home Auditorium 8 How to treat an anal fissure and what are its symptoms. Anal fissure How to cure anal fissure with folk remedies

How to treat an anal fissure and what are its symptoms. Anal fissure How to cure anal fissure with folk remedies

Bursting heels are a problem for many, so how to treat cracked heels is a very pressing question. Women are predominantly affected by the disease, but it also occurs quite often in men. This skin lesion is not age-related, as is commonly believed; young people are often bothered by this nuisance.

What causes the disease, does it have any effect on our body and how to deal with it?

Clinical manifestation

This ailment, which creates a lot of inconvenience, manifests itself both independently and can also be a consequence of concomitant diseases. For example, almost everyone who suffers from diabetes has cracked heels. Even hypovitaminosis causes illness. So, what is this disease?

Due to their functional purpose, the feet experience a lot of stress. For this reason, our well-being often depends on their condition. And this is quite justified, because a huge number of nerve endings are concentrated here, directly connected to all our organs and systems.

Therefore, cracks in the feet, calluses, and corns always indicate certain malfunctions in the human body and are an indicator of its condition.

Cracking of the skin is nothing more than the loss of firmness and elasticity of the skin. Cracks in the legs initially form small and practically do not hurt.

But if you don’t pay attention to them and don’t try to treat them, then over time they become deep. Such formations can bleed and prevent you from moving and working calmly. This can be clearly seen in the photo above.

Dry heels and cracks on them are clearly visible here. The change also occurs on the joints of the big toes, as well as in any area of the leg where natural folds form, even cracks appear on the hips.

Symptoms of pathology

Such formations appear due to the influence of various factors, but they have a common manifestation:

significant pain while walking and when changing the position of the feet;
peeling of the skin;
bloody issues;
characteristic unpleasant odor;
thickening of the skin on the heels.

This clinical picture leads to a nervous state of patients, since all this, creating a lot of inconvenience (the inability to wear nylon stockings or tights, walk in open shoes, visit saunas, swimming pools, etc.), does not have the best effect on their usual lifestyle .

If the disease is not treated in time, then it is aggravated by the possibility of developing fungal infections, and this is not so easy to cure.

Why do heels crack?

For high-quality treatment of this disease, you need to know exactly what causes cracked heels.

A cracked wall should not be treated carelessly. A crack in the wall of a house is a consequence of a violation of the technology for constructing the foundation or walls. After reading our short educational program, you will learn how to correctly determine the cause of cracks based on indirect signs. And, as a result, you will be able to quickly eliminate the mistake, avoiding further complications.

Causes of cracks

Due to the movement of soil layers, the entire building tilts in one direction or the other, but in general the building is held tightly and monolithically, thanks to a massive and strong base. And this is precisely what is frightening: if cracks appear on the wall, it means that the foundation is not fulfilling its function.

Meanwhile, there are a number of reasons due to which cracks can form without destroying the base. And if the foundation is not rigid enough or the supporting soils do not evenly accept the load, the tape will bend more than the walls can withstand. We can safely say that cracks appear due to imperfections in the building design, design errors or shortcomings during construction.

Cracks may be the result of errors in design, construction or improper operation of the building

The root cause is the fact that the soil layer under the foundation is heterogeneous. In high-density areas, the pressure is greater, causing the building to rest on just a few points and deform under its own weight. The main feature is that the density of plots can change significantly over time or depending on weather conditions. Due to freezing, soil heaves occurs, when wet, it becomes too soft, and less often geological, seismic and geomorphological factors come into play.

Simply repairing or hiding a crack is not enough; you should find out the cause of its formation and only then begin restoration.

How to determine the cause of a crack

When cracks are first detected, it is necessary to begin close monitoring of their development, simultaneously recording temperature changes and the presence of precipitation during this period. To have the most complete understanding of cracking patterns, it is helpful to keep a detailed log throughout the year.

To visualize changes in the width of cracks, small lumps of alabaster, soaked to the consistency of plasticine, are attached to them. Beacons are installed along the entire length of the crack every meter. By checking the marks periodically, for example after a month, two, and so on, we can draw a conclusion about the nature of the damage:

If the mark has cracked or fallen off, it means the crack is continuing to expand. The gap in the mark can be used to judge the speed of divergence.
If the mark is cracked, there is no gap, the wall is subjected to dynamic loads, but there is no longer any tension in the material, and no further discrepancies are observed.
If the mark remains intact, it means there is no stress in the wall. The crack was the result of one-time shrinkage.

