Individuals suffering from an anal fissure are often in some kind of pain. Aside from causing blood in the stool, it can result to pain during and after defecation. Anal fissures, depending on the time of resolution, may be classified as either acute or chronic.
Acute anal fissures
This comprises the majority of anal fissure cases (approximately 90% of patients). Acute cases often resolve on their own with little to no medical and dietary intervention. The most common change involved in these cases is the addition of fiber and laxatives in the diet in order to prevent constipation, straining and trauma to the mucosal lining of the anus.
Normally, anal fissures are classified as acute when the condition heals within 6 weeks or less. Pain is also noted to disappear within this timeframe. It is known that patients who suffer from anal fissures are plagued with pain during the process of defecation and sometimes, even after the act. Pain, though acute, may be amplified especially in cases of multiple fissures.
Chronic anal fissures
A case is categorized as chronic when the condition has not healed within a 6-week period even when placed on a typical treatment regimen. Approximately 10% of cases turn out to be chronic anal fissures.
Chronic cases are often brought about by a variety of underlying factors such as childbirth, immune disorders and diseases of the gastrointestinal tract. This is the main reason why in most cases of chronic anal fissures, further investigation should be done in order to determine the underlying cause as to why the condition failed to respond to the usual treatment.
Another cause for alarm in chronic cases would be the amount of pain that the patient has to endure. Little has been determined on the actual process leading to the formation of chronic anal fissures and numerous factors have been suspected to be involved in it. Some of these are local ischemia, childbirth, and anal spasms.
Treatment for acute cases
Since most acute cases of anal fissures are self-limiting, the most common treatment is to add fiber-rich foods in the diet. Taking laxatives to help pass stool without straining is also a good treatment option. The use of the latter also prevents any further pain during bowl movement.
In addition to this, it is also advised to increase the amount of water intake in order to prevent dehydration, which may lead to softer stool formation. No medications for pain are often prescribed since these also resolve on their own.
Treatment for chronic cases
As for cases of chronic anal fissures, if the traditional methods of treatment do not work, drug therapy and surgical intervention are the usual action plans to consider. Most treatment plans for chronic cases are geared towards allowing the fissure to heal and prevent whatever it is that hinders the process. From topical ointments, oral medications to surgical procedures, a variety of options are available to treat chronic cases. These all depend on the degree of trauma that has been caused by the anal fissure.
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