Materiały źródłowe

• #1 Anal Fissure: What It Is, Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/13177-anal-fissures

  An anal fissure is a crack or split in the tissues that line your anal canal. Trauma causes the lining to tear, causing acute pain and bleeding. Most fissures heal with self-care. […] Most anal fissures heal within a few days to weeks. A chronic anal fissure lasts more than eight weeks. If you’re in treatment for a chronic anal fissure, it may take another six to 12 weeks for the treatment to work and the fissure to finally heal. […] Most anal fissures will heal on their own, but you can help the process along with a little self-care. Here’s some advice: To make pooping more comfortable, consider a stool softener. Use a step stool to support your feet while sitting on the toilet, which helps position your hips in a squatting position. […] Apply a topical ointment or cream to your fissure. Petroleum jelly can promote healing by sealing in moisture and acting as an antibiotic. Medicated creams can treat inflammation and pain.

• #2 Anal fissure | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/anal-fissure

  An anal fissure is a tear or split in the lining of the anus (anal mucosa). […] Treatment options include laxatives and surgery. […] Around half of cases heal by themselves with proper self-care and avoidance of constipation. However, healing can be a problem if the pressure of passing bowel motions constantly reopens the fissure. Treatment options include surgery. […] Medical treatment for an anal fissure may include: pain-relieving medication, laxatives, anaesthetic creams, nitroglycerin creams or Botox injections to relax the associated muscle spasm, surgery. […] Severe anal fissures need to be surgically corrected. The fissure and associated scar tissue is removed. […] Be guided by your health care professional, but general suggestions include: Apply petroleum jelly to the anus. […] Many cases of anal fissures are caused by chronic constipation. Suggestions include: Eat a high-fibre diet. […] Drink plenty of water to help soften stools.

• #3 Anal fissure: diagnosis, management, and referral in primary care

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6650108/

  Anal fissures are tears of the anal mucosa. They can cause extreme pain (often up to 12 hours post-defaecation) and in many cases bleeding. […] If not treated effectively, anal fissures can lead to recurrence, infection, or abscesses. They can also lead to faecal impaction as patients avoid defaecation, not to mention the overall reduced quality of life. A mainstay of management of anal fissures is ensuring that stools are soft, regular, and passed easily. Adults should increase their dietary fibre intake to 1830 g per day and ensure adequate fluid intake. […] Sound pain control is also required. This can be achieved through regular analgesia such as paracetamol or ibuprofen. […] Glyceryl trinitrate 0.2% or 0.4% rectal ointment can be prescribed to encourage healing of anal fissures. This should be used twice a day for up to 8 weeks.

• #4 Anal fissure – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/563

  Anal fissure causes severe pain on defecation, often described as 'like passing broken glass’. The pain may continue for 1 to 2 hours and can also be burning in nature. […] Initial treatment should include either topical glyceryl trinitrate or diltiazem, along with a programme of supportive care. […] Resistant or chronic fissures may benefit from botulinum toxin A, and most cases can be cured by surgical sphincterotomy or anal advancement flap.

• #5 Expert Care for Anal Fissures | UNC REX – Colorectal Surgery

  https://www.uncrexcolorectalsurgery.com/colorectal-condition-information-raleigh/anorectal-conditions/fissures/

  Anal fissures are tears in the lining of the anal canal, typically just inside the anus. These tears cause very sensitive nerve fibers to be exposed to constant irritation. Two main types of anal fissures can occur: […] Acute anal fissure. These severe tears typically heal with appropriate medical treatment, often in less than six weeks. […] Chronic anal fissure. These tears can last for months or even years, severely impacting your quality of life. […] Symptoms of anal fissures typically include bleeding and severe pain while having a bowel movement. Pain after bowel movements can last for hours. […] If you have an acute anal fissure, your surgeon will usually suggest a combination of medical treatments. An acute anal fissure has an 87 percent chance of healing with these treatments.

• #6 Anal Fissure | Section of Colon and Rectal Surgery | Washington University in St. Louis

  https://colorectalsurgery.wustl.edu/patient-care/cope-center/anorectal-disorders/anal-fissure/

  An anal fissure is a tear or split in the perianal skin that can cause bleeding and painful bowel movements. These are usually caused by constipation or repetitive diarrhea. Approximately 80-90% of anal fissures will heal if the following measures are taken: […] Maintain a high fiber diet (25-30 grams) You will be provided with a fiber information sheet. If you take a fiber supplement, it should be taken in the morning or afternoon (not before bed). Drink fiber supplements with plenty of fluids to reduce the chances of constipation. […] Sitz baths This is a method to provide pain relief and speed the healing of the fissure. This involves sitting in a warm bath or shower, directed at the anal area. These should be done two to three times a day for 10 to 15 minutes. These can also be used to clean the anal area after a bowel movement to avoid further irritation caused from using toilet paper.

• #7 Anal Fissure Treatment & Management: Approach Considerations, Medical Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/196297-treatment

  Failure of medical therapy to resolve the acute fissure is an indication for surgical intervention. […] The main contraindication for surgical treatment of an anal fissure is impaired fecal continence, a state that could be exacerbated by a surgical procedure. […] Patients with gross fecal incontinence (solid material) rarely develop fissures; however, those with irritable bowel syndrome (IBS) and incontinence to liquid stool can develop fissures if they become constipated. […] Initial therapy for an anal fissure is medical in nature, and more than 80% of acute anal fissures resolve without further treatment. […] The goals of treatment are to relieve the constipation and to break the cycle of hard bowel movement, associated pain, and worsening constipation. […] First-line medical therapy consists of administration of stool-bulking agents, such as fiber supplementation and stool softeners.

• #8 Anal Fissure – Clinical Features – Management – TeachMeSurgery

  https://teachmesurgery.com/general/anorectal/anal-fissure/

  An anal fissure is a tear in the mucosal lining of the anal canal, most commonly due to trauma from defecation of hard stool. The medical management of an anal fissure involves treating any underlying precipitating factors and providing adequate analgesia. The majority of patients do not require surgery. Advise the patient to increase their fibre and fluid intake and can trial stool-softening laxatives (such as Movicol) if needed. Topical anaesthetics, such as lidocaine, can also provide short term symptomatic relief. In symptomatic patients, GTN cream or diltiazem cream can be trialled – these act by increasing the blood supply to the region and relaxing the internal anal sphincter, putting less pressure on the fissure, promoting healing, and reducing pain. Surgical therapy is mainly reserved for chronic fissures, where medical management has failed to resolve the symptoms. Most patients will be trialed initially with Botox injections, given into the internal anal sphincter acting to relax the sphincter and promote healing of the fissure. In patients with ongoing symptoms despite these measures, a lateral sphincterotomy can be performed, involving division of the internal anal sphincter muscle. Recurrence of anal fissures post-surgery occurs approximately in 1-5% patients. Anal fissures present with intense pain post-defecation, as well as potential bleeding or itching. Risk factors include constipation and IBD. Most cases can be managed conservatively with medical management. Consider investigating for underlying causes for those with anterior fissures or recurrent disease.

