Anal fissures can be acute or chronic. People are instructed to put a little dollop of the paste on their butt three times a day, for up to six weeks, but most fissures heal after two or three weeks. Increased tension in the anal sphincter causes a spasm after a bowel movement, which decreases blood flow to the area and impedes healing.
Risk factors for progression from an acute to a chronic anal fissure, or one that lasts more than four to six weeks without healing, include internal anal sphincter hypertonia, as well as location of the tear. Acute anal fissures can be caused by trauma from dry, hard stools that are difficult to pass, childbirth, Crohn's disease, anal intercourse, or anal instrumentation. The alternative for patients who cannot tolerate that position is lying on the left lateral side with the right knee pulled toward the chest. Listen to the Podcast: Underlying pathology is the cause of primary but not secondary anal fissures. Reports of bright red blood on toilet paper with bowel movements are not unusual, and many patients are afraid to have bowel movements because of the pain and therefore will delay defecation. What is the treatment for an anal fissure? A majority of anal fissures occur at the posterior midline. The exact etiology is unknown. Hard stools are more often the cause of anal fissures, but loose stools also cause the tears. People should know that anal fissures can be treated and that there are things you can do to help heal them. Increased tension in the anal sphincter causes a spasm after a bowel movement, which decreases blood flow to the area and impedes healing. The pain, potential embarrassment, and experience of seeing blood coming from the butt can be emotionally traumatic for many people, causing them to suffer in silence instead of seeking treatment. Every time they bottom, the fissure will break open again, and the fissure remains chronically open. The goal of treatment is to relieve pain, constipation , and spasms, as well as reduce the resting internal anal sphincter pressure so that the fissure can fully heal. People are instructed to put a little dollop of the paste on their butt three times a day, for up to six weeks, but most fissures heal after two or three weeks. Anal surgery is a predisposing risk. The small to medium ones are treated with a cream that dilates the blood vessels and stimulates blood flow to the fissure. Talk to your health care provider! How do I get treated? Small fissures can heal up on their own without any treatment. Fissures are a small split or tear in the skin. Pain that lasts from minutes to hours after a bowel movement is common, whereas in between bowel movements, patients are asymptomatic. People can get fissures if they get pounded hard during sex or have a really large bowel movement. If you get a tear, the lack of blood flow can prevent it from healing. During a bowel movement, the fissure is stretched, leading the injured tissue into contact with stool, which can further delay healing. And they will just think it is a consequence of having sex.
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