Introduction
Some health problems, such as anal fissures, hurt and interfere with the quality of your life. Tiny cracks in the lining of the anus may lead to stinging pain, bleeding, and soreness. Individuals suffer from this, more specifically, while having a bowel movement. Neglecting the issues can intensify the pain and cause difficulties while sitting or walking. Let us discuss the various remedies that are available to alleviate the pain and cure anal fissures successfully.
What is an Anal Fissure?
An anal fissure is a small tear in the lining of the anus. It causes pain, bleeding, and discomfort, particularly during bowel movements. The tear leaves exposed sensitive nerve endings that cause sharp pain and irritation. When the fissure occurs, the muscles in the anus can tighten, preventing healing.
Acute fissures (of less than six weeks duration) heal more quickly, whereas chronic fissures last longer than six weeks and may need medical intervention. Chronic fissures can become even more painful if left unmanaged and can prolong the healing process.
Are Anal Fissures Common?
Anal fissures are common in children and adults. It can also happen in babies. Some research indicates that one in five individuals have anal fissures during their lifetime.
- Anal fissures usually occur because of constipation, straining or passing hard stools.
- Dehydration, chronic diarrhoea, and low-fibre diets can also make you predisposed to get frequent anal fissures.
- Pregnant women and postpartum women are also at higher risk because the anal area is under pressure.
- Individuals with inflammatory bowel disease or reduced blood flow to the rectum also have a higher risk.
What are the Signs of an Anal Fissure?
Anal fissures result in several uncomfortable signs, including:
- Pain: Pain may occur during or after a bowel movement and usually lasts minutes to hours.
- Bleeding: You may find bright red smears on toilet tissue or in the stool.
- Irritation and swelling: The skin may become swollen, sore, or tender.
- Visible tear or crack: In some instances, a small cut can be seen around the anus.
- Itching or burning: Discomfort can build up when sitting for extended periods.
What Does an Anal Fissure Feel Like?
An anal fissure is a sharp, burning pain that you may experience during and after bowel movements. The pain can persist for minutes or hours, depending on the severity.
Less severe fissures cause transient pain and minor irritation, while bad cases bring intense, persistent pain that worsens with movement or pressure.
Some may have a persistent ache and cannot sit easily. The bare nerve endings in the tear increase sensitivity so that every bowel movement causes pain. The pain may become continuous and unbearable if nothing is done about it or if there is an infection underneath.
Anal Fissures Vs Hemorrhoids: How to Tell the Difference?
Most of the patients who have pain in the anal area do have one common question – how can I identify whether I have a haemorrhoid or an anal fissure? Although both occur in the anal area, they have distinctive features:
Anal Fissures
- Pain is usually at the anal opening and increases with bowel movements.
- Cause Sudden, severe pain with and after passing stool.
- You may see bright red streaks on the stool or toilet paper.
- There might be a visible crack or tear in the vicinity of the anus.
Hemorrhoids
- Internal haemorrhoids can bleed but do not usually hurt.
- External haemorrhoids produce itching, swelling, and discomfort.
- Thrombosed external haemorrhoids can create a painful lump on the anus.
Seek medical advice if pain, bleeding, or discomfort persists for several days. Immediate care is necessary if bleeding is severe or accompanied by dizziness. A doctor can provide an accurate diagnosis and rule out other serious conditions.
Main Reasons of Anal Fissures
Following are some reasons why you might develop anal fissure:
- Straining during a bowel movement: Forcing too hard to pass stools compresses the anal tissue, leading to tiny tears.
- Chronic constipation or diarrhoea: Hard stool stretches the lining of the anus, and frequent loose stools irritate it.
- Fissures caused by childbirth: Childbirth may overstretch the anal region, resulting in tiny tears.
- Inflammatory diseases: Crohn’s disease and other inflammatory diseases weaken the tissue of the anus, which can be susceptible to fissures.
- Poor circulation: Decreased circulation delays healing, making it more likely for the fissures to recur.
What are the Complications of Anal Fissures?
It is best to treat anal fissure in the early stages. Otherwise, it may cause complications such as:
- Recurring pain and chronic fissures: If not treated, acute fissures may become chronic, with persistent pain occurring with every bowel movement.
- Anal skin tag formation: Over time, chronic fissures can result in the development of excess skin, also called sentinel piles, around the region of the fissure.
