My Anal Fissure

Information About Anal Fissures

If you just learned that you have an anal fissure or you think you might have one, the below information may be educational.

Brief Overview of an Anal Fissure

An anal fissure is a tear or cut in the anus lining. It causes extreme pain when you take a crap, and in some severe cases passing gas can be painful. This pain feels like a knife cutting your ass. The fissure will often bleed bright red. This blood may be visible in the stool or on the toilet paper after wiping.

In most cases the anal fissure will heal itself, but your diet will need to change (think FIBER). It may take a very long time to heal, or it may never heal. Think about how you treat an injury on another part of your body. You protect it. Your sphincter will protect your anus injury. The muscle tightens up around the wound to protect it. When you go to the bathroom, the muscles around the fissure do not relax. While you're trying to push out a load, the muscles won't "give" so the healing wound just rips open again. It's a vicious cycle.

Treatment

A high fiber diet is the first thing you need to do. I don’t mean a couple of prunes a day, I mean you need FIBER. You might need a box of prunes a day (*ask you doctor what to eat). You’ll quickly learn to read the nutritional information on every food product hunting for that word “fiber”. Fiber is not as easy to come by as you might think.

Stool softeners are a good thing too. You might be thinking to yourself that you’re heading into a situation where you are going to have explosive diarrhea. Trust me, you’re not. The goal here is to make the stool as soft as possible.

If diet alone doesn’t improve your condition, your doctor might prescribe a medicated ointment. These ointments are applied directly to your anus to help relax the muscles. Some examples are Nitroglycerine at 0.2% (point two percent) and Diltiazem at 2% (two percent). I've recently read that Botox injections might help.

Surgery

If all other attempts to heal your anal fissure fail, then you may be a candidate for surgery. The surgery is an outpatient procedure. The surgeon will make a small incision in the sphincter muscle to help relax the area around the fissure. The benefit of this surgery is that it is quick and “easy”. Your anus should be completely healed within a few weeks. The only downfall to having the surgery is that there is a very, very, very small chance that the surgery damages or interferes with the muscle and you could experience difficulty controlling your sphincter - forerver.

 

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