• #9 Anal Fissure | Colon and Rectal Care | Mercy Health

  https://www.mercy.com/health-care-services/gastroenterology/conditions/anal-fissure

  Anal fissures are most often caused by passing large or hard stool. […] The first step to treating anal fissures is caring for yourself. The goal is for the fissure to heal on its own. Start by increasing the amount of non-caffeinated and alcohol-free liquids you drink throughout the day. You may need to also take a fiber supplement to get 20 to 35 grams of fiber every day. […] Sitz baths involve soaking your anal area in warm water a few times a day. You can do this for up to 15 minutes each bath. These can help improve blood flow to the area and relax your sphincter muscle. […] Sometimes these treatments don’t work. You may need surgery. Your doctor makes a small cut in your sphincter muscle to reduce the pressure and allow your fissure to heal.

• #10 Anal Fissures – Children’s Hospital of Orange County

  https://choc.org/programs-services/gastroenterology/constipation/anal-fissures/

  Anal fissures are tears or cracks in the anus. Fissures result from stretching the anal mucosa beyond its normal capacity. Once the tear occurs, it leads to repeated injury. The exposed internal sphincter muscle beneath the tear goes into spasm. This causes severe pain. The spasm also pulls the edges of the fissure apart, making it difficult for the wound to heal. The spasm then leads to further tearing of the mucosa during bowel movements. This cycle leads to the development of a chronic anal fissure in approximately 40 percent of patients. […] An acute anal fissure typically heals within six weeks with conservative treatment. Some disappear when constipation is treated. Anal fissures that last for six weeks or more are called chronic anal fissures. These fail conservative treatment and require a more aggressive, surgical approach.

• #11 Patient education: Anal fissure (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/anal-fissure-beyond-the-basics

  ANAL FISSURE OVERVIEW […] An anal fissure is a tear in the lining of the anus, the opening where feces are excreted. The tear typically extends into a circular ring of muscle called the internal anal sphincter. The fissure is described as acute if it has been present for less than six weeks or chronic if present for more than six weeks. […] Once a fissure develops, the internal anal sphincter typically goes into spasm, causing further separation of the tear, constricting blood flow to the area, impairing healing, and causing pain. […] ANAL FISSURE TREATMENT […] Medical and surgical treatments are aimed at reducing the tone of the internal sphincter muscle, leading to pain relief and healing of the anal fissure. People with a new anal fissure may resolve this ailment without medical treatment, though a higher rate of cure is associated with treatment by a physician. By contrast, those with a chronic anal fissure usually require medical intervention.

• #12

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uh3165

  An anal fissure is a tear in the lining of the lower rectum (anus). It can itch and cause pain. You may notice bright red blood on toilet paper after you wipe. A fissure may form if you’re constipated and try to pass a large, hard stool or if you don’t relax your anal muscles during a bowel movement. […] Most anal fissures heal with home treatment after a few days or weeks. If you have an anal fissure that takes more time to heal, your doctor may prescribe medicine. In rare cases, surgery may be needed. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

• #13 Anal Fissure | Digestive Care Center

  https://dccevv.com/conditions/anal-fissure/

  An anal fissure (fissure-in-ano) is a small, oval shaped tear in skin that lines the opening of the anus. Fissures typically cause severe pain and bleeding with bowel movements. The typical symptoms of an anal fissure include severe pain during, and especially after, a bowel movement, lasting from several minutes to a few hours. Patients may also notice bright red blood from the anus that can be seen on the toilet paper or on the stool. Many patients are fearful of having a bowel movement and may try to avoid defecation secondary to the pain. […] The majority of anal fissures do not require surgery. The most common treatment for an acute anal fissure consists of making the stool more formed and bulky with a diet high in fiber and utilization of over-the-counter fiber supplementation (totaling 25-35 grams of fiber/day). Stool softeners and increasing water intake may be necessary to promote soft bowel movements and aid in the healing process. Topical anesthetics for pain and warm tub baths (sitz baths) for 10-20 minutes several times a day (especially after bowel movements) are soothing and promote relaxation of the anal muscles, which may help the healing process.

• #14 Diagnosis and Management of Patients with Anal Fissures | AAFP

  https://www.aafp.org/pubs/afp/issues/2003/0401/p1608.html

  Patients with anal fissures usually present with pain and bleeding. Pain is often most severe during or after a bowel movement, while bleeding is usually bright red and minimal. An accurate diagnosis can often be made on the basis of the patient’s history. The American Gastroenterological Association has issued recommendations on the diagnosis and management of anal fissures. […] Increased fiber and fluid intake, sitz baths, and topical analgesics are the usual measures used in the management of acute fissures, and most fissures heal with minimal care. Emollient suppositories also may be useful. […] Further treatment options include surgery, topical therapy, and botulin toxin. Surgery involves a sphincterotomy that rapidly reduces symptoms but occasionally results in fecal incontinence that can be permanent.

• #15 Anal fissure: diagnosis, management, and referral in primary care

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6650108/

  It is important that patients understand that these topical preparations do not in themselves relieve pain on application, although they lead to successful healing of fissures in most cases. […] For fissures in unusual positions, in multiple locations, or not healing despite optimal conservative therapy, a secondary anal fissure should be suspected. For these patients, management of the underlying condition should also be optimised and referral initiated. […] Conservative management with stool softening and analgesia should be explored first. Glyceryl trinitrate can be used; however, the side effect profile and recurrence rate for some patients may mean that treatment is ineffective. Topical diltiazem and nifedipine can be tried as alternatives. If, after 8 weeks, medical therapy has not proven to be effective, referral to secondary care is welcomed. If an anal fissure is suspected to be secondary to a serious underlying condition, referral should be expedited.

• #16 Anal Fissure (Discharge Care)

  https://www.drugs.com/cg/anal-fissure-discharge-care.html

  An anal fissure is a cut or tear in the tissue inside your anus. An anal fissure may be acute or chronic. A chronic anal fissure comes back after treatment. […] Seek care immediately if: You have severe pain in or around your anus. You have bleeding from your anus that does not stop. […] Call your doctor if: You have questions or concerns about your condition or care. […] Stool softeners help make your bowel movements softer. This helps prevent constipation. You will be less likely to strain and cause an anal fissure if you are not constipated. […] Soak in a warm tub or take a sitz bath. A sitz bath may decrease your pain and relax your anal muscle. You may need to do this more than 1 time each day. […] Eat foods that are high in fiber. This will help keep your bowel movements soft. High-fiber foods include fruits, vegetables, and whole grains.

