Fissures: a non-surgical solution to a persistent problem

2023-01-27 01:17:56 - Grace Browns Grace Browns has been a lifestyle, fashion, and beauty writer for over 5 years, and she currently serves as a senior editor at

A surgical repair is not necessary for every anal fissure. Most people recover without resorting to surgery by making lifestyle adjustments and using OTC remedies like stool softeners and topical creams.

A person holding a glass of water on a table to hydrate themselves Send to Pinterest Photographer: Marc Tran/Stocksy

Faults in the anal mucosa, also known as anal fissures, are common. Affected areas include the anus and rectum. Sharp pain during bowel movements and burning pain hours later are both symptoms.

Acute anal fissures can be treated and healed by medical procedures and behavioral modifications. Treating tears that come back over and over again is difficult because conservative treatments often don't work.

This article discusses non-invasive options for treating anal fissures and addresses common concerns that patients have about this condition.

An anal fissure typically develops in a person who is constipated and has large or hard stools. Constipation is linked to low fluid intake, research shows.

If you don't get enough water every day, you risk dehydration, which in turn causes more difficult-to-pass stools.

According to the National Academy of Medicine, men should drink 13 cups of fluids per day, while women should drink 9 cups.

An increase in fluid and fiber intake was found to significantly reduce the risk of developing constipation after surgery in a study published in 2018.

Click here for information on the ailment of constipation.

To stimulate urination, caffeine is used. Diuretics are medications that encourage the kidneys to flush out excess water and salt.

However, dehydration brought on by caffeine's diuretic effect can increase the risk of anal fissures.

Although there is not yet definitive evidence for this, In some people, drinking more than 180 milligrams of coffee per day (roughly two cups of brewed caffeinated coffee) may cause increased urination in the short term, but may not cause dehydration.

According to the table above, healthy adults require between 13 and 9 cups of fluids per day (1 cup = 8 ounces).

Caffeinated drinks, such as coffee and tea, can add to a person's hydration levels throughout the day. On the whole, though, they contribute significantly less than that, and they might not even have any bearing on how well hydrated a person is.

Find out more about caffeine-free options.

For 10-20 minutes, a sitz bath entails reclining in a tub filled with warm water. Sphincter muscle tension can be reduced and fissure pain alleviated with a warm bath. Multiple times daily, and especially after each bowel movement, is recommended for maximum effect.

In addition to easing discomfort, sitz baths have been shown to speed healing by about 80 percent.

Cracks or tears in the anus are a common result of straining to pass hard stools. Irritation-free bowel movements can be achieved by following these methods:

  • In a seated position with a straight back, lean forward until your forearms rest on your knees. Use a footstool or lift the heels to keep the legs apart and the knees higher than the hips.
  • Keep your abs braced at all times.
  • Exhale with a slightly open mouth. When using the restroom, it's important to breathe normally and not hold your breath.

The use of laxatives facilitates bowel movements.

Laxatives containing bulk-forming agents are a common treatment for anal fissures in adults prescribed by doctors. These prevent the feces from drying out and becoming hard.

Polyethylene glycol (PEG) osmotic laxatives, such as MiraLAX, are commonly prescribed by doctors for children with anal fissures to increase bowel fluid and stimulate the need to defecate.

In children, the effects of PEG alone were comparable to those of PEG combined with topical agents, according to a study scheduled for 2020.

Docusate (Colace) and similar over-the-counter stool softeners are two examples that doctors may suggest.

Take some time to learn the distinction between laxatives and stool softeners.

A local anesthetic, such as lidocaine, applied to the skin around the anus can help alleviate pain.

Hydrocortisone is a steroid that is useful for alleviating anal symptoms like itching, pain, swelling, and discomfort.

To speed healing of a fissured genitalia, applying a topical nitrate like nitroglycerine to the affected area will help relax the muscles around the anus.

It could take 6-8 weeks, but up to 12 weeks, for the body to heal.

Relaxing the anal sphincter is another potential benefit of calcium channel blockers like diltiazem and nifedipine.

In addition to oral medications, doctors may recommend applying a topical form of this drug directly to the skin.

These medications, according to a study from 2020, are more effective than topical anesthetics alone in treating anal fissures.

Case reports suggest this drug is being used off-label to treat anal fissures, but more research is needed to confirm this.

The fissure should heal completely after 3–4 months of paralysis of the internal anal sphincter caused by a botulinum toxin (Botox) injection.

It can increase the rate of healing by 60-80%. In contrast, up to 42% of previously treated patients with Botox report a return of their symptoms.

It's worth noting that using Botox to treat fissures is not approved by the FDA. If a person is interested in using a treatment that is not on the FDA's black box label, they should consult a doctor.

If the individual no longer has any of the symptoms that are common with anal fissures, the treatment or home remedies have likely been successful.

Participants' two most common complaints, according to a study scheduled for 2020, were pain and bleeding during bowel movements.

Pain during or after defecation, with or without bleeding, warrants medical attention. They plan on conducting a comprehensive physical examination to determine the root of the problem.

Any changes in pain or bleeding severity should prompt a visit to the doctor for those who suffer from anal fissures.

And if their symptoms persist or worsen after 8 weeks of treatment, they should make an emergency doctor's appointment.

Questions frequently asked about anal fissure treatments are addressed below.

At what point do anal fissures become surgically necessary?

Treatment of an anal fissure typically does not involve surgery. In contrast, chronic anal fissures are notoriously difficult to heal.

When fissures are persistently painful, difficult to treat with medication, and resistant to dietary and lifestyle modifications, doctors may recommend surgical repair.

Can fissures in the skin be treated with natural methods?

Conservative treatments are only effective in about half of those with chronic fissures. Acute fissures respond better to natural treatments like laxatives and sitz baths than chronic ones.

One more study found that medical and natural treatments for chronic anal fissures do help, but only temporarily, and that the condition often returns.

Why do some cracks not close when treated with herbs?

There is often a reoccurring cycle of anal fissures. When the internal anal sphincter is suddenly injured, it causes pain and spasms. As a result, blood flow is restricted and healing is slowed. When this cycle is not broken, tensions continue to build.

Furthermore, if the underlying causes of the fissures are not addressed, they will likely recur. Constipation is one such example, as is an underlying condition like Crohn's disease.

After a surgical repair, is there a chance that the fissures will re

However, up to 6% of people who have had surgery to treat a fissure have a recurrence of the fissure within a year.

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