmitted diseases (HIV, syphilis or herpes), anal cancer or tuberculosis.
Who is affected by anal fissures
Anal fissures occur among people of all ages and have equal distribution among both genders. Most people have acute fissures which tend to heal by themselves and with self-care in around 6 weeks. It is quite common that people assume it is piles and try and treat is as such, and consequently do not get the desired results.
Anal fissures medicine
There are several natural treatment possibilities out there. You can buy treatment oils, creams aid etc and there are also several home remedies that you can apply. Read it through and apply the best suitable for you. You must also not forget that you need to check and apply correct nutrition and also exercise practices. To support your body in the healing process.
When you have an anal fissure, your ultimate goal is to reduce the pain and discomfort and heal the tear. As mentioned above you need to treat the right condition. There are special oils that are specially formulated depending on the condition you have. We have put together a guide on how to choose the correct treatment oil, it covers Anal Fissures, Hemorrhoids, and Bleeding hemorrhoids.
You can read it here.
Natural home remedies:
If are good in kitchen and want to mix your own treatment aid, then these following natural remedies have been proven to be effective for dealing with anal fissures.
Olive oil, Bees Wax, and Honey:
A healing and soothing salve made from olive oil, beeswax and honey has antibacterial as well as therapeutic properties without any adverse side effects.
Here is how to make the salve:
1. Add some beeswax to a microwaveable bowl.
2. Warm the beeswax in the microwave for a few seconds till it melts completely.
3. Add equal amounts of olive oil and honey as the beeswax to the bowl and stir till they combine well
4. Allow the mixture to cool then apply it on the affected area
5. Repeat several times daily
Aloe Vera has been used for thousands of years on wounds, buns and other skin conditions for its healing properties. Aloe Barbedensis is a good species of Aloe Vera with proven healing action.
For a most effective treatment, it is best to use fresh Aloe Vera in order to treat yourself. You can use it as a suppository or as a salve. For the suppository, you simply cut away the green and yellowish bitter outer layer until you are left with the clear meat of the plant. Cut a piece of a desired length or width and insert it into your rectum. You can freeze the piece and wrap it in cellophane to make it easier to insert. You then leave it in till your next bowel movement here it will exit naturally and then put in another piece.
For the salve, you can just off scrape the clear meat into a gel and apply it on the affected area. You should apply it several times a day.
A sitz bath is a warm, shallow bath that is used to help with the relaxation of the anal muscles. It can be used to promote daily hygiene too but it is used effectively to aid the healing of minor tears in anal tissue, and reducing pain, swelling and itching.
You can buy a sitz kit from your local drug store which you use over your toilet. You can also use your bathtub.
Here is how to perform a sitz bath:
1. You should ensure the bathtub is cleaned first. You can do this ideally by using 2 tablespoons of bleach to one gallon of water.
2. Fill the tub with 3 to 4 inches of warm, not hot, water.
3. Soak your bottom for around 15 to 20 minutes. Try bending your legs or dangling your legs over the sides of the tub to ensure the anal area is well soaked. Be careful not to rub the area, just let it soak.
Coconut oil will effectively keep your anal sphincter well moisturized. This will prevent further damage and allow the tea to heal faster on its own. Coconut oil also has some healing properties and has been known to be used by natural healthcare practitioners to treat bedsores and other skin lesions. It is best to apply the coconut oil throughout the day and before bed.
Lifestyle and dietary changes
In order to heal the fissures, it is important to treat the underlying cause which is usually constipation. We can do this by implementing the following changes:
Drinking More Water
A simple way to ease chronic constipation is to increase your daily water intake. Dehydration can lead to constipation. When you eat, the food travels through your digestive tract from the stomach into the colon. If you are dehydrated, the colon absorbs the water in the food. This leads to hard stools that are difficult to pass. This may make your fissures much worse and prevent them from healing despite the remedies that you are using.
In order to prevent dehydration, it’s important to watch the amount of water you drink, listen to your body and drink more water than the recommended daily amount when you exercise or when it is hot. You should let your body guide you as to how much water you need. It’s generally recommended for all people to ensure they drink 8 glasses of water per day. Nevertheless, this could still be more or less depending on your dietary needs or medical conditions.
Increasing Dietary Fiber Intake
What should you eat
If you are otherwise healthy, increasing the amount of fiber you consume will help ease your constipation. Dietary fiber is simply the edible parts of plants that cannot be digested. Some of the fiber is soluble in water while the other is insoluble. Soluble fiber slows down digestion which helps you absorb more nutrients.
Foods with high levels of soluble fiber include: dried beans, rice bran, barley, oats, oat bran, citrus fruits, strawberries, apples, peas, and potatoes. Insoluble fiber, on the other hand, adds bulk to your stool helping it to pass faster through your tract. This is the kind of fiber you need to ease constipation. It is found in foods such as: wheat bran, whole grains, cereals, seeds, and the skins of many fruits and vegetables. Read more.