• #17

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=zx4632

  Support your child’s feet with a small step stool when your child sits on the toilet. This helps flex the hips. It places the pelvis in a squatting position. […] If your doctor recommends it, use or have your child use baby wipes or medicated pads, such as Preparation H or Tucks. Use them instead of toilet paper to clean after a bowel movement. These products do not irritate the anus. […] Call your doctor or nurse advice line now or seek immediate medical care if your child has new or worse pain. Your child has new or worse bleeding from the rectum. […] Watch closely for changes in your child’s health, and be sure to contact your doctor or nurse advice line if your child has trouble passing stools. Your child does not get better as expected.

• #18 Anal Fissures | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/anal-fissures

  An anal fissure is a small crack or tear in the delicate skin around the anus that causes sharp pain and bleeding during and after a bowel movement. […] Patients can often treat their anal fissures with simple measures, such as taking warm baths and adding more fiber to their diet. […] The goal of treatment is to alleviate pain and control spasms so that the tear in the skin can heal. […] Most acute anal fissures will heal on their own within four to six weeks. You can help the process along with the following self-care measures: Take a warm bath, without soap, two or three times a day, especially after bowel movements. The warm water soothes the area and relaxes the anal sphincter muscles. […] When a fissure is chronic, the first line of treatment is usually one of the following topical medications: Lidocaine. While it won’t help heal the fissure, lidocaine can relieve the pain by numbing the area.

• #19 Anal fissure – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/anal-fissure/diagnosis-treatment/drc-20351430

  Our caring team of Mayo Clinic experts can help you with your anal fissure-related health concerns […] Anal fissures often heal within a few weeks with appropriate home treatment. Take steps to keep the stool soft, such as increasing your intake of fiber and fluids. Soak in warm water for 10 to 20 minutes several times a day, especially after bowel movements. This can help relax the sphincter and promote healing. If symptoms persist, you’ll likely need further treatment. […] Several lifestyle changes may help relieve discomfort and promote healing of an anal fissure, as well as prevent one from coming back. Changes include: Adding fiber to your diet. Eating about 25 to 35 grams of fiber a day can help keep stools soft and improve fissure healing. […] While you’re waiting to see your healthcare professional, take steps to avoid constipation, such as: Drinking plenty of water. Adding fiber to your diet. Exercising regularly. […] Also, don’t strain during bowel movements. The extra pressure may lengthen the fissure or create a new one.

• #20 Anal Fissure: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.anal-fissure-care-instructions.uh3165

  Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] If your doctor prescribed cream or ointment, use it exactly as prescribed. Call your doctor if you think you are having a problem with your medicine. You will get more details on the specific medicines your doctor prescribes. […] Sit in a few inches of warm water (sitz bath) 3 times a day and after bowel movements. The warm water helps the area heal and eases discomfort. Do not put soaps, salts, or shampoos in the water. […] Avoid constipation: Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fiber.

• #21

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uh3165

  If your doctor prescribed cream or ointment, use it exactly as prescribed. Call your doctor if you think you are having a problem with your medicine. You will get more details on the specific medicines your doctor prescribes. […] Sit in 8 to 10 centimetres (3 to 4 inches) of warm water (sitz bath) 3 times a day and after bowel movements. The warm water helps the area heal and eases discomfort. Do not put soaps, salts, or shampoos in the water. […] Avoid constipation: Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fibre. […] Drink plenty of fluids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink. […] Get some exercise every day. Build up slowly to at least 2 hours of moderate to vigorous exercise a week.

• #22 Anal Fissures | Conditions | UCSF Health

  https://www.ucsfhealth.org/education/anal-fissures

  An anal fissure is a small crack or tear in the delicate skin around the anus that causes sharp pain and bleeding during and after a bowel movement. […] Patients can often treat their anal fissures with simple measures, such as taking warm baths and adding more fiber to their diet. […] The goal of treatment is to alleviate pain and control spasms so that the tear in the skin can heal. […] Most acute anal fissures will heal on their own within four to six weeks. You can help the process along with the following self-care measures: Take a warm bath, without soap, two or three times a day, especially after bowel movements. The warm water soothes the area and relaxes the anal sphincter muscles. […] When a fissure is chronic, the first line of treatment is usually one of the following topical medications: Lidocaine. While it won’t help heal the fissure, lidocaine can relieve the pain by numbing the area. […] If your fissure persists or your symptoms are severe, your doctor may suggest one of two procedures to relax the muscles in the anal sphincter. Both are highly effective. […] Both treatments are done on an outpatient basis (no hospital stay required).

• #23 Anal fissure treatment – Recovery | Guy’s and St Thomas’ NHS Foundation Trust

  https://www.guysandstthomas.nhs.uk/health-information/anal-fissure-treatment/recovery

  Most people have surgery in the day surgery unit and can leave hospital on the same day. […] You need a family member or friend to travel home and stay with you for at least 24 hours after your surgery. It’s important that you rest for the remainder of the day. […] We might give you some painkillers, gel or creams to put on your bottom. […] Try to wash the area with water and pat it dry, or use alcohol-free wet wipes after going to the toilet to have a poo. Avoid using dry toilet tissue. […] Keep the area clean and gently bathe your wound in a warm bath each day, if possible. This can also help with your pain. […] Do not use soap, or put salt or any perfumed products in the water until your wound has healed. These could irritate your wound. […] You should be able to go to the toilet normally and naturally after surgery. It is important to keep your poo (stool) soft. This can prevent any damage to your anus and ease your pain.

• #24 Anal Fissure | Section of Colon and Rectal Surgery | Washington University in St. Louis

  https://colorectalsurgery.wustl.edu/patient-care/cope-center/anorectal-disorders/anal-fissure/

  An anal fissure is a tear or split in the perianal skin that can cause bleeding and painful bowel movements. These are usually caused by constipation or repetitive diarrhea. Approximately 80-90% of anal fissures will heal if the following measures are taken: […] Maintain a high fiber diet (25-30 grams) You will be provided with a fiber information sheet. If you take a fiber supplement, it should be taken in the morning or afternoon (not before bed). Drink fiber supplements with plenty of fluids to reduce the chances of constipation. […] Sitz baths This is a method to provide pain relief and speed the healing of the fissure. This involves sitting in a warm bath or shower, directed at the anal area. These should be done two to three times a day for 10 to 15 minutes. These can also be used to clean the anal area after a bowel movement to avoid further irritation caused from using toilet paper.

• #25

  https://fascrs.org/patients/diseases-and-conditions/a-z/anal-fissure

  Anal fissures typically cause a sharp pain that starts with the passage of stool. This pain may last several minutes to a few hours. As a result, many patients may try not to have bowel movements to prevent the pain. […] Treatment includes: A high-fiber diet and over-the-counter fiber supplements (25-35 grams of fiber/day) to make stools soft, formed, and bulky. Over-the-counter stool softeners to make stools easier to pass. Drinking more water to help prevent hard stools and aid in healing. Warm tub baths (sitz baths) for 10 to 20 minutes, a few times per day (especially after bowel movements to soothe the area and help relax anal sphincter muscles). This is thought to help the healing process. […] Most patients can return to work and go back to daily activities a few days after surgery. Complete healing after both medical and surgical treatments can take 6 to 10 weeks. Even when the pain and bleeding lessen, it is important to maintain good bowel habits and eat a high-fiber diet. Continued hard or loose bowel movements, scarring, or spasm of the internal anal muscle can delay healing.

