Like any wound, anal fissures need proper care and treatment to promote healing. Though one may think that a fissure will just fade away on its own, it can sometimes worsen if neglected. An anal fissure can be caused by different things, so identifying the cause and acting on it will help prevent further incurrence of skin damage and speed up natural healing.
If a fissure remains untreated for a long time, complications may arise and healing will be more difficult. The following are the common complications that emerge from untreated fissures:
Bleeding – If a fissure sustains more damage, the skin tear will worsen and affect proximal capillaries or veins. This will cause mild to moderate bleeding, depending on the extent of the injury. This is especially true when a person is constantly passing hard or large stools and does not do anything about it. The use of emollients or stool-softening laxatives can help greatly in reducing strain during bowel movements to prevent further injury.
Infection – Fissures that are neglected can become infected, especially if bleeding is also present. The infection usually comes from bacteria in the stool and from any existing genital infections. The key to preventing infection is to clean the anus and perianal area thoroughly after every bowel movement and frequently during treatment applications. Proper treatment of other existing infections like bacterial vaginosis will also help prevent the infection from spreading to the parianal area. If infection occurs, it is usually managed and eliminated through antibiotic treatment. Anti-bacterial creams may be prescribed, as well as oral antibiotics for complicated skin infections.
Ulceration – Anal fissures can become ulcerated, especially chronic fissures that fail to heal within 7 weeks. Chronic fissures may deepen and the wound may reach the soft tissues under the skin, making it more difficult to heal. Ulcers can also form if an infection of the fissure is not treated right away.
Incontinence – When fissures become deeper, normal muscle control around the anal sphincter may weaken and cause incontinence. Incontinence is the inability to control the passage of urine or stool, which can cause feelings of shame and powerlessness in a person who suffers from chronic fissures. Incontinence usually develops when there are other neglected underlying disorders that have become complicated. It is also caused by ulceration of the fissures and severe pain when keeping the stool in.
Constipation – Complicated anal fissures may cause incontinence, but it may also cause constipation in some people. Constipation is the opposite of incontinence, but it is not a better or milder condition in any way. This may arise from the fear of defecating due to severe pain. When a person holds in the stool just to prevent the feeling of pain, the stool becomes impacted or tightly compact and will likely cause even more pain and tissue damage when it is passed. Constipation may also be caused by anal stenosis, where the anal canal becomes abnormally narrow. Stenosis can result from spasms in the anal muscles especially after a surgical treatment. The best way to prevent painful defecation is not to hold it in, but to use stool-softeners to make the passage of stool smoother and more bearable.
Frequent flatulence – Gas and bloating may occur when a person who has fissures take in too much fiber. This happens when the attempt to improve digestion and defecation is overdone out of the fear of straining and painful passing of stools.
The best way to prevent these complications is to attend to anal fissures properly. Obtaining medical care and undergoing tests for possible underlying disorders can make fissure healing a breeze.
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