ANAL FISSURES

Overview
A fissure is a tear in the anal canal lining, often caused by trauma from hard stools or straining.

Symptoms
• Sharp pain with bowel movements
• Bright red blood
• Spasms
• Itching
• Fear of defecation

Causes
• Constipation
• Chronic diarrhea
• Childbirth
• Anal trauma

Diagnosis
Visual exam (gentle).

Treatment
• Stool softeners
• Fiber + hydration
• Sitz baths
• Nifedipine/nitroglycerin ointment
• Botox injections
• Lateral internal sphincterotomy (surgery)

Prevention
Avoid hard stools by tracking hydration, fiber, and meals.