ANAL FISSURE :DEFINITION , CAUSES ,CLINICAL FEATURES ,DIAGNOSIS & PREVENTION

DEFINITION :

Longitudinal tear in the lower end of the anal canal results in anal canal .It is the most painful condition affecting the anal region .commonly seen in young patients .

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CAUSES :

90% anal fissure occurs in the posterior part of the anal canal & 10% anal canal .It is hard stool initiated by hard stool causing a crack .Due to pain ,internal sphincter spasm takes place which  makes constipation worse resulting in a chronic fissure .Anterior fissures occur in elderly women secondary to repeated pregnancies .
Various factors involved : Hard faeces  , Ischaemia , Haemorrhoidectomy , Sphincter hypertonia , Crohn's disease etc , Repeated child birth .

                             

ANAL FISSURE

CLINICAL FEATURES :

1. Severe pain during & after defaecation ,burning in nature ,lasting for about 1/2 hour to 1 hour .
2. Severe constipation .
3. Stools are hard ,pellet like & there is drop of blood or streak of fresh blood .

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DIAGNOSIS :

1.When the buttocks are spread apart ,a longitudinal tear & hypertrophied ,thickened skin seen near the lower end of fissure .
2.Per rectum examination done & sphincter spasm can be appreciated .

PREVENTION :

1. Avoid constipation -encourage fibre diet ,mild laxatives ,not to postpone defaecation .
2. Sitz bath .
3. Surface anaesthetic jelly / cream .
4. Regular diet & regimen maintain.