About Anal Fissures
Our board-certified surgeons at Houston Colon and Rectal Surgery see patients with a number of concerns, ranging in both severity and complexity. One of the more common conditions we treat at our North Houston and West Houston, TX offices are anal fissures. An anal fissure is a small rip or tear in the delicate tissue that lines the anus called the mucosa. Although tiny, these lesions can cause a significant amount of pain and can occur in patients of all ages, ranging from young infants to the elderly. Anal fissures typically develop as a result of trauma or stretching to the anal canal, which can be caused by passing hard stools, difficult bowel movements, constipation, or sexual activity. In many cases, fissures can heal over time with a high-fiber diet, stool softeners, supplements, or in chronic circumstances, minor surgery.
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SIGNS and Symptoms
Anal fissures commonly occur in patients of all ages. They're often caused by stretching or trauma to the anal canal, usually as a result of difficult bowel movements. Patients with constipation, diarrhea, or those who strain to pass stools run a higher risk of damaging the soft tissue lining of the anus. Additionally, sexual activity or the insertion of foreign objects can result in a fissure developing. While fissures are typically easily diagnosed after an external examination, the symptoms you experience can mirror other conditions, such as Crohn's disease or hemorrhoids. The only way to know for sure that you have an anal fissure is to seek the medical guidance of a trained and experienced colon and rectal surgeon.
Some of the signs of an anal fissure are:
- Pain during or even after bowel movements, which may last up to several hours
- Blood in the stool or on toilet paper after a bowel movement
- A lump or skin tag near the anus
- A visible crack in the delicate skin that surrounds the anus
Treatment OPTIONS
Once one of our colorectal surgeons has assessed your anal fissure, we will then be able to create a personalized treatment plan to resolve the problem. Depending on your unique condition, we may consider nonsurgical or surgical options. Typically, anal fissures can be treated with a high-fiber diet that incorporates a good amount of water consumption, prescription or over-the-counter stool softeners, and certain supplements to make your bowel movements more relaxed. We may also prescribe certain medications or ointments to be applied externally to help manage your discomfort as you heal and relax the sphincter muscles (the muscles in the anal cavity that allow stools to pass).
A fissure that has not healed after eight weeks is considered chronic. In this case, our colorectal surgeons may suggest a minimally invasive surgical procedure to address the issue. This can include BOTOX, which is frequently used for chronic fissures, or a lateral internal sphincterotomy. The latter is a process by which a portion of the anal sphincter is divided, then stretched to reduce some of the tension when passing stools. Both of these options are minimally invasive and can be completed in our office as an outpatient procedure.
RECOVERY
Following your anal fissure treatment, a member of our team will provide you with detailed post-op instructions so you can properly care for the area as it heals. Most patients can return to work and resume their normal schedules after a few days, but it will take around 6 – 10 weeks for your fissure to heal completely. If you fissure has not healed after 8 – 10 weeks, you will likely receive a second treatment through surgical means (with BOTOX or a lateral internal sphincterotomy). If retreatment also fails to resolve your fissure, we may run tests to determine if there is another underlying issue causing your symptoms.
You should continue to follow your high-fiber diet plan even after your anal fissure has healed so your stools are softer, which will reduce the chances of bowel movements causing additional trauma to the soft tissue lining of the anus. In many cases, anal fissures can return if proper care is not taken and lifestyle changes are not made. You should attend all scheduled follow-up visits at our North Houston and West Houston, TX office so our colon and rectal surgeons can monitor your progress and ensure that your condition is improving.
SEEK TREATMENT NOW
Chances are, you or somebody you know has dealt with an anal fissure in their lifetime. This small but painful tear in the soft tissue lining of the anus can cause extreme discomfort during bowel movements, blood in the stool, and get in the way of your enjoyment of life. Thankfully, the board-certified surgeons at Houston Colon and Rectal Surgery see patients with issues like these daily. Using advanced treatments and techniques, we will work with you to restore your overall wellness. Get in touch with one of our North Houston or West Houston, TX offices today to schedule a consultation with a trained specialist.