• #26 Anal Fissure

  https://mentalhealth.networkofcare.org/Alameda/HealthLibrary/Article?docType=na&articleId=uf4764

  Anal fissures are a common problem. They affect people of all ages. […] Most anal fissures heal with home treatment after a few days or weeks. These are called short-term (acute) anal fissures. If you have an anal fissure that hasn’t healed after 8 to 12 weeks, it is considered a long-term (chronic) fissure. A chronic fissure may need medical treatment. […] If your doctor prescribed cream or ointment, use it exactly as prescribed. Call your doctor if you think you are having a problem with your medicine. You will get more details on the specific medicines your doctor prescribes. […] Sit in a few inches of warm water (sitz bath) 3 times a day and after bowel movements. The warm water helps the area heal and eases discomfort. Do not put soaps, salts, or shampoos in the water. […] Avoid constipation: Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fiber.

• #27 Anal Fissure: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.anal-fissure-care-instructions.uh3165

  Drink plenty of fluids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink. […] Get some exercise every day. Build up slowly to 30 to 60 minutes a day on 5 or more days of the week. […] Take a fiber supplement, such as Benefiber or Metamucil, every day if needed. Read and follow all instructions on the label. […] Use the toilet when you feel the urge. Or when you can, schedule time each day for a bowel movement. A daily routine may help. Take your time and do not strain when having a bowel movement. But do not sit on the toilet for more than 10 minutes. […] Support your feet with a small step stool when you sit on the toilet. This helps flex your hips and places your pelvis in a squatting position.

• #28

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uh3165

  Use baby wipes or medicated pads, such as Preparation H or Tucks, instead of toilet paper to clean after a bowel movement. These products do not irritate the anus. […] Be safe with medicines. Read and follow all instructions on the label. If the doctor gave you a prescription medicine for pain, give it as prescribed. […] If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine. […] Call your doctor or nurse advice line now or seek immediate medical care if: You have new or worse pain. […] You have new or worse bleeding from the rectum. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if: You do not get better as expected. […] You have trouble passing stools.

• #29 Anal Fissure: Symptoms, Causes, and Treatment

  https://patient.info/digestive-health/rectal-bleeding-blood-in-faeces/anal-fissure

  An anal fissure is a small tear in the lining of the skin around the back passage (anus). For most people, the anal fissure heals quite quickly but some form of treatment is often needed. Anal fissures may keep coming back. […] For most people the anal fissure heals within a week or so, just like any other small cut or tear to the skin. Treating anal fissures aims to ease the pain and to keep the stools (faeces) soft whilst the fissure heals. […] Warm baths, also known as Sitz baths, are soothing and may help the back passage (anus) to relax to help ease the pain. […] A cream or ointment that contains an anaesthetic (to numb the skin) such as lidocaine may help to ease the pain. […] Wash the anus carefully with water after going to the toilet. Dry gently. Don’t use soap or wet wipes whilst it is sore as this may cause skin irritation.

• #30 Anal Fissure: What It Is, Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/13177-anal-fissures

  An anal fissure is a crack or split in the tissues that line your anal canal. Trauma causes the lining to tear, causing acute pain and bleeding. Most fissures heal with self-care. […] Most anal fissures heal within a few days to weeks. A chronic anal fissure lasts more than eight weeks. If you’re in treatment for a chronic anal fissure, it may take another six to 12 weeks for the treatment to work and the fissure to finally heal. […] Most anal fissures will heal on their own, but you can help the process along with a little self-care. Here’s some advice: To make pooping more comfortable, consider a stool softener. Use a step stool to support your feet while sitting on the toilet, which helps position your hips in a squatting position. […] Apply a topical ointment or cream to your fissure. Petroleum jelly can promote healing by sealing in moisture and acting as an antibiotic. Medicated creams can treat inflammation and pain.

• #31

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uh3165

  Take a fibre supplement, such as Benefibre or Metamucil, every day if needed. Read and follow all instructions on the label. […] Use the toilet when you feel the urge. Or when you can, schedule time each day for a bowel movement. A daily routine may help. Take your time and do not strain when having a bowel movement. But do not sit on the toilet for more than 10 minutes. […] Support your feet with a small step stool when you sit on the toilet. This helps flex your hips and places your pelvis in a squatting position. […] Your doctor may recommend an over-the-counter laxative, such as Milk of Magnesia or Restoralax. Read and follow all instructions on the label, and do not use these medicines on a long-term basis. […] Do not use over-the-counter ointments or creams without talking to your doctor. Some of these preparations may not help.

• #32

  https://www.nhs.uk/conditions/anal-fissure/treatment/

  Like other small cuts or tears to the skin, an anal fissure will often heal by itself within a few weeks. […] However, you should see a GP if you have an anal fissure as they can give you advice and medicines to help ease your symptoms and allow the fissure to heal more quickly. […] Most anal fissures will heal with treatment, although they can happen again easily, particularly if you do not follow self-help advice. […] There are a number of self-help measures the GP may recommend to relieve constipation and reduce the pain caused by anal fissures. […] Relieving constipation can allow anal fissures to heal and reduce the chance of further fissures developing in the future. […] There are a number of different medicines a GP may recommend to help reduce your symptoms and allow your anal fissure to heal.

• #33

  https://www.nhs.uk/conditions/anal-fissure/treatment/

  If you have prolonged burning pain after having a poo, the GP may recommend taking common painkillers, such as paracetamol or ibuprofen, which you can buy from a pharmacy or supermarket. […] If your symptoms do not improve within a week or 2, the GP may prescribe a medicine called glyceryl trinitrate (GTN), an ointment applied to the anal canal, usually twice a day. […] The majority of acute fissures (present for less than 6 weeks) will heal with GTN treatment. […] If you have particularly severe anal pain, the GP may prescribe a topical anaesthetic to numb your anus before you have a poo. […] Topical calcium channel blockers are thought to be about as effective as GTN ointment for treating anal fissures, and may be recommended if other medicines have not helped. […] Surgery may be recommended if other treatments have not worked.

• #34 Information and Treatment for Anal Fissure | Brown University Health

  https://www.brownhealth.org/centers-services/pelvic-floor-disorders-program/pelvic-floor-disorders/information-and-treatment

  To avoid an anal fissure caused by constipation, keep your bowels regular and stools soft by getting plenty of fiber in your diet or taking supplementary fiber, and drinking plenty of water, six to eight 10-ounce glasses a day. […] You can soothe the pain of an anal fissure with acetaminophen or ibuprofen, use topical anesthetics that contain lidocaine, and take sitz baths (sit in warm water for 10 to 20 minutes) several times a day. The soaks promote relaxation of the anal muscles, which may hasten healing. […] Anal fissures usually heal within a few weeks without the need for treatment. Your health care professional may recommend applying medicated ointment, taking soothing sitz baths (sitting in warm water), and taking over-the-counter analgesics. Narcotic pain medications are not recommended, as they promote constipation.