To obtain more accurate information, observations are continued over a long period, and damaged tags are replaced with new ones, recording the previous result.

Any hard but brittle material that can detect the slightest deformation of the base can be used as marks.

The shape of the cracks can say a lot about the nature of the movement. If the fracture site is smooth, the edge is sharp and has no chips, then the crack has expanded and simply torn the lighthouse. If the edges of the crack on the lighthouse have chipped edges, or it has fallen off completely, most likely, the crack, on the contrary, has decreased, and the lighthouse has collapsed from compression.

The special shape of the tags and beacons helps to identify the most minor fluctuations

By projecting these changes onto the geometric model of the house and foundation, you can determine with high accuracy how settlement occurs over time, whether it depends on the wetness of the ground during rain, where there are places of high and low density.

And yet, the most complete information can only be provided by a comprehensive analysis performed by specialists based on an examination, which includes:

control of the strength of supporting structures;
analysis of supporting soils;
identifying hidden cracks or uneven load distribution.

Ultimately, with your own observations or with outside help, it will be possible to draw up an action plan to strengthen the foundation and walls of the building and eliminate cracks.

We eliminate the cause, get rid of the crack

The most dangerous case is when the crack continues to expand. This indicates that the walls of the building or the foundation will be irreparably damaged. The problem can be radically solved only by completely rebuilding the damaged section of the building. However, if you notice the problem in time, a much less radical method will help - covering the house.

Everything is done quite simply:

Steel corners with a 100 mm flange are installed at the outer corners.
On crutches, at least two lines of smooth reinforcement are laid along the walls - upper and lower.
A thread is cut on each rod: left on one side, right on the other. Nuts are screwed onto the reinforcement and welded to the corners.
A meter from the corner, on the side of the reinforcing bars, a small parallel rod is welded so that rotation can be transmitted with a regular adjustable wrench.
During final tightening, two people twist the bar simultaneously, gradually increasing the tension.

In this case, the cracks literally melt before our eyes, all that remains is to replace the protective plaster of the walls and base, reinforcing it with steel mesh.

An example of tightening a building along the plinth

It is possible that the markers on the crack will remain intact for a long time or the gap will constantly expand and contract, but overall not increase. This is a clear sign that the foundation is working normally, and that there were initially excess stresses in the wall material, which resulted in a crack.

To strengthen the wall in a problem area use:

external reinforcement with carbon fiber, steel mesh;
anchors and metal frames;
embedded reinforcing elements along grooves;
injection method.

It is important to close the crack and restore the strength of the structure. If the cause was improper ligation of brick rows, then it is quite possible that the only effective remedy will be a complete or partial re-lining of the wall in the emergency area.

Laying reinforcement in the grooves helps to contain further deformations

Massive reinforcement with an external frame with anchor fastening to the wall

Strengthening walls with external carbon fiber reinforcement

Repairing cracks using the injection method

To seal any cracks, it is necessary to clean it along its entire length and depth from dirt, dust, remove the layer of mortar and base material, expanding it to 15 mm or more. The resulting gap is filled with mortar, having previously been reinforced using one of the methods listed above.

Heaving as a result of soil soaking

To prevent the soil under the foundation from becoming oversaturated with moisture, a blind area is installed around the house and the drainage pipes are pulled as far away as possible. However, over time, the screed may collapse, and rainwater will seep directly under the foundation, washing it away.

Typically, a sign of such a phenomenon is the gradual expansion of cracks, which occurs mainly during heavy rainfall or some time after it. It is typical for such phenomena that cracks seem to “split off” the corners of the house, passing through the nearest window openings.

Frost heaving can destroy the foundation of a house

The foundation continues to remain intact, but the overall tilt of the building may increase from year to year. In addition, no one knows how much the next shrinkage will occur and how this will affect the integrity of the concrete base. Heaving due to high humidity can also occur due to rising water.

A drainage system assembled around the perimeter of the building to drain groundwater and overhead water away from the foundation will help solve the problem qualitatively. It is necessary to expose the foundation to the base, lay the drainage pipe on the prepared sand and gravel cushion around the perimeter of the foundation and drain it to the side. To discharge water, you will need to prepare a drainage well or run a pipe to the nearest body of water.

