An anal fissure is a tear in the skin around the opening of the anus. Anal fissure can cause sharp pain during bowel movement and it is often accompanied by itching, signs of bleeding, and smelly discharge. The most common cause of anal fissure is constipation or the passing of hard and large stools. It may also be caused by frequent diarrhea and childbirth.
A visual inspection of the anal area is often enough to diagnose anal fissure. More intensive examination may be required if the doctor suspects inflammatory bowel diseases or other conditions. The location of anal fissure and the presence of skin tags may indicate underlying conditions.
Most anal fissures heal on their own after weeks of self-care. Before you can start with an appropriate home treatment, it’s important to know how to differentiate anal fissures from abscess, polyp, pruritus ani, and other anorectal conditions.
An anal abscess is a painful, pus-filled cavity near the anus. Anal abscesses commonly result from bacterial infection of small anal glands and often appear as a red, warm, boil-like swelling in the anal area. Pus may develop on both anal fissure and abscess. However, an anal abscess is a lump or nodule in the anal area with pus, while an anal fissure is a cut which may or may not be accompanied by pus. An anal fissure causes pain during bowel movement while an anal abscess is almost always painful until the pus is discharged. Other symptoms of anal abscess include painful or tender tissue, redness, swelling, fatigue, fever, and chills. A doctor may easily identify anal abscess thorough an examination of the anal area, but an anoscope may be required if the abscess is not located on the skin surface.
Polyps are abnormal cell growths within the lining of the colon or rectum. Most are benign but can lead to cancer if not treated. A polyp also may develop at the inner edge of an old fissure. Both polyps and anal fissure can both cause blood to appear on the stool, but polyps are growths on the large intestines or rectum while anal fissures are superficial and visible lesions on the anal canal. Polyps may be diagnosed through endoscopic or virtual colonoscopy, flexible sigmoidoscopy, and barium enema. Anal fissures are easily identified through routine physical examination.
Pruritus ani is the itching of the skin surrounding the anus. The symptoms appear typically after bowel movement and most sufferers complain of the irresistible urge to scratch. Pruritus ani may start with skin redness which can gradually progress to skin thickening. Cracks or open sores can also develop which may cause some blood to end up on the tissue when wiping after passing stools. Pruritus ani is a symptom that is common to most anorectal conditions and will disappear once the cause is treated.
Knowing how to differentiate anal fissures from abscess, polyp, pruritus ani, and other anal conditions can help simplify the treatment approach and allow a sufferer to start self-care as soon as possible.
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