• #35 Patient education: Anal fissure (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/anal-fissure-beyond-the-basics

  Laxatives — A variety of drugs and natural products are available for treating constipation. […] Topical nifedipine and topical nitroglycerin — Topical nifedipine works by reducing the internal anal sphincter pressure. Nifedipine is available in pill form for other indications but is best used for fissure treatment when compounded into a topical treatment and applied directly to the perianal skin. Topical treatment with 0.2 to 0.3% nifedipine two to four times a day has few side effects. […] Nitroglycerin also results in a reduction in pressure of the internal anal sphincter, which decreases pain and further facilitates healing. […] Botulinum toxin — Botulinum toxin is a neurotoxin produced by a bacterium, Clostridium botulinum. It temporarily paralyzes muscles for up to three months, and it can be injected into the internal anal sphincter muscle in a clinician’s office without anesthesia or sedation.

• #36

  https://www.nhs.uk/conditions/anal-fissure/treatment/

  If you have prolonged burning pain after having a poo, the GP may recommend taking common painkillers, such as paracetamol or ibuprofen, which you can buy from a pharmacy or supermarket. […] If your symptoms do not improve within a week or 2, the GP may prescribe a medicine called glyceryl trinitrate (GTN), an ointment applied to the anal canal, usually twice a day. […] The majority of acute fissures (present for less than 6 weeks) will heal with GTN treatment. […] If you have particularly severe anal pain, the GP may prescribe a topical anaesthetic to numb your anus before you have a poo. […] Topical calcium channel blockers are thought to be about as effective as GTN ointment for treating anal fissures, and may be recommended if other medicines have not helped. […] Surgery may be recommended if other treatments have not worked.

• #37

  https://bpac.org.nz/BPJ/2013/April/anal-fissures.aspx

  All topical treatments for anal fissures should be applied for at least six weeks to allow re-epithelialisation of the fissure. […] A topical nitrate, e.g. glyceryl trinitrate 0.2% ointment, should be considered if the fissure has been present for at least three weeks. […] If the fissure has not healed after six to eight weeks of topical treatment and dietary changes, the patient should be referred to secondary care to assess the appropriateness of other treatments, usually botulinum toxin or surgery. […] Surgical techniques commonly used for anal fissures which aim to relax the internal sphincter include; open lateral sphincterotomy, closed lateral sphincterotomy and posterior midline sphincterotomy. […] Surgery is consistently superior to medical management options, although it should only be considered in people with chronic, non-healing anal fissures where medical treatments have failed.

• #38 Anal Fissure

  https://mentalhealth.networkofcare.org/Alameda/HealthLibrary/Article?docType=na&articleId=uf4764

  Your doctor may recommend an over-the-counter laxative, such as Miralax, Milk of Magnesia, or Ex-Lax. Read and follow all instructions on the label, and do not use these medicines on a long-term basis. […] Most anal fissures heal in a few days or weeks with home treatment. But if a fissure lasts more than 8 to 12 weeks, you may need prescription medicines. These may include cream or gel vasodilator medicines or botulinum toxin (Botox) injections. […] In rare cases, surgery may be needed. The most common surgery is called a lateral internal sphincterotomy. In this procedure, a doctor cuts into part of the internal sphincter to relax the spasm that is causing the fissure.

• #39

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uh3165

  Take a fibre supplement, such as Benefibre or Metamucil, every day if needed. Read and follow all instructions on the label. […] Use the toilet when you feel the urge. Or when you can, schedule time each day for a bowel movement. A daily routine may help. Take your time and do not strain when having a bowel movement. But do not sit on the toilet for more than 10 minutes. […] Support your feet with a small step stool when you sit on the toilet. This helps flex your hips and places your pelvis in a squatting position. […] Your doctor may recommend an over-the-counter laxative, such as Milk of Magnesia or Restoralax. Read and follow all instructions on the label, and do not use these medicines on a long-term basis. […] Do not use over-the-counter ointments or creams without talking to your doctor. Some of these preparations may not help.

• #40 Anal Fissure

  https://mentalhealth.networkofcare.org/Alameda/HealthLibrary/Article?docType=na&articleId=uf4764

  Your doctor may recommend an over-the-counter laxative, such as Miralax, Milk of Magnesia, or Ex-Lax. Read and follow all instructions on the label, and do not use these medicines on a long-term basis. […] Most anal fissures heal in a few days or weeks with home treatment. But if a fissure lasts more than 8 to 12 weeks, you may need prescription medicines. These may include cream or gel vasodilator medicines or botulinum toxin (Botox) injections. […] In rare cases, surgery may be needed. The most common surgery is called a lateral internal sphincterotomy. In this procedure, a doctor cuts into part of the internal sphincter to relax the spasm that is causing the fissure.

• #41 Anal Fissure Treatment & Management: Approach Considerations, Medical Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/196297-treatment

  Sitz baths after bowel movements and as needed provide significant alleviation of symptoms by relieving some of the painful internal sphincter muscle spasm. […] Recurrence rates are in the range of 30-70% if the high-fiber diet is abandoned after the fissure is healed. […] Second-line medical therapy consists of intra-anal application of 0.4% nitroglycerin (NTG; also called glycerol trinitrate) ointment directly to the internal sphincter. […] Nitroglycerin rectal ointment is approved by the US Food and Drug Administration (FDA) for moderate-to-severe pain associated with anal fissures and may be considered when first-line conservative therapies have failed. […] Surgical therapy is usually reserved for acute anal fissures that remain symptomatic after 3-4 weeks of medical therapy and for chronic anal fissures.

• #42

  https://www.nhs.uk/conditions/anal-fissure/treatment/

  It is generally considered to be the most effective treatment for anal fissures, with more than 9 out of 10 of people experiencing good long-term results. […] A lateral sphincterotomy involves making a small cut in the ring of muscle surrounding the sphincter to help reduce the tension in your anal canal. […] A lateral sphincterotomy is one of the most effective treatments for anal fissures, with a good track record of success.

• #43 Patient education: Anal fissure (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/anal-fissure-beyond-the-basics

  Surgery — Surgical procedures are generally reserved for people with symptoms that have persisted despite medical therapy for at least one to three months. The procedure of choice is called a lateral internal sphincterotomy, which relaxes the internal anal sphincter by cutting this muscle. This is generally performed as an outpatient procedure while providing the patient a general anesthetic. Pain from the sphincterotomy is usually mild and is often less than the pain of the fissure itself. Patients often return to normal activity within one week. […] The main concern with surgery is the development of fecal incontinence. Fecal incontinence can include the inability to control gas and/or stool. Mild incontinence in the form of anal seepage can occur in up to 45 percent of patients in the immediate postoperative period, and this may be mistaken by patients for permanent incontinence. However, this immediate postsurgical incontinence is rarely permanent and is usually mild. The risk for permanent incontinence should be discussed with your surgeon.