Drainage for removing groundwater from atmospheric precipitation and melt water from the base of the foundation

A wide blind area will not allow precipitation to flow under the foundation

An obligatory step to eliminate the problem is the restoration of the cement blind area and its expansion. Typically, for a shallow strip foundation, a blind area of about 40-60 cm wide is sufficient, and for buried foundations - up to one and a half meters. It would also be a good idea to install ebb tides and dump rainwater 4-5 meters from the house.

What to do if the problem is in the foundation

If no measures are successful, you will have to look for the problem in the foundation. A prerequisite for this may be not only the visible formation of a crack in the exposed area, but also the general structural unsuitability of the base, causing insufficient rigidity.

Local foundation faults should be repaired immediately. First, a dig is made to a depth of 60-100 cm under the bottom edge of the tape and up to 2 meters wide. A pedestal reinforced with reinforcement is poured under the fracture site, after which the pit dries, the pit is expanded another meter in each direction and topped up again.

Strengthening the foundation with piles

Do not forget that the reason may be an initial miscalculation in the design of the house or failure to comply with the requirements during construction:

the properties of supporting soils are not taken into account;
the foundation depth is incorrectly selected to the actual freezing depth;
the width of the foundation is not enough for real loads, etc.

Strengthening the foundation by additionally pouring reinforced concrete around the perimeter of the building

If cracks appear in the foundation and walls of the house, then you should immediately take measures to strengthen the foundation, for example, screw piles, side or bottom grout. It is possible to determine which method of reinforcement is required only by relying on data from construction expertise and the preparation of the appropriate project, which is best left to professional designers.

Anal fissure is one of the diseases that is not commonly discussed. Indeed, not every person admits that he has problems with the anus. And yet, such a disease exists, and millions of people suffer from it. According to statistics, the disease ranks third among proctological diseases after hemorrhoids and paraproctitis. The disease can affect people of any age and gender. Women get sick somewhat more often than men, and children - less often than adults.

Description of the disease

An anal fissure (anal fissure, rectal fissure) is a narrow and long defect in the mucous membrane of the anus. At this point, the mucous membrane seems to be torn into pieces, exposing the muscle layer. The length of the anal fissure is usually small - no more than 2 cm. The width and depth are several millimeters. Cracks may not form anywhere in the anus, but only on its front and back walls. Anterior localization of the crack is much more common in women than in men, which is associated with the biological features of the structure of the weaker sex. Rarely, a crack occurs on the lateral surfaces of the anus.

The disease has two main forms – acute and chronic. A crack that has appeared relatively recently is called acute. A sharp crack can heal if conditions are favorable. But without proper treatment, an acute crack can become chronic after a few weeks.

A chronic fissure is characterized by rougher edges and small bumps at the beginning and end. A chronic fissure almost never goes away on its own and requires surgery to treat. Although the disease may experience remissions, one should not hope that they will lead to a complete cure. Under certain circumstances (diet violation, constipation), the disease may return with renewed vigor. In most cases, an anal fissure is accompanied by sphincter spasm, which makes defecation even more difficult, especially during constipation.

Complications

With each act of defecation, an unhealed fissure is exposed to feces. This is especially dangerous with constipation, when the stool is hard. In addition, a huge amount of bacteria settles on the crack (as is known, more than half of human feces consists of bacteria). This leads to even greater inflammation of the wound.

Untreated fissures located in the anus can lead to serious complications - acute purulent paraproctitis, the formation of fistulas, trophic ulcers, massive bleeding, gangrene and sepsis. In men, anal fissures increase the likelihood of prostatitis.

Symptoms

Photo: Brian A Jackson/Shutterstock.com

Cracks in the anus make themselves felt by severe pain that appears after using the toilet or during the act of defecation itself. The pain is usually acute and resembles the sensation of having broken glass in the anus. The pain syndrome associated with a crack can persist for a long time, intensifying with prolonged sitting. It can lead to neurotic conditions and insomnia. The patient may also develop a peculiar fear of defecation. This leads to even more severe constipation, which in turn further aggravates the disease.

Another important sign is bleeding during bowel movements. It can be either minor, consisting of a few drops of blood, or serious, leading to anemia. It all depends on the nature and size of the crack.

The disease can affect a person's lifestyle. The inability to sit painlessly entails the inability, for example, to engage in sedentary work. And the loss of a job already aggravates the patient’s unfavorable mental state.

Causes

The immediate causes of the disease can be divided into mechanical damage to the anal passage and damage to the mucous membrane as a result of sphincter tension.

Mechanical damage can occur:

during defecation - due to damage to the mucous membrane by solid objects found in the stool
during anal sex
during instrumental examinations of the rectum, a crack may appear as a result of unqualified actions of medical personnel

Tears of the mucous membrane due to muscle tension mainly occur when pushing during bowel movements. Also, quite often, rectal fissures can occur in women during childbirth.

It has long been established that the main factor provoking the appearance of a fissure is chronic constipation. Constant efforts during bowel movements lead to increased tension in the muscles of the anus. In addition, hard feces have a negative impact on the condition of the anal mucosa. All this can lead to its rupture and crack formation. Somewhat less often, cracks can form as a result of diarrhea.

Some experts believe that hemorrhoids also contribute to the formation of anal fissures. Although there is another point of view, which is that hemorrhoids do not affect this process in any way. These two diseases have many similar symptoms, but generally different etiologies, and their treatment approaches are also very different. However, it is not uncommon to find both diseases present in one patient.

Factors also contributing to the occurrence of the disease are:

drinking alcohol, eating too fatty, spicy or salty foods
sedentary work
lifting weights
sedentary lifestyle
diseases of the lower intestines - colitis, proctitis, irritable bowel syndrome

In addition, diseases of the upper gastrointestinal tract - stomach and duodenal ulcers and gastritis, cholecystitis, blood diseases that lead to impaired coagulation and stagnation in the lower parts of the body - contribute to the formation of cracks, although to a lesser extent.

Separately, it is worth mentioning pregnancy and the birth process. These factors can also contribute to the appearance of fissures in the anal area. In the first case, the reason is an increase in the size of the uterus and the associated difficulty in defecation. This weakens the anal area, and childbirth, accompanied by pushing, can cause damage to the anal mucosa. Of course, in the first days after childbirth little attention is paid to this circumstance, but at the moment of the first bowel movement it will inevitably make itself felt.

Anal fissures in children

This disease is more common in adults, but its occurrence in children cannot be excluded. In this case, it may also be associated with constipation, as well as the fact that in children the excretory organs are not yet fully formed. Therefore, even relatively mild constipation can cause damage to the child's anal area. Symptoms of an anal fissure in young children may include fear of the toilet, blood in the stool.

Photo: filippo giuliani/Shutterstock.com

Diagnostics

When pain occurs in the anus, the patient is naturally unable to determine the cause of the syndrome and make a diagnosis, and, moreover, determine the size and shape of the crack. Therefore, it is recommended to immediately contact a proctologist so that he can analyze the symptoms and prescribe treatment. In most cases, cracks are clearly visible upon visual inspection. In some cases, palpating the anus may be necessary, but this operation may be difficult due to extreme pain for the patient and spasm of the sphincter. Also used for diagnosis are sigmoidoscopy (examination of the anus 20 cm deep) and colonoscopy. When diagnosing, it is necessary to differentiate a fissure from hemorrhoids, proctitis and paroproctitis, erosions, polyps and tumors.

How to treat the disease

Treating a fissure in the anus, especially one that arose long ago and is large in size, is a difficult task. Nevertheless, a complete cure for the disease is possible, although it requires significant effort, both on the part of the patient and on the part of doctors.

Unlike many other diseases, with anal fissure, the acute form of the disease is treated conservatively, and the chronic form is treated surgically.

If a small anal fissure, a microcrack, occurs, it is better to let it heal on its own. Such cracks can heal in a few days, provided that they do not become re-irritated. This can be achieved if stool does not form and does not come out. That is, you can go on a diet for several days and wait until the crack heals itself.

However, as a rule, the anal fissure is too large and will take too long to heal. In the case of a large crack, a complex treatment method is used, which includes:

drug treatment
diet
lifestyle change

How to treat the disease

Conservative treatment of cracks is carried out using a comprehensive and gradual method. Practice shows that effective treatment of the disease can be carried out at home. In the presence of severe pain and sphincter spasm, painkillers and antispasmodics are first used, and then wound healing agents are used. In most cases, treatment can be carried out at home and hospitalization is not required. The duration of conservative treatment depends on the severity of the disease and the chosen course of therapy and can take from 2 to 8 weeks. Medicines that are used for fissures can be delivered to the anus either directly or taken in the form of tablets.

Photo: i viewfinder / Shutterstock.com

Of the tablet medications, laxatives should be noted first. These drugs can be prescribed in case of illness caused by constipation. As a rule, preparations based on senna and aloe are the most effective, but they are contraindicated for irritable bowel syndrome. In this case, it is best to use preparations based on plantain seeds and artificial cellulose. You can also use laxatives based on polyhydric alcohols, such as Duphalac.

Antispasmodic medications, such as drotaverine, can also be taken in tablet form. Antibiotics in tablets for anal fissures are usually not prescribed, since local remedies are much more effective.

Main forms for rectal treatment:

baths with bactericidal solutions
candles (suppositories)
ointments and creams
microenemas

The choice of dosage form is dictated by the circumstances of the disease and accompanying symptoms. In case of severe pain, it is difficult to use suppositories, and in case of discharge from the anus - ointments. In some cases, injections of painkillers and antispasmodics are indicated.

An anal fissure, in its etiology, differs little from an ordinary wound, and when treating it, similar principles must be followed. In this case, however, two unfavorable factors should be taken into account that make it difficult to treat the fissure - the sphincter spasm accompanying the disease and the constant infection of the wound area with pathogenic bacteria. Therefore, drugs used in the treatment of cracks must perform two functions - relieve muscle spasms and have strong anti-inflammatory and bactericidal properties.

Ointments

Ointments should usually be applied to the area around the anus once or twice a day after bowel movements. There are antispasmodic ointments and ointments with a predominantly wound-healing effect.

Among local antispasmodics, nitroglycerin ointment 0.2% has proven itself well. This ointment is not sold in a pharmacy in finished form, but is prepared in a pharmacy upon presentation of a doctor's prescription.

Among the new treatment methods, ointments containing botulinum toxin, which relieve vascular spasms, should be noted.

For antiseptic purposes, an ointment for cracks with strong antibiotics is used, for example, Levomikol, containing chloramphenicol. Ointments based on sea buckthorn oil, Relief ointment, and Argosulfan have also proven themselves well. The drugs Actovegin and Solcoseryl, which stimulate healing processes, have shown high effectiveness.

Also worth noting are the ointments Ultraproct, Aurobin, Dexpanthenol, Bepanten, Methyluracil.

Suppositories

Healing suppositories are considered the most effective dosage form for treating cracks. If there are no contraindications for use, then it is preferable to opt for them. Crack suppositories are usually used after bowel movements once or twice a day. Most of them have a wound-healing effect, and many suppositories also have laxative properties. Some drugs may have an effect that stimulates local immunity. For example, Posterizan suppositories contain killed bacteria that cause a response from the immune system. This drug also has a wound healing and analgesic effect.

Many suppositories also have an analgesic effect. Among them it is worth noting Proctoglivenol, Ultraproct, Anestezol, suppositories with ichthyol, belladonna extract.

Relief suppositories, containing shark liver components, have both anti-inflammatory, analgesic and hemostatic effects.

Not all suppositories are suitable for use in childhood and pregnancy. Anti-inflammatory suppositories Natalsid are among the drugs approved during pregnancy.

You can also note Methyluracil - suppositories that are well suited for wound healing and have immunomodulatory properties, Hepatrombin - suppositories with a hemostatic and healing effect

Baths

For acute cracks, it is recommended to take baths every day, preferably in the evening, with disinfecting solutions, for example, a solution of potassium permanganate. The water temperature should be +40 ºС. Baths with plain warm water can also be performed, which help relieve spasms. The duration of the procedure is 10-20 minutes.

Enemas

For anal fissures, microenemas containing sea buckthorn oil and chamomile decoction help well. This mixture must be injected into the anus in a volume of 50 ml. The procedure is carried out daily before bed for two weeks.

To facilitate stool, you can use counter enemas, administered 10 minutes before. before defecation. They contain 100 ml of pasteurized sunflower oil and 200 ml of boiled water.

Diet

The diet is primarily aimed at eliminating the main cause of the disease – constipation. Indeed, no matter how effective treatment with ointments and suppositories is, it will be completely pointless if the next stool leads to severe tension in the sphincter and an even greater increase in the size of the crack in the anus.

