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Anal fissure

Related Terms

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Background

  • The anus is the external opening of the rectum (the final portion of the colon). A rip or tear in the skin of the anal canal is called an anal fissure. Anal fissures may result in anal bleeding, which is noticeable on toilet paper or in stool in the toilet. Pain is associated with both acute and chronic anal fissures. In general, the fissures extend from the anal opening and are located posteriorly in the midline. The depth of the fissure varies; it may be superficial or as deep as the underlying sphincter muscle (the muscle that holds the anus closed). An anterior fissure is very rare (10% of female and 1% of male cases).
  • Anal fissures are generally caused by stretching of the anal mucosa (moist tissue). This may occur because of constipation, passing hard and/or large stools, prolonged diarrhea, decreased blood flow to the area (as seen occasionally in older adults), childbirth, dietary choices, or inflammatory bowel disorders such as Crohn's disease. Anal fissures occur commonly in infants. Less common causes include anal sex and diseases such as cancer, HIV, tuberculosis, and syphilis.
  • The drug nicorandil (a potassium-channel activator) may increase the risk of anal fissure, although the available research is limited.
  • Anal fissures may affect all age groups, with an equal incidence in both sexes. In the United States, over 200,000 new cases of anal fissure are reported, and 40% persist for months to years. In pregnancy, up to one-third of women develop anal fissures and external hemorrhoids. Constipation and dyschezia (retaining stool in the rectum) during pregnancy are the main risk factors for their development.
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Causes

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Risk Factors

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Types of the Disease

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Signs and Symptoms

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Diagnosis

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Complications

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Treatment

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Integrative Therapies

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Prevention

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Author Information

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References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

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The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.