Join Now!      Login

Whole Person Wellness Program
 
healthy.net Wellness Model
Skip Navigation Links
 
 
FREE NEWSLETTER
   
   
   
 
Health Centers
Key Services
 
Vitamin D Poll
Are you currently taking a Vitamin D supplement?
Yes
No



 
 
 What Doctors Don't Tell You: Anal fissures 
 
What Doctors Don't Tell You © (Volume 13, Issue 5)
Q I’ve been experiencing pain after going to the toilet, and I’ve also noticed blood on the toilet paper. A friend thinks I could have anal fissures. Can you tell me what these are, and how they might be treated? - MS, Huddersfield

A An anal fissure is an ulcer in the tissue which lines the anal canal, which runs from the rectum to the anal opening. The ulcers are thin, elongated tears. They are fairly common, especially among young - and otherwise healthy - people. In acute cases, the fissure develops quickly, and heals almost as fast. A chronic case lasts for longer than a month or so, and recurs. A chronic fissure often develops when a healed fissure tears every time the sufferer defecates.

Fissures affect both sexes equally, and are common in children, too. Some fissures, usually those that occur in the front wall of the anus, appear in women who have given birth, while children who have strained too hard to defecate can also develop them. It has been estimated that up to one-third of all women suffer either haemorrhoids or anal fissures after giving birth (Dis Colon Rectum, 2002; 45: 650-5).

Sometimes, a fissure can arise after anal surgery, such as for the removal of haemorrhoids, or as a result of ulcerative colitis, irritable bowel syndrome, Crohn’s disease or gonorrhoea. An anal fissure may also be caused, or worsened, by anal intercourse. In the main, however, they are caused by the passing of large or hard faeces, which tear off the tissue lining in the anal canal. The problem is often associated with persistent constipation.

The fissure usually begins as a scratch, which fails to heal because of repeated contractions and stretching of the orifice. The tear can cause severe pain during and after bowel movements, and may become infected. Some sufferers may delay going to the toilet because of the pain. This, in turn, can cause further drying and compacting of the faeces, thus worsening the condition.

The main symptom is pain during or after bowel movements, sometimes persisting for several hours. Pain can also occur when any pressure is placed on the anal area, such as when sitting on a chair. Sometimes the pain stops for days or weeks at a time.

Bleeding can occur during or after bowel movements. Often, the sufferer believes they have haemorrhoids - usually because of the bleeding - when, in fact, they have a fissure. The tell-tale sign is pain during or after defecation.

Acute fissures are easier to treat than chronic ones. Sitz baths, suppositories and stool-bulking agents might be tried first, and hydrocortisone may be prescribed to reduce inflammation. However, one study found that sitz baths were of limited benefit. On analysing anal pressures before and after the bath, and comparing the results with those who didn’t have a bath, the researchers found no differences between the groups (Dis Colon Rectum, 1993; 36: 273-4).

Topical nitroglycerin ointment can provide pain relief, and so allow the anus to relax. In one trial of 80 patients, 68 per cent of those given glyceryl trinitrate ointment reported fissure healing within eight weeks compared with just 8 per cent who used a placebo (Lancet, 1997; 349: 11-4).

Although such studies have made topical glyceryl trinitrate a first-line therapy for chronic fissures, an Australian study was more circumspect. By questioning 31 treated patients, the study team found that just 15 of them could be said to be cured; symptoms recurred in four of them. Side-effects were reported by 21 patients, and two of these had effects so severe that they stopped the treatment (Dis Colon Rectum, 1999; 42: 1007-10).

CONTINUED    1  2  3  Next   
 Comments Add your comment 

 About The Author
What Doctors Don't Tell You What Doctors Don’t Tell You is one of the few publications in the world that can justifiably claim to solve people's health problems - and even save lives. Our monthly newsletter gives you the facts you won't......more
 
 From Our Friends
 
 
 
Popular & Related Products
 
Popular & Featured Events
Wellness Inventory Certification Training
     September 16-December 16, 2014
     Teleclass, CA USA
 
Additional Calendar Links
 
Stevia Products & Info
 
Dimensions of Wellness
Wellness, Eating, dimension!

Home       Wellness       Health A-Z       Alternative Therapies       Find a Practitioner       Healthy Products       Bookstore       Wellness Inventory
Healthy Kitchen       Healthy Woman       Healthy Man       Healthy Child       Healthy Aging       Wellness Center       Nutrition Center       Fitness Center
Free Newsletter      What Doctor's Don't Tell You      Stevia.com      Discount Lab Tests      First Aid      Global Health Calendar      Privacy Policy     Contact Us
Disclaimer: The information provided on HealthWorld Online is for educational purposes only and IS NOT intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek professional medical advice from your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.
Are you ready to embark on a personal wellness journey with our whole person approach?
Learn More/Subscribe
Are you looking to create or enhance a culture of wellness in your organization?
Learn More
Do you want to become a wellness coach?
Learn More
Free Webinar