• #44 Fissure Surgery Postop Instructions – Paul E. Savoca

  https://www.paulsavocamd.com/instructions/fissure-surgery-postop-instructions/

  A sphincterotomy is a procedure performed to treat anal fissures. An anal fissure is a split in the lining of the anal canal, possibly resulting from a hard bowel movement. Muscle spasms and subsequent bowel movements prevent healing. […] During a sphincterotomy, the outermost part of the internal anal sphincter is cut. This breaks the muscle spasm, improving blood flow to the area of the fissure, resulting in relief of pain and healing of the fissure. […] Following your sphincterotomy, you may experience some mild to moderate pain or discomfort in your rectal area. You may also experience constipation, difficulty urinating, and possibly some rectal bleeding. The following are some general guidelines for proper care after your procedure. […] A small amount of bleeding is common following rectal surgery. A sanitary napkin or gauze may be worn over the anal opening to keep the underclothing clean.

• #45 Anal Fissure | Digestive Care Center

  https://dccevv.com/conditions/anal-fissure/

  Other medications (such as nitroglycerin, nifedipine, or diltiazem) may be prescribed that allow relaxation of the anal sphincter muscles. Chronic fissures are generally more difficult to treat, and your surgeon may advise surgical treatment. […] Surgical options for treating anal fissure include Botulinum toxin (Botox) injection into the anal sphincter and surgical division of a portion of the internal anal sphincter (lateral internal sphincterotomy). The goal of these surgical options is to promote relaxation of the anal sphincter, thereby decreasing anal pain and spasm, allowing the fissure to heal. Botox injection results in healing in 50-80% of patients, while sphincterotomy is reported to be over 90% successful. […] It is important to note that complete healing with both medical and surgical treatments can take up to approximately 6-10 weeks. However, acute pain after surgery often disappears after a few days. Most patients will be able to return to work and resume daily activities in a few short days after the surgery.

• #46 Anal Fissures | Colon & Rectal Surgical Specialists

  https://www.crssny.com/conditions/anal-fissures/

  Anal fissures can occur in patients of all ages, including young infants. […] The primary symptom of anal fissures is anal pain that gets worse with bowel movements. […] In many cases, anal fissures can heal within a few weeks with home treatments. […] Soaking in a warm bath several times a day, particularly after bowel movements, can help relax the sphincter and increase blood flow, and steroid creams can ease discomfort. […] Nonsurgical treatments, all of which relax the sphincter and encourage blood flow to promote healing, may include: […] If the anal fissure does not respond to nonsurgical treatments, then surgery will become necessary. […] Studies show that approximately 95% of anal fissures heal following surgery, and recurrence rates are extremely low (0-3%).

• #47 Anal Fissure Treatment & Management: Approach Considerations, Medical Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/196297-treatment

  The administration of two Fleet enemas on the morning of the procedure is sufficient bowel preparation for surgical treatment of an anal fissure. […] Sphincter dilatation is a controlled anal stretch or dilatation under general anesthetic. […] Lateral internal sphincterotomy is the current surgical procedure of choice for anal fissure. […] The purpose of the operation is to cut the hypertrophied internal sphincter, thereby releasing tension and allowing the fissure to heal. […] Sphincterotomy is performed either in an outpatient setting or as an office procedure, and patients return home the same day. […] Complications from surgery for anal fissure include infection, bleeding, fistula development, and incontinence (the most feared complication). […] Stool softeners and fiber supplementation should be prescribed after the surgical procedure, and fiber supplementation should be recommended indefinitely to prevent future problems with constipation.

• #48 Fissure Surgery Postop Instructions – Paul E. Savoca

  https://www.paulsavocamd.com/instructions/fissure-surgery-postop-instructions/

  Difficulty urinating after sphincterotomy is unusual but can occur due to spasm of the urinary sphincter resulting from pain due to the surgery. […] Take the pain medication you were prescribed and do warm sitz baths either in a bath tub or sitz basin. […] Some patients have less pain after the surgery than they had prior to the surgery, but this is difficult to predict. […] Take these drugs exactly as directed. Never take more than the recommended dose, and do not take the drugs more often than directed. […] Avoid strenuous activity for 1 week after your procedure. […] Take sitz baths (sit for 15-20 minutes in warm water) three times a day and after each bowel movement for the first few days. […] Dont worry if you have some bleeding, discharge, or itching during your recovery. This is normal.

• #49 Postoperative care of anal fissure surgery

  https://www.operarme.com/blog/postoperative-care-of-anal-fissure-surgery/

  Postoperative period after anal fissure surgery in hospital […] The main advantage of lateral internal sphincterotomy is the short postoperative hospitalisation period, which usually lasts no more than two days, the symptoms disappear in the patient immediately after the operation and it is not usually an operation that causes complications. […] Immediately after the operation, during the first postoperative hours, the patient should be able to move around and get up. It is advisable to start walking a couple of hours after the operation, which will help the blood flow. In addition, the patient will be able to start tolerating food as soon as possible. […] The postoperative period usually lasts between 3 and 4 weeks, from the operation until the surgical wound heals completely. […] It is normal for the patient to feel pain and discomfort in the operated area after anal fissure surgery. In these cases, the specialist will usually recommend the intake of certain analgesic drugs to reduce the pain.

• #50 Anal fissure treatment – Recovery | Guy’s and St Thomas’ NHS Foundation Trust

  https://www.guysandstthomas.nhs.uk/health-information/anal-fissure-treatment/recovery

  It’s important that you take your prescribed amount (dose) of painkillers regularly. This keeps you as comfortable as possible. […] We will give you laxatives to help you go to the toilet. Laxatives help you to open your bowels to have a poo. They also help to keep your poo (stools) soft. […] Most people take a few days off work, but this depends on how you feel and how active your job is. […] Increasing the amount of fibre in your diet can soften your poo and help you go to the toilet more easily. […] Try to eat lots of high-fibre foods, such as muesli, brown rice or pasta, prunes and other fruits and vegetables. This helps to prevent the anal fissures from returning. […] If your condition changes, you can start (initiate) a follow-up by contacting us. This is known as patient initiated follow-up (PIFU). If you have any concerns in the initial 6 months after your surgery, you can contact us by email: [email protected]

• #51

  https://fascrs.org/patients/diseases-and-conditions/a-z/anal-fissure

  Anal fissures typically cause a sharp pain that starts with the passage of stool. This pain may last several minutes to a few hours. As a result, many patients may try not to have bowel movements to prevent the pain. […] Treatment includes: A high-fiber diet and over-the-counter fiber supplements (25-35 grams of fiber/day) to make stools soft, formed, and bulky. Over-the-counter stool softeners to make stools easier to pass. Drinking more water to help prevent hard stools and aid in healing. Warm tub baths (sitz baths) for 10 to 20 minutes, a few times per day (especially after bowel movements to soothe the area and help relax anal sphincter muscles). This is thought to help the healing process. […] Most patients can return to work and go back to daily activities a few days after surgery. Complete healing after both medical and surgical treatments can take 6 to 10 weeks. Even when the pain and bleeding lessen, it is important to maintain good bowel habits and eat a high-fiber diet. Continued hard or loose bowel movements, scarring, or spasm of the internal anal muscle can delay healing.

