Fracture of the anus: symptoms, causes and treatment

An anal fissure, or fissure of the anus, is a rupture of the mucosa of the rectum of different depths.There are anal fissures in those people who lead a sedentary life or suffer from chronic constipation.

Anal fissures are diagnosed in 18% of patients who are handling discomfort in the rectal area. They are more common in women of reproductive age.

The anal fissure itself, the symptoms and treatment of which we will consider, can be an independent phenomenon that has arisen as a result of the influence of various traumatic factors. Nevertheless, much more often the painful defects of the rectal mucosa and the epithelium in the region of the anus are associated with different concomitant diseases (abnormalities in the work of the gastrointestinal tract, peptic ulcer of the stomach or duodenum, internal and external hemorrhoids).

Causes

. The causes of anal fissure are usually associated with injuries to the rectum or other diseases, such as hemorrhoids, constipation. The appearance of a mucosal defect in the anus is facilitated by the same factors as in hemorrhoids:

1. Injury of the anal canal mucosa, which occurs when passing through a hard dry stool during constipation. Prolonged stretching of the anal canal leads to traumatic damage to its posterior wall, especially in men. This zone of the anal canal has anatomical prerequisites for the formation of cracks, since the muscles of anal pulp converge here. In women, the weak point of the anal canal is its anterior part, where the vulva, vagina and crotch center converge. Therefore, cracks in the anterior part of the anal canal are more common in women. On the side walls of the anal canal, cracks occur rarely.
2. Diseases of the digestive system- Various colitis, gastritis, peptic ulcer, hemorrhoids can lead to the formation of cracks in the anus. As statistics show, the anus crack is present in 95% of patients suffering from inflammation of the hemorrhoids.
3. Violation of the cardiovascular systemand related diseases (congestion in the pelvic and rectal region, thrombophlebitis, obliterating atherosclerosis, aneurysms, vasculitis, etc.).
4. Chronic diseases of the upper gastrointestinal tract(gastritis, cholecystitis, stomach ulcer, duodenal ulcer).
5. Pregnancy and childbirth- The pressure of the growing uterus on the internal organs, including the large intestine, leads to problems with defecation, as a result of which the future mother may have anal fissures. It is not uncommon for this pathology and in young mothers - the appearance of cracks in the anus is facilitated by the perineal ruptures obtained during labor.

It is not necessary to hope that the newly formed defect of the mucosa will heal by itself, especially if the patient does not change anything in his way of life and nutrition. Moreover, an acute crack (acute it is considered the first 4 weeks of its existence) can pass into Chronic, which lasts for months and takes the patient out of the state of physical and mental equilibrium.

If a person in time turned to a specialist, then to treat the crack in the anus at home ointments or candles are prescribed, and only in the neglected case they offer a surgical operation. Microcracks can be several millimeters, and deep ones reach two centimeters.

Symptoms of anus fracture

When an anal fissure occurs, the most important and basic symptom is pain and minor bleeding (see Fig. a photo). Unpleasant sensations persist after defecation, with itching and burning. Over time, spasm of the sphincter can join them. Such signs are observed at any stage of the disease.

However, if in an acute form the wound can heal in a few weeks without special treatment, then the chronic crack does not close very long. Pain with prolonged stays in a sitting position, constant discomfort causes fear of defecation. As a consequence, constipation appears, which only worsens a person's condition. The patient becomes irritable, there are violations of sleep.

Anal fissure in children

Children suffer from cracks to a lesser extent than adults, but such symptoms can occur even in infants. If a child is confronted with the disease, it is very important to begin treatment in a timely manner so that the crack does not go into chronic form, and does not provoke a lot of complications.

Do not treat a child at home. Folk remedies can only relieve symptoms, unlike medications.

Chronic fracture

Over time, the acute form of the disease is able to flow into the chronic stage, especially if the care of the wound is inappropriate or the use of incorrect medications. Most often, a fissure of the anus in women after labor is acquired, which is also explained by regular changes in the body of the newly-born mother.

