What is “anal fissure”?
”Modern medicine considers anal fissure as a chronic ischemic ulcer, which is directly caused by local injury caused by dry stool and excessive force during defecation, followed by infection of the trauma surface to form a chronic anal fissure that is difficult to heal. The main symptoms are periodic anal pain during defecation, blood-stained toilet paper or blood attached to the surface of feces, vicious cycle of constipation and anal dampness and itching, and various local discomfort in the anus, which are divided into early anal fissures and old anal fissures. Most of the fissures that require surgery in the sense that conservative treatment is ineffective are chronic old fissures that are difficult to heal and have produced various complications.
Anal fissures are most common in young adults, and the disease is most common in young women between the ages of 20 and 40, with a male to female ratio of about 1:2.5.
Once an anal fissure occurs, almost all of them will become chronic if not treated in time, which will not only cause painful symptoms and affect the quality of life, but also lead to a series of complications that will complicate the surgery, increase the chance of postoperative complications, prolong the postoperative recovery time, and greatly increase the pain.
What kind of people are prone to “anal fissures”?
People with chronic constipation, dry stools and long defecation times often need to struggle hard to defecate, which can easily cause fissures in the skin and mucous membrane of the anal canal, so any factors that may cause dry stools are risk factors for anal fissures, such as the following.
①People with a diet that favors greasy, spicy, pickled, and heavily flavored foods
②People who love to drink alcohol or even long-term alcoholism
③Drink less water every day, the intake of water is not enough people
④ people who do not like to eat vegetables and fruits and consume less dietary fiber
⑤ long-term stay up late, work pressure, mental tension, resulting in poor living habits of the crowd
⑥People who are impatient and irritable, irritable and angry
How do I know I have “anal fissure”?
You should suspect that you have an anal fissure when you have the following symptoms.
The pain in the anus during defecation is severe, usually “sharp” pain such as cutting pain or stabbing pain, and the pain decreases and disappears within a few minutes to 10 minutes after defecation, which is the “pain interval”. Most of them can be gradually relieved by themselves; the pain during defecation can also last for a long time and then be relieved without any obvious interval.
Bleeding during defecation, bright red, usually not much, often with blood on the toilet paper or a small amount of blood dripping down or a small amount of blood on the stool.
The more you don’t defecate, the more intense the pain during defecation and the more difficult it is to pass stool, forming a “vicious circle”.
The swelling around the anus is often at the end of the fissure, which is the location in front of and behind the anus.
The area around the anus is moist, itchy, and has a lot of discharge, and you feel very uncomfortable.
“What are the dangers of anal fissures?
Pyramidal ulcers: Fresh fissures become uneven-edged, deep-bottomed, grayish-white ulcers after repeated infection and irritation.
Connective tissue external hemorrhoids: inflammation, congestion, and redness of the tissue around the fissure, resulting in obstruction of superficial venous and lymphatic flow, causing edema and connective tissue proliferation, forming superfluous external hemorrhoids, commonly known as “sentinel hemorrhoids”, which will gradually increase in size and affect local sensation and defecation if left untreated.
Anal papillitis, anal papillomegaly: There are 2-12 normal tissue structures called “anal papillae” in the anus, which cannot be seen or felt under normal circumstances, but when repeated hard stools, bleeding and frictional stimulation can cause inflammation of the anal papillae and hypertrophy to form anal papillomas, which can even prolapse from the anus in large cases.
Anal cryptitis: This is the cause of perianal abscess and anal fistula, which are painful diseases in anorectology, and must be detected and treated in time.
Subterranean fistula: A single internal fistula is formed due to the infection of the corresponding anal saphenous fossa, and in longer cases it can also penetrate the skin to form a complete anal fistula and spread in all directions.
Perianal eczema: Both fissure ulcers and anal gland infections can cause increased perianal secretions and long-term dampness and irritation, eventually leading to eczema and severe itching around the anus, which gradually worsens and expands, and if the skin damage is severe enough, it can seriously affect the healing of the wound after surgery.
It is important to note that one or more of these symptoms may occur in the case of more serious anorectal diseases such as anal skin cancer, rectal cancer, anal tuberculosis ulcers, Crohn’s disease anal ulcers, syphilitic ulcers, etc. Therefore, every patient should be reminded to seek medical attention at a regular hospital in a timely manner when one or more of these symptoms occur, so that a clear diagnosis can be made and the necessary treatment can be taken in a timely manner to avoid delaying the condition.
What kind of “anal fissure” needs surgery?
After the occurrence of more obvious symptoms of anal fissure, patients often go to a specialist, at this time the professional anorectal physician will judge the freshness of the fissure according to your medical history and local conditions, and then recommend that you first conservative treatment with drugs or directly recommend that you be hospitalized for surgery, do not blindly use drugs on their own to avoid delaying the disease and increasing pain. For patients who are sure to undergo surgical treatment, they must go to a regular hospital, and must not trust private hospitals and various small advertisements to prevent being cheated.
General medication for fresh anal fissure
For fresh anal fissures (generally considered to be those within 1-2 weeks), which are especially common in young women, the first thing you need to do is to keep the stool soft and clear. 2 bags of Fosamax Bulk is recommended, to be taken once a day in the morning with 600ml of water. The plan of external medicine is as follows: after defecation, use cotton swab dipped in “povidone iodine” to disinfect inside the anus 2-3 times repeatedly, then use anal pessary dipped in Longzhu ointment or compound Pientzehuang ointment to nail the anus, and put on medicine once at night no matter defecation or not, that is, use medicine 2 times a day, basically it will be fine in about a week, if it is invalid, then consider it is old anal fissure or other diseases, need to seek medical consultation in time.