• #52 Fissure Surgery Postop Instructions – Paul E. Savoca

  https://www.paulsavocamd.com/instructions/fissure-surgery-postop-instructions/

  Avoid constipation. […] If you were given a prescription for an ointment, apply this two or three times a day at the edge of the anal opening. […] Call the office if your temperature is greater than 101 degrees. […] Follow-Up Appointment a follow-up appointment as directed by our staff. The first follow up is usually 3 weeks following surgery.

• #53

  https://fascrs.org/patients/diseases-and-conditions/a-z/anal-fissure

  Fissures often come back. A fully healed fissure can come back after a hard bowel movement or trauma. Medical problems such as inflammatory bowel disease (Crohns disease), infections, or anal tumors can cause symptoms similar to anal fissures. If a fissure does not improve with treatment, it is important to be evaluated for other possible conditions.

• #54 Anal Fissure: Treatment, Symptoms, Causes, Healing, and More

  https://www.healthline.com/health/anal-fissure

  If your symptoms persist after trying home remedies, you should consult your doctor, who may recommend further treatments. […] Most anal fissures will heal without surgical intervention. Anal fissures are open wounds, so keeping the area clean and dry will assist in the body’s natural healing processes. […] Eating a high-fiber diet, drinking plenty of fluids, taking sitz baths, and using anti-inflammatory ointments can help current fissures heal and prevent new ones. […] You can’t always prevent anal fissures, but you can reduce your risk of getting one by taking the following preventive measures: keeping the anal area dry, cleansing the anal area gently with mild soap and warm water, drinking plenty of fluids, eating fibrous foods, and exercising regularly to avoid constipation, treating diarrhea immediately, changing infants’ diapers frequently if they have the condition. […] You can normally treat anal fissures at home with good wound hygiene, and avoid recurrences by making small dietary and lifestyle changes.

• #55 About Anal Fissures | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/patient-education/about-anal-fissures

  If these treatment options dont help your anal fissure, your healthcare provider may recommend other treatments, such as surgery. Your healthcare provider will give you more information if other treatments are an option for you. […] You can prevent anal fissures by avoiding constipation and diarrhea. […] You can also prevent anal fissures by following a healthy diet.

• #56 Anal fissure – symptoms, causes, and treatments | healthdirect

  https://www.healthdirect.gov.au/anal-fissure

  Your doctor may prescribe glyceryl nitrate (GTN) cream. […] If GTN doesn’t work, your doctor may prescribe a medicine called calcium channel blockers. […] Botox is another treatment option. […] Your doctor may recommend surgery if other treatments have not been helpful. […] Anal fissure surgery is known as a lateral internal sphincterotomy. […] You can prevent anal fissures by eating a diet that’s high in fibre. […] You can also: exercise regularly, drink lots of water, not ignore the urge to poo this can cause your poo to dry out and become harder to pass.

• #57 Anal Fissure: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.anal-fissure-care-instructions.uh3165

  Your doctor may recommend an over-the-counter laxative, such as Miralax, Milk of Magnesia, or Ex-Lax. Read and follow all instructions on the label, and do not use these medicines on a long-term basis. […] Do not use over-the-counter ointments or creams without talking to your doctor. Some of these preparations may not help. […] Use baby wipes or medicated pads, such as Preparation H or Tucks, instead of toilet paper to clean after a bowel movement. These products do not irritate the anus. […] Be safe with medicines. Read and follow all instructions on the label. If the doctor gave you a prescription medicine for pain, take it as prescribed. […] If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine. […] Call your doctor now or seek immediate medical care if you have new or worse pain. […] You have new or worse bleeding from the rectum. […] Watch closely for changes in your health, and be sure to contact your doctor if you have trouble passing stools. […] You do not get better as expected.

• #58 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Anal-Fissures-Treatment.aspx

  While most patients will not require surgery for an anal fissure, it is recommended for chronic cases when other methods have failed to bring about healing. […] Most patients will require a follow-up appointment several weeks after treatment, depending on the severity of the anal fissure and the technique used. Ongoing care is important for severe anal fissures because the likelihood of recurrence is high.

• #59

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=zx4632

  Anal fissure is a tear in the lining of the lower rectum (anus). It can itch and cause pain. There may be bright red blood on the toilet paper after your child wipes. A fissure may form if your child is constipated and tries to pass a large, hard stool. It may also form if your child doesn’t relax the anal muscles during a bowel movement. […] Most anal fissures heal with home treatment after a few days or weeks. If your child has an anal fissure that takes more time to heal, your doctor may prescribe medicine. In rare cases, surgery may be needed. […] Follow-up care is a key part of your child’s treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if your child is having problems. It’s also a good idea to know your child’s test results and keep a list of the medicines your child takes.

• #60 Anal Fissure | Riley Children’s Health

  https://www.rileychildrens.org/health-info/anal-fissure

  An anal fissure is a tear in the opening at the end of the gastrointestinal tract, called the anus. […] Anal fissures in children are most often caused by constipation and the passage of hard or large stools. […] A child with an anal fissure may have the following symptoms: Blood in the stool, Painful bowel movements. […] Most anal fissures will heal without treatment over time. Several home treatments can aid healing. Your child’s physician may recommend the following: Sitz bath. Sitting in a warm bath for 20 minutes, two or three times a day can ease pain and promote healing. Ointments. Application of petroleum jelly or zinc oxide ointment can reduce itching and discomfort. Stool softener. Use of a stool softener can make bowel movements easier and less painful. […] Constipation is the most frequent cause of anal fissures. Most anal fissures heal on their own. A one-time anal fissure is a common childhood condition.

• #61

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=zx4632

  Have your child sit in 8 to 10 centimetres (3 to 4 inches) of warm water (sitz bath) 3 times a day and after bowel movements. The warm water helps the area heal and eases soreness. Do not put soaps, salts, or shampoos in the water. […] Avoid constipation: Include fruits, vegetables, beans, and whole grains in your child’s diet each day. These foods are high in fibre. Give your child lots of fluids. Encourage your child to do moderate to vigorous activity for at least an hour each day. Your child may like to take a walk with you, ride a bike, or play sports. […] If your doctor recommends it, have your child take a fibre supplement, such as Benefibre or Metamucil, every day if needed. Read and follow all instructions on the label. […] Have your child use the toilet when your child feels the urge. Or when you can, schedule time each day for a bowel movement. A daily routine may help. Ask your child to take time and not strain when having a bowel movement. But do not let your child sit on the toilet for more than 10 minutes.

