Anal Fissure
An anal fissure is a small tear or cut in the skin that lines the anus. Fissures typically cause pain and often bleed.
Fissures are quite common, but are often confused with other causes of pain and bleeding, such as hemorrhoids. The typical symptoms of an anal fissure are pain during or after defecation and bleeding. Patients may try to avoid defecation because of the pain. Anything that can cut or irritate the inner lining of the anus can cause a fissure. A hard, dry bowel movement is typically responsible for a fissure. Other causes of a fissure include diarrhea or inflammatory conditions of the anal area.
Anal fissures may be acute (recent onset) or chronic (present for a long time or recurring frequently). Chronic fissures often have a small external lump associated with the tear called a sentinel pile or skin tag. Often treating one's constipation or diarrhea can cure a fissure. An acute fissure is typically managed with non-operative treatments and over 90% will heal without surgery. Fissures can recur easily, and it is quite common for a healed fissure to recur after a hard bowel movement. If the problem returns without an obvious cause, further assessment may be needed. Fissures do not lead to Colon Cancer. Persistent symptoms, however, need careful evaluation since conditions other than fissure can cause similar symptoms. Your doctor may request additional testing even if your fissure has successfully healed. A colonoscopy may be required to exclude other causes of bleeding.