Pain in chronic form brings suffering not only during defecation or after a long sitting, but also at any forced uncomfortable position, walking. To the itching, discomfort and bleeding added panic fear of the toilet.

The patient increasingly resorts to laxative drugs, enemas, suppositories, thereby aggravating the process. Possible development of insomnia and increased irritability.

Effects

Complications of anal fissures include:

1. Acute paraproctitis (in case of infection through a defect of the rectal mucosa in the surrounding fatty tissue).
2. Severe pain. As a rule, pronounced pain syndrome with anal fissures is explained by an anal sphincter spasm.
3. Colitis (inflammatory disease of the inner shell of the large intestine.
4. Prostatitis (inflammatory lesions of the prostate gland).
5. Copious bleeding.
6. Fistulas of the rectum.

Diagnostics

The proctologist can easily determine the presence of an anal fissure even at the stage of a routine examination, as the patches of swelling and mucous membranes are broken. If the chronic rectal fissure is located inside, a finger examination is performed.

So the proctologist can determine its size, feel the edges. When there are problems with palpating, then in the anus is introduced a sigmoidoscope. This apparatus makes it possible to examine the rectum at a depth of twenty centimeters. If necessary, colonoscopy, irrigoscopy is prescribed.

How to treat an anal fissure

If the cause of this problem is any disease, then its treatment is necessary, since it is impossible to cure the cracks in the anus without eliminating the cause of their appearance.

In addition, when starting anal fissure treatment, one should clearly realize that no funds will be effective enough if the patient suffers from constipation. Solid feces will injure the anus, so the wound will be difficult to heal, and new cracks can appear periodically. Therefore, all patients need to follow a diet recommended for constipation.

The choice of a way to combat such ailment in a specific case is determined by a proctologist after a preliminary examination, depending on the clinical manifestations and nature of the disease.

Cracks in the anal canal are treated in the following ways:

1. Drug methodis the use of medications that allow to achieve an analgesic effect and healing of a crack in the passage. The course of treatment depends on the degree of the disease, is carried out by the patient independently at home.
2. Minimally invasive methodis a laser removal of a crack in a hospital.
3. Online modealso performed in the hospital, performing removal of the laser and sphincterotomy.

Of course, they begin with the conservative one. It can include such activities:

1. Accept warm baths 2-3 times a day for 10-20 minutes. Thanks to this procedure, the muscles of the anus relax.
2. Treatment of the anal area with petroleum jelly.
3. Prevention of constipation. To do this, you need to consume more fluids, fruits, vegetables, or, after consultation with your doctor, take a laxative.

If these measures do not bring the desired effect or need to be obtained more quickly, you can resort to the use of ointments and suppositories.

Candles and ointments from cracks in the anus

As a drug, most often appointed special candles or ointments from cracks in the anus. They can remove the spasm of the internal anal sphincter.

Painkillerscandles:

• Ichthyol suppositories;
• Proctogliolol;
• Ultraproject;
• Glycerin suppositories;
• Salofalk;
• Candles with calendula;
• Betiol with belladonna;
• Anestezol.

They usually include some kind of analgesic, which alleviates pain in the anus.

Wound healing and anti-inflammatorycandles:

1. Relief (contain shark liver oil, which has anti-inflammatory, hemostatic and analgesic effects);
2. Propolis. To prepare the medicine, you should grate it on a fine grater, mix with butter, warm to dissolve. After the preparation of the liquid solution, the preparation merges into the candle shaped candles;
3. Methyluracil. Suppositories with this component have a good wound healing effect;
4. Natalside - an anti-inflammatory drug for the treatment of cracks in the anus, which does not contain hormonal components. Can be used during pregnancy;
5. Posterizan. This preparation contains inactivated bacteria of the intestine, as well as the products of their vital activity. The drug increases the immune defense and has an anti-inflammatory effect;
6. Hepatrombin T - rectal suppositories for stopping rectal intestinal bleeding with analgesic and anti-inflammatory action;
   Witch hazel (homeopathic remedy on a plant basis).

