The fracture of the anal canal according to statistics ranks third among diseases of the colon( after hemorrhoids and colitis).More often referred to as an anal fissure, it is a longitudinal rupture or ulcer of the anus mucosa. Occurs as a result of rupture or fissure of the mucosa of the anal canal. The length of such a crack in most cases is about 1-1.5 cm.
This problem, like an anal fissure, can be acute( less than a month ago) or chronic( more than a month old and started to "malfunction").
- 1 Where does the anal fissure appear?
- 2 Possible causes of anal fissures
- 3 Characteristic signs of anal fissure:
- 3.1 Diseases that can accompany anal fissures:
- 4 Diagnosis
- 5 How to treat anal fissures
Where does an anal fissure appear?
- In 80-85% of cases( especially in men) it is located on the back median line( Figure 1), and this crack is also said to be on 6 hours of the conditioned dial( posterior anal fissure).Simply put, we can say that the overwhelming majority of cracks arise from the side of the coccyx - above, if a person is in a standing position.
- In 15%( according to other data in 6-9%) cases are characterized by localization of the anal fissure on the anterior median line( anterior anal fissure), in this case they say that it is on 12 hours of the conditioned dial. Sometimes anal fissure is located on the lateral line, but in this case it can often be a symptom of serious diseases: cancer, tuberculosis, syphilis, AIDS, or inflammatory bowel disease. The disease is most common in people aged 30-50.years.
Possible causes of anal fissures
- stiff stool;
- anal stress of the anal sphincter or spasm;
- birth injury( in women during labor);
- foreign body in the rectum;
- some types of examination using the input of a special device - anoscopy, rectoscopy, colonoscopy;
- blood flow disturbance around the anus.
Characteristic signs of anal fissure:
- bleeding and severe pain during defecation. In rare cases, pain can almost not be observed.
- degassing of gases;
- anal itching, sometimes unbearable;
- allocation from the anus, which some confuse with sweat;
- the presence of excreta, which can intensify after walking or running.
Diseases that can accompany anal fissures:
- stricture( narrowing) of the anal canal;
- fistula of the rectum( sphincter);
- sphincter fibrosis.
It is important to visit a doctor of the proctologist who excludes the possibility of other diseases of the rectum, among which is cancer. The diagnosis is based on symptoms and a proctologic examination, which includes a number of procedures. The first will be a visual inspection with a slow apart of the buttocks, and then an examination of the anus and rectum can be performed with the help of a finger( rectal examination).It is not so easy to conduct it, I take into account that the pain will force the patient to strongly compress the sphincter. In some cases, additional studies may be required, such as rectoscopy or anoscopy, which are performed when inserting into the anus of special instruments - the rectoscope and anoscope, respectively. This is necessary to exclude possible other diseases of the anus. In connection with severe pain, such studies are performed under general or local anesthesia.
How to treat anal fissures
The first measure is conservative treatment( no operation) with:
- diet, containing foods rich in fiber and eliminating acute, fatty, salty foods, alcohol, i.e. The one that irritates the mucous membranes and makes the stool harder;
- use a sufficient amount of fluid( at least 2-3 liters for an adult), otherwise a diet rich in fiber will be of little use;
- preparations of softening and thinning stools( if the diet does not help) - mild laxatives, preferably on a plant basis;
- ointments containing nitroglycerin or nifedipine;
- sitting in the bathroom with water at a temperature of about +40 C ° - this is very important, as it helps to remove the spasm of the sphincter, without which healing is almost impossible. This procedure should be done in the morning and in the evening, and even better after each bowel movement. The duration should be about 15-20 minutes;
- rectal suppositories, such as with belladonna extract( Ukrainian "beladoni"), with methyluracil, sea buckthorn, "Relief", etc.
If all these rules are observed, the acute anal fissure will be scarred in 1-2 months.
Conservative treatment sometimes also uses botulinum toxin, which helps reduce the internal sphincter of the anus and the healing of the anal fissure.
When conservative treatment does not work, surgical methods are used, for example, sphincterotomy - an operation during which an incision is made, which leads to a relaxation of the sphincter and a decrease in stress on the crack. In most cases, it is not accompanied by the occurrence of side effects in the future.