What are the Anal Fissures ? It is basically a cut or tearing in the anus part of the body that comes out upwards into the anal canal. Fissures are common situations of the anus and anal canal and are responsible for 6% to 15% of the visits to a colon and rectal (colorectal) surgeon. It can be found in Men, Women, Young and Old ones. Fissures is the most painful situation in the bowel movement that often is severe. Anal fissure is the most common cause of rectal bleeding. Anal Fissures occurs in the specialized tissue that covers that lines the anus and anal canal which is called anoderm. A line just inside the anus the skin of the inner buttocks changes to anoderm. Less likely to skin, anoderm has no hairs, sweat glands, or sebaceous (oil) glands. It contains a large number of sensory nerves that can feel the light touch and pain. The hairless, gland-less, extremely sensitive anoderm surrounds the entire length of the anal canal until it meets the demarcating line of the rectum, called the denate line. An anal fissures is a small tear in the thin, moist tissue (mucosa) that covers the anus. Anal fissure may occurs when you pass hard or large stools during a bowel movement. It usually causes pain and bleeding with the bowel movement. You may also some contraction in the ring of the muscle at the end of your anus. 1

Signs and symptoms of an anal fissure include:  Pain, sometimes severe, during bowel movements  Pain after bowel movements that can last up to several hours  Bright red blood on the stool or toilet paper after a bowel movement  Itching or irritation around the anus  A visible crack in the skin around the anus  A small lump or skin tag on the skin near the anal fissure 2

Common causes of anal fissure include:  Passing large or hard stools  Constipation and straining during bowel movements Constipation  Chronic diarrhea  Inflammation of the anorectal area, caused by Crohn’s disease or another inflammatory bowel disease  Childbirth Less common causes of anal fissures include:  Anal cancer  HIV  Tuberculosis  Syphilis  Herpes 3

Factors that may increase your risk of developing an anal fissure include:  Infancy. Many infants experience an anal fissure during their first year of life; experts aren’t sure why.  Aging. Older adults may develop an anal fissure partly due to slowed circulation, resulting in decreased blood flow to the rectal area.  Constipation. Straining during bowel movements and passing hard stools increase the risk of tearing.  Childbirth. Anal fissures are more common in women after they give birth.  Crohn’s disease. This inflammatory bowel disease causes chronic inflammation of the intestinal tract, which may make the lining of the anal canal more vulnerable to tearing. 4

The goal of treatment for anal fissure is to release the spasm of anal muscle and cure the anal tear. Jyoti Nursing Home Proctology deptJyoti Nursing Home Proctology dept. offered the both conservative and laser treatment for anal fissure. Jyoti Nursing Home proctology team treated the acute and chronic anal fissure with the self- researched Ayurveda medicine ( Anoac, Anoac Tablet, Constac Powder ) cream powder anal tablet for the acute fissure. ) For chronic fissure, we offered the best- advanced laser treatment for release the spasm and heal the anal tear with the power of laser advanced laser treatment 5

Several lifestyle changes may help relieve discomfort and promote healing of an anal fissure, as well as prevent recurrences:  Add fiber to your diet. Eating about 25 to 30 grams of fiber a day can help keep stools soft and improve fissure healing. Fiber-rich foods include fruits, vegetables, nuts and whole grains. You also can take a fiber supplement. Adding fiber may cause gas and bloating, so increase your intake gradually.  Drink adequate fluids. Fluids help prevent constipation.  Exercise regularly. Engage in 30 minutes or more of moderate physical activity, such as walking, most days of the week. Exercise promotes regular bowel movements and increases blood flow to all parts of your body, which may promote healing of an anal fissure.  Avoid straining during bowel movements. Straining creates pressure, which can open a healing tear or cause a new tear. If your infant has an anal fissure, be sure to change diapers frequently, wash the area gently and discuss the problem with your infant’s doctor. 6

Anal fissures Anal fissures often heal within a few weeks if you take steps to keep your stool soft, such as increasing your intake of fiber and fluids. Soaking in warm water for 10 to 20 minutes several times a day, especially after bowel movements, can help relax the sphincter and promote healing. If your symptoms persist, you’ll likely need further treatment. Nonsurgical treatments Your doctor may recommend:  Externally applied nitrogylcerin, to help increase blood flow to the fissure and promote healing, and to help relax the anal sphincter. Nitroglycerin is generally considered the medical treatment of choice when other conservative measures fail. Side effects may include headache.  Steroid creams, to help relieve discomfort.  Botulin toxin type A (Botox) injection, to paralyze the anal sphincter muscle and relax spasms.  Blood pressure medications, which can help relax the anal sphincter. These medications may be taken by mouth or applied externally and may be used when nitroglycerin in not effective or causes significant side effects. Surgery  If you have a chronic anal fissure that is resistant to other treatments, or if your symptoms are severe, your doctor may recommend surgery. Surgery usually involves cutting a small portion of the anal sphincter muscle to reduce spasm and pain and promote healing. Surgery has a small risk of causing incontinence.surgery 7

Jyoti Nursing Home Road No 4, Opposite SBI Bank, Near Police Station, Sikar Road, Vishwakarma Industrial Area, Murlipura, Jaipur, Rajasthan – , India. Mobile: Web: 8