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Fissures What is an Anal Fissure? An anal fissure is a small tear, which looks like an ulcer, in the lining of the anus which can cause pain, bleeding and/or itching. What Causes an Anal Fissure? A hard, dry bowel movement can cause a tear in the anal lining, resulting in a fissure. Other causes of a fissure include diarrhea and inflammation of the anorectal area. Fissures can also be caused by increased spasms of the anal sphincter. How Can a Fissure Be Treated? At least 50 percent of fissures heal either by themselves or with non-operative treatment, including application of special medicated cream, use of stool softeners, avoidance of constipation, and the use of sitz baths (soaking the anal area in plain warm water for 20 minutes, several times a day). What Can Be Done if a Fissure Doesn't Heal? A fissure that fails to respond to treatment should be re-examined to determine if a definitive reason exists for lack of healing. Such reasons can include scarring or muscle spasm of the internal anal sphincter muscle. Those which continue to cause pain and/or bleeding can be corrected by surgery. What Does Surgery Involve? Surgery may consist of a small operation to remove the fissure and the underlying scar tissue. Cutting a portion of one of the anal muscles helps the fissure to heal by preventing pain and spasm, which interferes with healing. This cutting of muscle is more like thinning hair. The chances of losing control of bowel movements after this operation are minimal. This is sometimes done in conjunction with removal of hemorrhoids. This is usually done on an outpatient basis and is done under some local or regional anesthesia. How Long Does the Healing Process Take after Surgery? Complete healing occurs in a few weeks, although pain often disappears after a few days. Will the Problem Return? More than 90% of patients who require surgery for this problem have no further trouble from fissures. Can Fissures Lead to Colon Cancer? No! Persistent symptoms need careful evaluation, however, since conditions other than fissure can cause similar symptoms. |
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