• #62 Anal Fissures – Children’s Hospital of Orange County

  https://choc.org/programs-services/gastroenterology/constipation/anal-fissures/

  Treatments for anal fissures may include: Changing your child’s diet to increase fiber and water to help regulate his or her bowel movements and reduce both diarrhea and constipation. Learn more about adding fiber to your child’s diet. Taking warm baths for up to 20 minutes a day. Taking stool softeners, such as fiber supplements, as needed. Taking medications, such as nitrates or calcium blockers. Having surgery, such as a lateral internal sphincterectomy. This surgery releases pressure inside the anus, allowing more blood to flow through the area to heal and protect tissues. […] If your child has an anal fissure, take these precautions to avoid making it worse and avoid recurrences: Give your child all medicines as prescribed. Be sure your child gets the recommended amount of fiber in his or her diet. Learn more about adding fiber to your child’s diet. Encourage the child to drink enough water to stay hydrated. Learn more about proper hydration. Help the child maintain a routine bowel habit. Your child’s health care team can help you come up with strategies for getting your child on track. Avoid giving the child spicy foods because they may make symptoms worse. […] Contact your child’s provider if you notice blood in your child’s stool or if their bowel movements are so painful that they are avoiding going to the bathroom.

• #63 Anal Fissure | Riley Children’s Health

  https://www.rileychildrens.org/health-info/anal-fissure

  An anal fissure is a tear in the opening at the end of the gastrointestinal tract, called the anus. […] Anal fissures in children are most often caused by constipation and the passage of hard or large stools. […] A child with an anal fissure may have the following symptoms: Blood in the stool, Painful bowel movements. […] Most anal fissures will heal without treatment over time. Several home treatments can aid healing. Your child’s physician may recommend the following: Sitz bath. Sitting in a warm bath for 20 minutes, two or three times a day can ease pain and promote healing. Ointments. Application of petroleum jelly or zinc oxide ointment can reduce itching and discomfort. Stool softener. Use of a stool softener can make bowel movements easier and less painful. […] Constipation is the most frequent cause of anal fissures. Most anal fissures heal on their own. A one-time anal fissure is a common childhood condition.

• #64 Anal Fissures – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK526063/

  An anal fissure is a superficial tear in the skin distal to the dentate line. […] This activity highlights the critical role of the interprofessional care team in caring for patients with anal fissures and improving long-term outcomes. […] The initial treatment of anal fissures is with medical interventions. Frequent sitz baths, analgesics, stool softeners, and a high-fiber diet are recommended. […] Patients with anal fissures should be educated on the importance of following a high-fiber diet, using stool softeners, and avoiding constipation. […] An interprofessional team best manages anal fissures. […] The prognosis for most patients is good as long as they change their lifestyle and diet. For recalcitrant cases, surgery may be an option.

• #65 Anal Fissures – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK526063/

  An anal fissure is a superficial tear in the skin distal to the dentate line. […] This activity highlights the critical role of the interprofessional care team in caring for patients with anal fissures and improving long-term outcomes. […] The initial treatment of anal fissures is with medical interventions. Frequent sitz baths, analgesics, stool softeners, and a high-fiber diet are recommended. […] Patients with anal fissures should be educated on the importance of following a high-fiber diet, using stool softeners, and avoiding constipation. […] An interprofessional team best manages anal fissures. […] The prognosis for most patients is good as long as they change their lifestyle and diet. For recalcitrant cases, surgery may be an option.

• #66 Anal Fissure – Grand Ave Urgent Care

  https://grandaveurgentcare.com/patient-education/health-library?DOCHWID=uf4764

  Anal fissures are a common problem. They affect people of all ages. […] Most anal fissures heal with home treatment after a few days or weeks. These are called short-term (acute) anal fissures. If you have an anal fissure that hasn’t healed after 8 to 12 weeks, it is considered a long-term (chronic) fissure. A chronic fissure may need medical treatment. […] If your doctor prescribed cream or ointment, use it exactly as prescribed. Call your doctor if you think you are having a problem with your medicine. You will get more details on the specific medicines your doctor prescribes. […] Sit in a few inches of warm water (sitz bath) 3 times a day and after bowel movements. The warm water helps the area heal and eases discomfort. Do not put soaps, salts, or shampoos in the water. […] Avoid constipation: Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fiber.

• #67 Anal Fissure Treatment: Importance, Types, Cost, and Care

  https://scihospital.com/treatments/anal-fissure-treatment-importance-types-cost-and-care

  Anal fissures are a common and often painful condition characterised by a small tear in the lining of the anus. […] It’s important to treat anal fissures right away to avoid problems like long-term pain, infection, or a chronic fissure that’s hard to heal. […] If you’re experiencing painful bowel movements, bleeding, or signs of infection like swelling or discharge, it’s a good idea to see a doctor. […] By making some changes to your daily routine and using certain medicines, you can feel better. […] Eating a healthy diet rich in fruits, vegetables, and whole grains can help prevent constipation, which is a common cause of anal fissures. […] Sitz baths can provide relief from pain and burning sensation and promotes healing. […] After undergoing treatment for an anal fissure, it’s important to focus on immediate recovery to ensure optimal healing. […] Long-term care is essential to prevent the recurrence of anal fissures. […] By following the recommended post-treatment care and long-term prevention strategies, individuals can minimise discomfort and prevent recurrence.

• #68 Anal Fissures – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK526063/

  An anal fissure is a superficial tear in the skin distal to the dentate line. […] This activity highlights the critical role of the interprofessional care team in caring for patients with anal fissures and improving long-term outcomes. […] The initial treatment of anal fissures is with medical interventions. Frequent sitz baths, analgesics, stool softeners, and a high-fiber diet are recommended. […] Patients with anal fissures should be educated on the importance of following a high-fiber diet, using stool softeners, and avoiding constipation. […] An interprofessional team best manages anal fissures. […] The prognosis for most patients is good as long as they change their lifestyle and diet. For recalcitrant cases, surgery may be an option.

• #69

  https://fascrs.org/patients/diseases-and-conditions/a-z/anal-fissure

  Anal fissures typically cause a sharp pain that starts with the passage of stool. This pain may last several minutes to a few hours. As a result, many patients may try not to have bowel movements to prevent the pain. […] Treatment includes: A high-fiber diet and over-the-counter fiber supplements (25-35 grams of fiber/day) to make stools soft, formed, and bulky. Over-the-counter stool softeners to make stools easier to pass. Drinking more water to help prevent hard stools and aid in healing. Warm tub baths (sitz baths) for 10 to 20 minutes, a few times per day (especially after bowel movements to soothe the area and help relax anal sphincter muscles). This is thought to help the healing process. […] Most patients can return to work and go back to daily activities a few days after surgery. Complete healing after both medical and surgical treatments can take 6 to 10 weeks. Even when the pain and bleeding lessen, it is important to maintain good bowel habits and eat a high-fiber diet. Continued hard or loose bowel movements, scarring, or spasm of the internal anal muscle can delay healing.

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