Anal fissures, that is, cracks in the anus, cause increased anal spasm. The patient feels severe pain during defecation and is afraid to go to the toilet. It delays going to the toilet. The water content of the stool decreases and becomes solid as it waits. It becomes harder and more painful to pass this stool. This vicious circle goes on. The aim of anal fissure treatment is to break this vicious circle at some point. There are two types of muscle groups around the anus. The inner one of these works involuntarily. The patient cannot control this muscle. In fissures, this muscle becomes thickened and hardened. Additionally, passing feces through here increases this. In fissure treatment, procedures are performed on this muscle.
Anal fissures generally occur on the back wall of the anus. This area is the most vulnerable and weakest area against trauma. There is a bone structure in the back. Hard stool causes tearing here as it passes. Most cracks are acute fissures. It gets better in a short time with diet treatment and some precautions. If the complaints last more than 3-4 weeks, chronic fissures are mentioned. Spontaneous recovery should not be expected in chronic anal fissures unless anal spasm is eliminated.
Diagnosis is easy in chronic fissures. There is a vertical slit in the rear wall. Fibers of the inner muscle are usually seen on the floor of the fissure. In addition, a hypertraphic papilla is seen on the anal skin at the base of the sentinel fissure. This papilla is formed as a result of the swelling of the sweat glands there.
The most common cause of fissures is chronic constipation. On the contrary, long bouts of diarrhea may also cause this. Apart from these, a diet devoid of fibrous foods, constant use of laxatives, pregnancy and birth, sexual contact through the anus, and insertion of various foreign substances into the anus are also reasons that cause fissures. Anal fissure is a disease seen at all ages. Cracks seen in babies are generally acute cracks and can be easily corrected with simple measures.
The most obvious symptom of cracks is pain during and after defecation. This pain is in the form of burning and tearing. It may last for hours after defecation. Apart from this, there may be bleeding from the fissure floor from time to time. This bleeding is not much. It is seen as smeared on the napkin. Apart from these, most Swelling in the skin fold due to infection and anal itching due to discharge may be observed.
The aim of the treatment of anal fissures is to eliminate the spasm that has occurred in the internal sphincter. There are surgical and non-surgical methods for this.
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