BASIC INFORMATION
DESCRIPTION
A laceration, tear, or crack in the lining of the anus. It
affects all age groups, including infants.
FREQUENT SIGNS AND SYMPTOMS
Sharp pain with passage of a hard or bulky stool. The
pain may last up to an hour and returns with the next
bowel movement.
Pain when sitting on a hard surface.
Streaks of blood on the toilet paper, underwear or diaper.
Itching around the rectum.
Children may refuse to have a bowel movement.
CAUSES
The exact cause is unknown, but the symptoms usually
occur after the stretching of the anus from a large, hard
stool.
RISK INCREASES WITH
Constipation.
Multiple pregnancies.
Leukemia.
Crohn's disease.
Immunodeficiency disorders.
PREVENTIVE MEASURES
- Avoid constipation by:
Drinking at least 8 glasses of water daily.
Eating a diet high in fiber.
Using stool softeners or other laxatives, if needed.
- Don't strain at stool.
- Avoid anal intercourse.
EXPECTED OUTCOMES
Most adults recover in 4 to 6 weeks with treatment,
making surgery unnecessary. Most infants and young
children recover after the stool is softened.
POSSIBLE COMPLICATIONS
Permanent scarring that prevents normal bowel movements.
TREATMENT
GENERAL MEASURES
Examination of the anus and rectum with an
anoscope or sigmoidoscope to rule out other causes of
anal or rectal bleeding.
Gently clean the anus with soap and water after each
bowel movement.
To relieve muscle spasms and pain around the anus,
apply a warm towel to the area.
Sitz baths also relieve pain. Use 8 inches of warm
water in the bathtub, 2 or 3 times a day for 10 to 20
minutes.
Surgery may be necessary, if conservative treatment is
not successful, to remove the fissure or to alter the muscle
that contracts and prevents normal healing.
MEDICATIONS
For minor pain, use non-prescription drugs, such as
acetaminophen or topical anesthetics.
Zinc oxide ointment or petroleum jelly applied to the
anal opening may help prevent the burning sensation.
Bulk stool softeners will help to avoid the pain occurring
with bowel movements.
Lidocaine ointment may be recommended.
ACTIVITY
No restrictions. Physical activity reduces the likelihood
of constipation.
DIET
Encourage a high-fiber diet and extra fluids to prevent
constipation.
NOTIFY YOUR PHYSICIAN IF
You or your child has symptoms of an anal fissure, especially
pain that persists despite treatment.
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