Most people, at some point, have experienced difficulties in the comfort room in terms of bowel movement. The two most common of these are constipation, infrequent and difficult excretion of hard stool, and diarrhea, frequent excretion of soft and watery stool. Both of these are too common that they are often ignored, but even as they are opposites, they may cause a disorder called anal fissures. An anal fissure is a tear in the skin of the anus caused by trauma. This trauma is usually due to large and hard stools or stress on the anal canal lining.
Having an anal fissure is very painful and uncomfortable. The pain may be felt during bowel movement and afterwards, lasting for hours. Aside from this, blood may appear on the stool and the anus may be itchy.
Anal fissures can appear in anyone. Age and gender does not matter. There is no higher or lower ratio for its occurrence in men or women, although it is found to be more common in young adults.
As the name suggests, an anal fissure appears in the anus. When a hard stool passes through the anal canal and it is too large for the opening to handle, it causes the skin in the area to get torn, thereby forming a fissure or a linear crack. In most cases, this tear appears in the middle posterior area of the canal, meaning at the back of the anal canal that is closest to the spinal cord. According to statistics, 90% of people having fissures, men and women alike, acquire them at this location. The reason for this is because the group of muscles in the anus, called anal sphincter, is weak at this point.
The anal sphincter is the part of the anus that provides support to the canal where stool passes. Because it is oval in shape, the density of muscles are at the lateral (left and right) sides of the canal. It is therefore more probable to have fissures anteriorly (front) and posteriorly (back). Most anterior fissure cases occur in women who acquire it after giving birth. This situation makes up about 10% of cases in women with anal fissure. On the other hand, fissures appearing anteriorly in men are only at 1%.
Although posterior location of anal fissures are most common, there are cases where they appear on the lateral sides. This is not caused by stress on the anus by the stool passage, however, but by the presence of diseases such as infectious diseases, HIV, and cancer in the anus, among others.
Anal fissures are usually very shallow and only on the surface of the skin, as in a paper cut. But in cases where it is prolonged and deepened due to slow healing, it could reach the sphincter muscles and get prolonged due to spasms of the internal sphincter. This is the chronic stage of fissures and would typically require medication or surgery.
Fissures are generally easy to treat through changes in diet while at the acute stages. So in order to save oneself from excruciating pain, money, and going through the knife, it is best to identify and treat them at the onset.
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