From the site: www.colorectalcentre.co.uk
Specifically, the anal fissure is a small "cut" that is created on the "homonymous opening, due to" excessive dilation during the passage of feces. Here the presence of abundant nerve endings makes the disorder particularly irritating and painful. The pangs become more intense at the time of defecation, especially when hard and bulky stools are expelled which, by friction, favor the lesion of the anal folds. In addition to aggravating this annoying disorder, constipation is also one of the main causal agents.
Considering the diffusion of the constipation problem, it is therefore not surprising that anal fissures constitute a "disease frequently encountered in proctological practice.
, with all its consequences, is the determining cause of anal fissures. In addition to the consistency of the faeces, other factors must be taken into consideration, such as the abuse of laxatives or the use of digital maneuvers to facilitate evacuation;The presence of fissures causes a spasm of the internal anal sphincter, whose control, unlike what happens for the outermost ring, is independent of the will of the individual. This contractural condition is responsible for the chronicity of the disorder, because, in addition to preventing the normal and physiological dilation of the anus, it hinders the flow of blood and with it the possibility of spontaneous healing.
The symptomatology of anal fissures, in its drama, is characteristic, so much so as to make the disorder easily identifiable. The pain associated with defecation is in fact particularly intense, so annoying as to push the patient to fear the mere thought of evacuation.
These psychological repercussions tend to induce secondary constipation or aggravate a pre-existing constipation, making the subsequent, and inevitable, evacuation even more tragic.
The pain associated with defecation recognizes three characteristic moments: the passage of stool becomes particularly acute, after which it subsides for a few minutes and reappears, with varying degrees of intensity, in the following three or four hours. To describe this symptomatology we speak of "painful syndrome in three stages of the fissure".
If the true extent of the injury is considered, the pain associated with anal fissures is often disproportionate. In addition to the generally contained dimensions, a fundamental anatomical feature of the cracks is the longitudinal course which appears, in the vast majority of cases, in the posterior and upper part.
Often the crack is so small that it is unrecognizable to the naked eye, especially if examined by a layman. As the disease becomes chronic, the edges of the lesion become more irregular and noticeable.
Another characteristic sign of the fissure is the finding of traces of bright red blood in the toilet paper, more rarely there are blood marks around the stool. However, it is a limited bleeding which, basically, has nothing to do with the more abundant one associated with the haemorrhoidal disorder.
Since in some cases the two pathologies are associated, the presence of blood traces may be due to the concomitant presence of hemorrhoids or other lesions.
- Natural remedies against anal fissuresOne of the few positive aspects of anal fissures concerns the relative ease with which the disorder resolves in a fair number of cases. The more superficial lesions can in fact heal spontaneously within a few days.
If this were not the case, the first approach to the disease involves the use of fiber supplements and mild laxatives, accompanied by abundant quantities of water.
The use of these dietary supplements must, of course, be preceded by a clear medical indication. In any case, it is good to start therapy slowly, to avoid that an excessive laxative effect results in diarrhea, worsening the problem.
Lukewarm baths and anesthetic ointments, on the other hand, have the purpose of keeping pain under control and favoring the loosening of the internal anal sphincter.
Washes with warm water, while effective in reducing sphincter spasm, only give temporary relief and must therefore be repeated with a certain frequency. The possible efficacy of anxiolytic drugs should not be underestimated, to avoid that daily stress and tensions end up being discharged on the "second intestinal brain".
If the internal anal sphincter remains heavily contracted, the doctor may recommend the use of anal dilators. In many cases, their regular use allows a slow recovery of the sphincter elasticity.
Whatever the real extent of the disorder, the regularization of the intestine is always and in any case an essential factor in promoting the healing of anal fissures.
Read also: All Remedies for Anal Fissures
Surgery
Sometimes this "soft" approach is not enough to solve the problem and, after phases of temporary improvement, the symptoms tend to recur.
In the case of chronic fissures, the surgical solution is often undertaken, based on the partial resection of the internal anal sphincter, or on the so-called annuloplasty. This last surgical technique is based on the recovery in loco of flaps of skin taken from elsewhere, with the aim of covering the injured area. Both interventions are quite simple, do not require particularly long stays (normally the patient is discharged within 24 hours) and have a low risk of complications. One more reason to overcome taboos and reticence, by turning to the doctor at the onset of the first symptoms attributable to the presence of anal fissures.
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