- Infected fissures: Open fissures can serve as a breeding ground for bacteria, and they end up causing infections marked with pain, swelling, and discharge.
- Muscle spasms and delayed healing: Spasms in the anal sphincter brought on by pain from fissures decrease blood flow to the region, slowing down the healing process.
How to Cure Anal Fissure Permanently?
Anal fissures can be treated effectively and potentially cured through a mixture of lifestyle changes, regular treatments, and, when required, operative measures.
Home Remedies
Some of the home remedies that can prove helpful in the initial stages of anal fissure are:
- Warm Sitz Baths: Immersing the anal region in warm water for 10-15 minutes, several times a day, to soothe and facilitate healing.
- High-Fiber Diet: Eat fruits, vegetables, whole cereals, and legumes to soften stools and alleviate straining on passing stools.
- Hydration: Take sufficient quantity of water daily to ensure stools remain soft and constipation is avoided.
- Proper Anal Hygiene: Gently clean the anal region by washing the area with warm water and keep the area dry after every bowel movement.
- Avoid Straining: Avoid straining during bowel movements to avoid additional injury and facilitate healing.
- Limit Caffeine Intake: Caffeine is a diuretic, which may result in dehydration and firmer stools. Limiting caffeine intake will help to keep stools soft.
Medical Treatments
After a couple of days of treatment at home, if you fail to get pain relief in the anal area, you can get the following treatments from a physician:
- Topical Medications: Use prescribed creams or ointments to soothe the anal sphincter, ease the pain, and heal.
- Internal medication: Internal medications according to your symptom – pain or bleeding, can be prescribed by the doctor after proper diagnosis.
Ayurvedic Treatments
People with chronic anal fissures can avoid surgery if they seek ayurvedic treatments through professionals. At Chirag, we recommend:
- Dietary Adjustments: Emphasise easily digestible, high-fibre foods to prevent constipation and promote regular bowel movements.
- Herbal Remedies: Utilise Ayurvedic herbs to balance doshas and support digestive health.
- Kshara Karma Therapy: A minimally invasive treatment that involves the application of a specialised herbal paste to the fissure to facilitate healing.
- Panchakarma Therapy: Panchakarma Therapy offers a range of tailored treatments designed to accelerate the healing of anal fissures and effectively prevent painful sphincter spasms.
- Lifestyle Changes: Regular exercise, yoga, stress management, and proper sleep to aid overall digestive health.
When to Seek Surgical Intervention?
If non-conservative treatments cannot cure the fissure within 8 weeks, surgery might be required. Procedures such as lateral internal sphincterotomy require cutting a small opening in the anal sphincter muscle to decrease tension and allow healing.
Anal Sphincter Tone Optimization, a minimally invasive technique developed at Chirag Global Hospitals, normalizes tight sphincters without cutting. This is often combined with laser ablation to treat any infection in the anal glands beneath the fissures. Surgery is normally considered when:
- Severe and persistent pain persists despite non-surgical treatments.
- The fissure keeps returning.
- Conservative treatments fail for a long period of time.
- A consultation with a colorectal surgeon can assist in determining the best course of action based on personal situations.
Exercises For Those with Anal Fissures
Anal fissure pain can be alleviated through gentle exercises. These also facilitate the tightening of muscles surrounding the anus to prevent fissures. Some exercises which you can attempt are:
- Kegel Exercises: Contraction of pelvic floor muscles help tighten the anal area and reduce stress.
- Gentle Stretching: Enhances flexibility and circulatory supply surrounding the anal zone, releasing tightness.
- Walking: Improves overall circulation and stimulates normal bowel movements, decreasing inflammation and pain.
- Squats: Constrict muscles of the lower body and provide increased blood flow to the anal region, assisting pelvic floor function.
- Yogasanas : Certain yoga asanas, such as Pavanamuktasana and Vakrasana, can significantly improve gut motility. This enhanced movement helps prevent hard stools and reduces straining during bowel movements, creating a favourable environment for fissure healing.
Conclusion
Anal fissures hurt, but with proper care, they can heal quickly. Proper fibre intake, hydration, and regular bowel habits prevent straining of the anal muscles to prevent fissures. Sitz baths, topical care, Ayurvedic therapies, comfort symptoms, and surgeries help healing in severe cases. Gentle exercise increases circulation and muscle tone, helping recovery. Strict adherence to anal fissure treatment and lifestyle changes prevents recurrence and keeps the anus healthy in the long run.