Prunes contain a chemical called sorbitol which acts as a natural laxative. They also contain high levels of both insoluble and soluble fiber with 1 cup containing 12g grams of fiber.
If these foods do not aid in constipation, you should try foods that contain psyllium seed husk, bran, and methylcellulose or try fiber supplements. These products increase stool weight and have a laxative effect. This prevents the food from staying in your tract for long hence less water is absorbed for softer stools. Dietary fiber as well as drinking a lot of water is very likely to get rid of constipation.
Exercise works to help gravity speed along the digestion process. It also increases blood flow to the intestines which helps increase the rate of digestion. By improving your blood flow and circulation, exercises will also promote faster healing of the anal fissures. Generic moderate-intensity exercises such as taking a walk or swimming for half an hour should help you speed up healing.
There are also specific kinds of exercises that work very well to relieve anal fissures:
Yoga is getting increasingly popular as it not only keeps you fit but also provides relief for many medical conditions. Several yoga poses are of particular relevance to those with anal fissures. The Trikonasana and Ustrasana poses stimulate the abdominal organs and help alleviate constipation. Other poses like Dhanurasana are useful for easing digestion and promoting bowel movements. Contact a yoga trainer for proper instruction on how to perform such poses.
This exercise promotes blood flow to the anal area to speed up the healing process. It also soothes the area to provide relief from pain. To perform a bath exercise, first fill a tub with warm water then sit within the water. While your anus is completely immersed, contract your anal muscles then relax them completely as if pushing out stool. Repeat this cycle every three minutes while in the tub and perform exercise thrice a day for maximum relief.Good bowel habits
Some people have a tendency to ignore the urge to have a bowel movement. This could be due to the location that you are or because of pain from the anal fissure. This makes the stool harder which leads to constipation and that can make the fissure worse or prevent healing. Having a schedule can help you get into the habit of having a bowel movement at a specific time of the day, say in the morning just after waking up.
This also goes hand in hand with having a proper hygiene routine. The chemicals in the stool might aggravate the anal fissures. It is therefore important to make sure the anus is very clean at all times. It is important to gently clean and dry yourself avoiding irritants such as scented soaps or wipes. This helps promote the healing of anal fissures.
In case the methods above are not effective, there are other methods that you can use. These methods have side effects that are both short-term and can cause life-long complications. It is therefore advisable to proceed with caution where they are concerned
There are many medications your doctor may prescribe to help in the healing of anal fissures.
Your doctor may prescribe a bulk adding laxative for an adult to soften stool. Osmotic laxative solutions are prescribed to children to help by adding water to the colon to soften the stool. Laxatives have side effects and it is important to consult with the doctor on how and the duration that should be taken. Some side effects include allergic reactions, poor absorption of other drugs and slowing down of natural bowel movements.
Your doctor may prescribe painkillers if bowel movements become too painful. It is important to follow the instructions and dosage to prevent any other complications
Glyceryl trinitrate (GNT)
If symptoms persist for over two weeks, the doctor may prescribe GNT. This is an ointment that is applied directly on the anus usually two times a day.
GNT works by increasing blood supply to the anus. This helps speed up the healing process. The ointment also helps to reduce pressure to the anal canal which helps reduce the pain. It is usually used for 6 weeks. 7 out of 10 patients with chronic fissures are treated successfully with GNT. However, headaches and dizziness are a common side effect of the drug. Children and pregnant or breastfeeding women cannot use the drug.
Your doctor may prescribe a topical anesthetic to reduce the pain. The ointment numbs the anus so you can take a bowel movement regularly. The most common topical anesthetic is lidocaine. It is applied directly on the anus before a bowel movement.
Calcium channel blockers
These are type of medication used to treat high blood pressure patient. They are successful in treating fissures when applied topically on the anus. They work by relaxing the anal sphincter and increasing blood supply to the fissure to promote healing. Calcium channel blockers are usually used for a duration of 6 weeks. However, they have a number of side effects such as headaches, dizziness, itching and burning.Botulinum toxin injections
These are usually used as a last resort after other medications fail. The injections help numb and relax the anal sphincter. This should help the fissure heal. It has not yet been established how effective this treatment is.
If the anal fissure is not taken care of and healed medical treatment – surgery is recommended. There is, however, a 30% risk of bowel incontinence after the surgery.
There are a number of techniques used with the most common being a lateral sphincterotomy. It involves making a small cut in the ring of muscle surrounding the anal sphincter that helps reduce the tension in the sphincter. It is an effective and simple surgery with a high success rate. There is the risk of minor incontinence which last for a few weeks.
Another procedure is the advancement of anal flaps. This involves taking tissue from another part of the body and using it to repair the fissure. It helps increase blood flow which promotes healing. It is mostly recommended for long-term chronic patients with anal fissures caused by pregnancy or an injury to the anal sphincter.
Tere are several ways how to approach Anal Fissures treatment. Most important is give it rest, by avoiding the cause and apply treatment to get it healing and avoid ending having to go for surgery.
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