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The anal fissure is a small wound that appears in the anus, like a cut that is located right at the entrance of the anus, and that causes symptoms such as pain, discomfort, small bleeding and burning when defecating.
Usually, this type of fissure is caused by the passage of very dry and hard stools, which dilate the sphincter, causing the injury. However, other problems such as constipation, severe diarrhea, intimate contact in the anal area, genital herpes or hemorrhoids can also lead to the development of a fissure.
Symptoms of anal fissure
The anal fissure can cause symptoms such as pain in the anus, burning and burning when defecating and urinating, and the presence of blood in the stool. Select the symptoms in the following test to find out if there is a risk of having an anal fissure:
- 1. Pain in the anus entrance area No Yes
- 2. Presence of blood on toilet paper No Yes
- 3. Presence of blood in the stool No Yes
- 4. Burning in the region, especially when defecating or urinating No Yes
- 5. Itching in the anus No Yes
The wound of the anal fissure can cause a spasm of the anal sphincter which makes evacuation difficult and in the most severe cases there may even be blood in the stool. In children and babies, the anal fissure can worsen constipation by causing pain, and it may be recommended that the child use some natural laxatives to make the stool more soft and its output to be favored. Check out some options of homemade laxatives for babies and children.
How the treatment is done
The most important thing in the treatment of anal fissure is to maintain adequate intimate hygiene, so that infections that hinder healing are avoided. To do this, whenever possible, after defecating or urinating, you should wash the area with plenty of water and a little intimate soap or wipe the toilet paper with water. Industrialized wet wipes may not be a good option, as they may contain alcohol and other substances that end up irritating the region.
In addition, sitz baths with warm water for 5 to 20 minutes, after defecating mainly, are also an option, as they calm the burning and reduce the pain, but other strategies are:
Ointments for anal fissure
Ointments should be used during treatment when symptoms are very intense and cause a lot of discomfort to defecate. Thus, some examples of ointment are:
- Proctyl or Ultraproct: are ointments that contain an anesthetic substance that reduces sensitivity to pain;
- Rectogesic and other ointments with nitroglycerin: helps in relaxing the anal sphincter and improves blood circulation in the region, facilitating the healing of the fissure;
- Bepantol or Hipoglós: are healing ointments that moisturize and stimulate the healing of the skin.
These ointments can be indicated by a proctologist and must be appropriate to the symptoms of each person and the specific cause of anal fissure.
In the most severe cases, when the anal fissure is large and deep, the doctor may indicate analgesics and oral anti-inflammatories, such as Paracetamol or Naproxen, for the relief of pain and inflammation, or antibiotics such as Neomycin or Gentamycin, for example, to treat possible infections.
Botox and surgery
Other possibilities for treating anal fissures, especially chronic ones, are the use of botulinum toxin, botox, and surgical procedures, which aim to reduce the tone of the anal sphincter and improve symptoms and the occurrence of new fissures when other treatments are not enough to heal the cracks.
How to prevent the crack from recurring
Most of the time, anal fissures are caused by very dry stools and constipation and, therefore, it is recommended to invest in a balanced diet rich in fiber, in addition to betting on regular physical activity to help regulate the bowel.
However, to avoid dry stools it is very important to drink enough water. Check out this video for tips from our nutritionist to drink more water during the day: