If severe pain suddenly appeared during a bowel movement, a drop of blood was found on the toilet paper, and the sphincter of the anus was tense, most likely you had an anal fissure. This is a common disease in proctological practice; the anus fissure is in third place in the frequency of treatment after hemorrhoids and colitis. When examining the anus, you can find a sore or mucosal defect that has a slit-like or ellipsoidal shape. A crack is located more often on the front wall of the anal canal, much less often a mucosal defect forms on the back wall or simultaneously on both.
Causes
Most often, an anal fissure is caused by constipation, while dense feces injure the mucous membrane of the anal passage. The causes can be debilitating diarrhea, prolonged stress during bowel movements. Vascular disorders, poor blood microcirculation in this area, hemorrhoids, inflammatory diseases of the rectum, and the postpartum period are predisposed to the onset of the disease. Often a crack heals on its own within a few days, but the disease can recur. There is a vicious circle: due to pain, a person begins to be afraid to go to the toilet, this leads to the hardening of feces, and, consequently, to a new mucosal injury. Severe pain leads to spasm of the sphincter, and the tense muscles of the anus hide the crack and interfere with the healing process.
Types of anal fissures
Upon examination, the doctor determines whether the patient has an anal fissure - a recent acute or already chronic. In the first case, a mucosal defect occurred less than a month ago, and with a finger examination, a densified and painful area in the anus is determined. Pain is short-lived, lasting no more than 15 minutes. Chronic anal fissure is diagnosed in cases where the healing of the mucosa does not occur for more than two months. With this form of the disease, when the ulcer does not heal for a long time, its edges are thickened and thickened, connective tissue begins to grow in this part of the passage, and a seal resembles a polyp - a “watchdog tubercle”.
In chronic anal fissure due to frequent and excruciating pain, patients develop “stool fear”, they begin to use various laxatives, enemas, irritability and insomnia appear. As you know, Napoleon Bonaparte for a long time suffered from a chronic anal fissure, this explains his favorite position - standing, one leg is on the drum. In this way, he alleviated his condition, and seizures of his strong irritability coincided with periods of exacerbation of the disease.
An anal fissure is dangerous by the appearance of bleeding and the development of inflammation - paraproctitis. In this case, the mucosal defect becomes the entrance gate, the infection penetrates the pararectal tissue. Launched anal fissures can cause inflammation of the colon and prostatitis in men.
How to treat an anal fissure?
Firstly, the process of bowel movement should be normalized. For this, patients are recommended a diet that includes beets, figs, prunes, dried apricots and other products that contribute to the formation of soft stools. Spicy foods and alcohol are undesirable. Diet should be followed after healing of the crack, as a preventive measure.
Patients are prescribed lubrication of the anus of the anus with ointments. Nitroglycerin ointment (0.2%) is used to relax the sphincter muscles. It must be applied to the damaged area in small portions, since nitroglycerin can cause a headache. Hands should be washed after using the medication.
For independent use, you can recommend combined medications - candles "Relief", "Proctosedil", "Proctosan". These medications will reduce pain, relieve inflammation in the anal area and accelerate healing.
A folk remedy that can be quite effective: take one teaspoon of petroleum jelly, butter, honey and aloe juice. Mix all components, keep in the refrigerator. Such an ointment should be used for at least 10 days.