Anal fissure at posterior midline

Assessment History and physical examination will allow the diagnosis of an anal fissure without further investigations in most patients. Open or closed techniques can be used with similar healing and complication rates. Adapted with permission from Nelson RL. Sign in. The lack of blood flow, in turn, leads to an ischemic ulcer, a chronic anal fissure. Dis Colon Rectum ; 44 Hard stools are more often the cause of anal fissures, but loose stools also cause the tears.

Twitter Facebook Linkedin Instagram Youtube. Diagnosis is confirmed on physical exam by gently spreading the buttocks apart. Almost half of all fissures heal with conservative therapy involving a high-fiber diet, sitz baths, and emollients. This website is intended for pathologists and laboratory personnel, who understand that medical information is imperfect and must be interpreted using reasonable medical judgment. It hurts. An incision is made at the leading edge of the muscle and extended proximally for a length approximating the length of the fissure. Most patients report feeling a tear, or a splitting sensation at the anus after a normal bowel movement, a bout of diarrhea, or after a particularly hard or large stool.

An incision is made at the leading edge of the muscle and extended proximally for a length approximating the length of the fissure. With the medical therapy, the aim is to chemically induce a relaxation of the internal sphincter muscle, while the aim of the surgical therapy is to mechanically cause that same effect. Symptoms include rectal bleeding, pain, and burning after defecation that could last from minutes to hours. Oftentimes, the pain associated with anal fissures is mistaken for hemorrhoidal pain, prompting patients to treat themselves with over-the-counter hemorrhoidal preparations.