ANAL FISSURE (TEAR IN THE MOIST TISSUE (MUCOSA) OF THE ANUS)
An anal fissure is a painful tear usually occurs at the posterior wall of the anus. These lesions can be classified as acute and chronic. Acute fissures are the ones healing rapidly in 1-2 weeks, while fissures persisting or recurring in periods of more than 6-8 weeks are considered chronic.
Anal fissures can occur at any age but they mostly affect young adults in the age range from 20 to 40 years, impairing their quality of life. Gender distribution is not significantly different.
Dietary changes (reduction of fiber quantity in diet), inappropriate defecation habits, constipation, and diarrhea may induce anal fissures.
WHAT ARE THE COMPLAINTS?
The predominant complaint in anal fissure patients is pain. The pain is described as sharp, a tearing sensation, and felt as if cut by a knife or broken glass. It typically begins after defecation and continues for about 1-2 hours. Fresh red bleeding may accompany pain during defecation. Fissures may cause wetness and itching sensations, too.
HOW IS DIAGNOSIS MADE AND TREATMENT CARRIED OUT?
Diagnosis is usually made based on the patient’s history and physical examination findings.
A thorough physical examination will reveal findings of chronic fissures. Endoscopic examination methods should be used when there is a suspicion of inflammatory bowel disease and cancer.