They help to cure rectal fissures and prevent complications.

Elimination of constipation and softening of stool

Making the stool masses softer, and the stool daily, one of the main reasons for the crack around the anus can be eliminated. Medications that ease defecation are divided into the following groups.

1. Facilities,increasing the volume of intestinal contents: plant based on agar or psyllium (Naturolax, Mukofalk, Fiberleks), based on cellulose (Fiberal, Fibercon).
2. Polyhydric alcohols: Dufalac, Normase, Lactulose (a standard that does not irritate the intestines), Sorbitol, Macrogol, Lactiol (see below). all laxatives).
3. Softening(vaseline and sea buckthorn oil, Norgalax). At home, if problems with the anal sphincter are used, counter microclysters 10 minutes before emptying (100 ml of pasteurized sunflower oil and 200 ml of boiled water at room temperature).

Folk remedies

To treat the crack in the anus at home, you can use some folk remedies. They will help to remove the inflammation, and reduce the intensity of pain.

1. To relieve pain, use a candle made from ordinary potatoes. It is cut out in the form of a suppository from a tuber, inserted into the anal canal, held overnight. Then it comes out when the bowels are empty. To enhance its therapeutic effect, you can dab before use in honey or oil, for example, sea buckthorn. The course is 10 candles.
2. If the crack goes deep into the anal canal, you can use curative microclysters. For example, mix 30 ml of sea buckthorn oil and infusions of chamomile flowers, gently in a warm form inject the mixture into the anus with a syringe and hold until enough patience. The procedure should be done before bedtime for 2 weeks.
3. Candles. For their preparation you will need cones of hops (8 pieces), unsalted lard (kg), St. John's wort (3/4 glass of grass), cup of boiling water. Hops and St. John's wort must be boiled, insist for 3 hours, wrapped in a warm cloth. Infusion to infuse.

Sitting baths are also very effective. They help to immediately remove local swelling, pain and help in healing the wound. For such trays you need infusions of herbs. The basis is taken all the same: chamomile, sporish, calendula, St. John's wort, oak bark, immortelle. The water must be warm at the same time, and the duration of the procedure is at least 20 minutes.

Proper nutrition and diet

Diet in the fissure of the anus should promote a regular stool, make the stool masses soft and not cause stagnation of blood in the rectum.

1. A person is recommended to drink daily, - 2 liters of water, which also makes the stool masses softer. A daily intake of fermented milk products gives a lax effect.
2. It is necessary to refuse bread from white flour, as it slugs the intestines, as well as from spicy seasonings, smoked and pickled products, alcohol, especially high fortress.
3. It is desirable that the basis of the ration was vegetables and fruits. They contain coarse fiber (dietary fiber), which helps digestion.

Surgery

In some cases, extensive and difficult to heal anal fissures require surgical intervention for effective treatment. Several effects are used. The most common operations are called lateral internal sphincterotomy.

During this procedure, the doctor makes a tiny incision and shares certain layers of the sphincter muscle. This allows you to prevent muscle spasms, which leads to complete elimination of tension during bowel emptying. The method of suturing the walls and excising the mucous membranes, which are affected by scarring and sclerosing, is also used.

How long does it take to treat an anal fissure?

The duration of anal fissure treatment in adults depends on the severity of the disease and the chosen therapy regimen.

Non-surgical treatment of a crack with the help of diet, hygiene procedures and medicines, at home can help alleviate the symptoms of the disease in a few days and lead to a full recovery in 4-8 weeks.

The complexity of the surgical treatment of the anal fissure and the length of the recovery period after surgery depend on the degree of development of the disease and the type of surgery performed.

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