SHOP NO 1 ,LAKHANI HERITAGE CHS PLOT NO 22, SECTOR NO 5 OPP.SEC NO 8 GROUND, near GOKUL DAIRY, New Panvel East, Panvel, Maharashtra 410206
NO STRAIN NO PAIN — Dr. SHRIVASTAV B. S. A. M. MUM, Dr. GUPTA B. Sc., B. A. M. S.
NO STRAIN NO PAIN — Dr. SHRIVASTAV B. S. A. M. MUM, Dr. GUPTA B. Sc., B. A. M. S.
NO STRAIN NO PAIN — Dr. SHRIVASTAV B. S. A. M. MUM, Dr. GUPTA B. Sc., B. A. M. S.
NO STRAIN NO PAIN — Dr. SHRIVASTAV B. S. A. M. MUM, Dr. GUPTA B. Sc., B. A. M. S.
NO STRAIN NO PAIN — Dr. SHRIVASTAV B. S. A. M. MUM, Dr. GUPTA B. Sc., B. A. M. S.
NO STRAIN NO PAIN — Dr. SHRIVASTAV B. S. A. M. MUM, Dr. GUPTA B. Sc., B. A. M. S.
NO STRAIN NO PAIN — Dr. SHRIVASTAV B. S. A. M. MUM, Dr. GUPTA B. Sc., B. A. M. S.
NO STRAIN NO PAIN — Dr. SHRIVASTAV B. S. A. M. MUM, Dr. GUPTA B. Sc., B. A. M. S.
NO STRAIN NO PAIN — Dr. SHRIVASTAV B. S. A. M. MUM, Dr. GUPTA B. Sc., B. A. M. S.
NO STRAIN NO PAIN — Dr. SHRIVASTAV B. S. A. M. MUM, Dr. GUPTA B. Sc., B. A. M. S.
NO STRAIN NO PAIN — Dr. SHRIVASTAV B. S. A. M. MUM, Dr. GUPTA B. Sc., B. A. M. S.
NO STRAIN NO PAIN — Dr. SHRIVASTAV B. S. A. M. MUM, Dr. GUPTA B. Sc., B. A. M. S.
NO STRAIN NO PAIN — Dr. SHRIVASTAV B. S. A. M. MUM, Dr. GUPTA B. Sc., B. A. M. S.
Anorectal Care

What is Fissure?

Fissure is created by stool tearing the anus, which is generally an acute, sharp pain. There may be associated muscle spasm, resulting in prolonged pain over hours.

The passage of difficult stool or severe diarrhea might tear the lining tissue with the anus. This dilemma is similar to having cracked lips in cold weather; blood vessels are exposed causing pain and bleeding during bowel movements.

Anal Fissure Medical Diagram
Fig 3.1: Fissure Location & Spasm Clinical Reference

Acute Fissure

A fresh tear that looks like a paper cut. Usually heals within 6 weeks with conservative care.

Chronic Fissure

Lasts longer than 6-8 weeks. May feature a small skin tag (sentinel pile) or exposed muscle fibers.

What is Symptoms?

01

A visible tear in the skin around the anus.

02

A skin tag, or small lump of skin, next to the tear.

03

Sharp pain in the anal area during bowel movements.

04

Anal fissures commonly bleed in infants.

05

Streaks of blood on stools or on tissue paper after wiping.

06

Burning or itching in the anal area.

07

Constipation: Can result in larger, harder stool causing further trauma.

08

Urinary Impact: Pain can cause discomfort when urinating (dysuria) or frequent urination.

09

Small amounts of bleeding, itching (pruritus ani), and malodorous discharge.

What is causes?

Some of the common causes include:

  • Chronic constipation
  • Passing a dry, hard stool
  • Rough or excessive wiping
  • Diarrhoea
  • Inflammation of anus/rectum
  • Crohn’s disease
  • Scratching (e.g. pinworm)
  • Anal injury
  • Pregnancy & Childbirth
  • Cancer of the rectum

Chronic constipation and chronic diarrhea can cause an anal fissure by repeatedly straining the lining of the anus.

Exams & Diagnosis

A gentle visual inspection is often enough. If the cause is unclear, advanced testing may be required:

Anoscopy
Flexible Sigmoidoscopy
Digital Rectal Exam
Colonoscopy

How to
Treat Fissure?

The most important prerequisite to healing is to minimize pressure on the anus while passing stools and manage the pain during and after bowel movements.

"Fissures especially require professional treatment if they do not heal within six weeks."

Dietary Management

Make dietary changes for easier passage of stools. Avoid chilies and hard-to-digest foods. Stay hydrated with plenty of fluids and roughage.

Natural Remedies

Apply coconut oil, aloe compresses, or wheat germ oil. These natural products have antiseptic and healing qualities to speed up recovery.

Sitz Baths

Sit in warm water for 20 minutes, 3 times daily. This minimizes infection, improves blood circulation, and helps muscle recovery.

Hygiene & Care

Keep the area dry. Use soft facial tissues instead of toilet paper. Use chamomile/witch hazel infusions to help blood vessels shrink and heal.

Medical Relief

Physicians may prescribe local anaesthetics like Lidocaine cream, ointments, or suppositories to stop the pain in the anus.

Surgical (LIS)

If medications fail, Lateral Internal Sphincterotomy (LIS) involves a small cut to relieve pressure and stop painful spasms.

How to Prevention?

Soft Stools

Eat a balanced diet with plenty of fiber. Ensure adequate fluid intake; water is the best fluid.

No Delays

Don't put off going to the toilet. Delayed bowel movements lead to larger, harder stools.

Gentle Hygiene

Use moistened cloths or cotton pads instead of rough toilet paper. Avoid perfumed products.

Regular Exercise

Exercise reduces constipation risk. Stay well-hydrated during and after physical activity.

Avoid Straining

Avoid straining or sitting on the toilet for long periods. Don't bring reading material to the toilet.

Prompt Treatment

Treat diarrhoea immediately. For babies, frequent diaper changes can reduce the risk of fissures.