An anal fissure is a tear in the thin mucosal tissue that lines the rectum. They occur most often in infants and toddlers due to straining associated with difficult to pass, hard stools but can occur in all populations. Other people that are more at risk of developing fissures are the elderly, post partum women, and those with irritable bowel disease.
Symptoms of a fissure may include:
- Bleeding during bowel movements
- Pain during bowel movements
- Spasms in the anal sphincter
Fissures are also strongly associated with constipation and anismus because those who have fissures often delay bowel movements in anticipation of pain and discomfort. Fissures develop often as a result of dehydration, which leads to constipation and hard stool that’s difficult to pass. Subsequent bowel movements are painful because of the fissure, so people are more likely to hold stool in, leading to a vicious cycle of harder, more painful stools, which can ultimately cause anismus.
A difficult to pass, hard stool that requires straining is the most common cause of anal fissures. Other factors that make an individual more susceptible to developing a fissure include:
- Slow circulation seen with aging, which decreases blood flow to the rectum
- Inflammation in the digestive tract, making the lining more prone to tearing
- Previous fissures
A rectal exam (doctor inserts a finger into the rectum to feel for physical manifestations) is the best way to detect and diagnose an anal fissure, as it can be felt and seen by the naked eye. Fissures can be a sign of other digestive conditions, such as Crohn’s disease, or IBD, and health history and symptoms are important in determining your risk for these conditions. Fissures that develop on the side of the anus are more strongly associated with Crohn’s disease as a result of intestinal inflammation.
Encourage Bowel Regularity
Preventing constipation and encouraging regular bowel movements are important steps in treating a fissure. The longer stool remains in the colon the harder it becomes and the more difficult it is to pass.
If you have a fissure, creating stool that is soft enough so it’s easy to pass is very important in not only allowing your fissure to heal, but also in preventing future fissures from re-occurring. Gutbliss experts recommend psyllium husk powder (or capsules), fiber, and increased water consumption to create soft, easy to pass stools.