It is the most painful anal condition if diagnosed early can easily be cured
ANAL FISSURE
Patients often come to my clinic with a severe pain and burning sensation in anus during and after passing stool. There is a common belief in people that, this is because of piles. But commonly the condition is Anal fissure.
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Anal fissure a linear tear in anal lining at mucocutaneous junction. Mucocutaneous junction is also called anal verge. Simply passing of hard stool few times or short time diarrhoea can cause this tear, but the reason is not always that much simple. Many a times anal fissure is a symptom of grave conditions like colon cancer and inflammatory bowel disease (IBD). Repeated child birth is one of the main causes of anal fissure in female. Some of my patients are habituated in taking purgatives and laxatives for long times without any specific indication and advice. This is called laxative abuse; this may also cause anal fissure. Abnormal sexual practices involving anal region often cause multiple tears in anus. Recently, work from home culture forces people to remain in sitting position for unusually long time, this is also causing anal fissure.
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Anal fissure is also known as fissure-in-ano. You will have severe pain and burning sensation in anus during defecation. This pain may persist for several minutes to hours after defecation. You may also see traces of blood in stool. The initial mass of your stool is often hard though rest of the stool is soft. This is because of pain-spasm-constipation triangle.
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Your doctor will diagnose anal fissure mostly by clinical examination. If your symptoms are not improving in spite of adequate conservative treatment, colonoscopy is advised. Always consult a surgeon If you notice some skin tag hanging from your anal verge, this might be a sentinel tag. My patients often be very anxious about this skin tags though this is not a very serious thing, rather it is a protective mechanism to cover up the underlying wound. You need to receive treatment for the wound, the cause. Though this skin tag is often termed as sentinel pile but it should not be understood as haemorrhoidal diseases. They are totally different conditions.
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Acute anal fissures are mostly treated with some oral medicines or creams for local application but chronic fissures may require surgical intervention. You are not supposed to continue medicinal treatment for indefinite time or ignore your condition. A simple chronic anal fissure may become a port of entry of infection to sub-mucous plane and can form a retro-fissure abscess, sometimes fistula.
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Various modalities of surgical treatment are available for anal fissure. Close or open lateral internal sphincterotomy (LIS), fissurectomy with or without LIS and flap enhancement are some of the commonly performed procedures with very good results. In early stage anal fissure is treated with medicines and get cured.