Photo: Barbara Dudzinska / Shutterstock.com

The diet must be selected individually, since different foods have different effects in different cases. However, most experts agree that it is best to remove fatty, fried, pickled and sweet foods, smoked foods from the diet and consume more plant fiber contained in vegetables and fruits, and dairy products. For meat, it is preferable to eat chicken and lean beef. You should also reduce the amount of white bread in your diet, replacing it with bran bread and drink more liquids (except coffee and alcohol).

Lifestyle change

You should give up a sedentary lifestyle and exercise more physical activity to avoid stagnation in the lower part of the body. Even simple walks can have a positive effect on the treatment of the disease.

Surgery

If conservative treatment is ineffective, as well as when the disease enters the chronic stage, which usually occurs a month after the formation of a fissure in the anus, surgical treatment is indicated. As a rule, the operation consists of removing scars and bumps along the edges of the crack that interfere with its healing. The operation can be performed either traditionally or using a laser. If sphincter spasm interferes with the treatment of the fissure, then sphincterotomy is performed - partial cutting of the sphincter muscle fibers.

Prevention

Compliance with preventive measures to prevent the disease will be useful not only for those who have already recovered from the disease, but also for those who have never encountered it.

The risk group includes people who lead a sedentary and sedentary lifestyle and suffer from constipation. Prevention of cracks largely coincides with the measures that are used in their treatment. First of all, it is aimed at preventing constipation. It is necessary to be physically active, move more, eat a varied diet, little by little, but as often as possible. Chewing food thoroughly is important, as hard, undigested remains increase the likelihood of injury to the anus. Therefore, it is necessary to treat diseases of teeth and gums in a timely manner. Anal sex should also be avoided.

An anal fissure is a disorder in the structure of the mucous membrane of the human anus. Most often, such a defect occurs on the back wall. The size of the crack usually ranges from one to two centimeters. But despite this, the disease, if left untreated, can lead to dangerous complications for a person’s health.

This disease ranks among the most common problems in the field of rectal diseases. More than fifty percent of the occurrence of this disease is observed in women, especially between the ages of twenty-five and forty. It occurs more frequently in men with non-traditional sexual orientation.

But not only adults are susceptible to anal fissure. Very rarely, but still, it can occur in children. Children of preschool and primary school age are often affected by the disease. Appears equally in children of any gender. In this case, the anal fissure does not exceed a few millimeters in size.

Over time, the edges of the crack thicken, making it more difficult to get rid of such a delicate problem. And if treatment is not started on time, then there is a possibility that several cracks will appear in the anus.

If you provide effective treatment, you can get rid of this disease in almost all cases. The only exception is failure to seek help from specialists in a timely manner.

Etiology

Anal fissures can be caused by many factors. Among the main ones are the following:

hard physical labor;
long;
excessive consumption of alcoholic beverages;
foreign object in the anus;
sedentary lifestyle or working conditions;
eating food seasoned with hot spices;
any damage or injury that directly affected the structure of the anal mucosa;
infectious intestinal diseases;
spicy ;
childbirth, the complication of which is such a pathology;
enemas, especially if this procedure is carried out incorrectly;
– the most common cause of anal fissure in a child;
damage during medical examination;
specific sexual relations – anal or same-sex sex.

Varieties

The disease exists in several forms and can be:

acute anal fissure – formation occurred less than a month ago. This type of damage heals on its own after a certain time, about a month and a half;
chronic anal fissure – characterized by long-term existence and accompanied by scanty bleeding.

Symptoms

There are several signs of the disease:

a strong burning sensation in the anus, which can transform into a continuous sensation of pain;
a slight discharge of blood along with the stool (can be easily seen on toilet paper). In this case, the structure and color of feces does not change.

Based on the course and frequency of symptoms of anal fissure, you can independently distinguish the form of the disease:

painful sensations. In acute cases, it is intense, lasting up to twenty minutes, disturbing a person only during the process of defecation. Chronic anal fissure is not very pronounced, lasts about three minutes, discomfort is felt both during and after the act of defecation;
spasms. The chronic form is not accompanied, but in the acute form, the spasm increases pain and adds a pulsating shade;
bleeding - both forms of the disease are characterized by the release of blood, the difference is only in the quantity. Chronic - to a lesser extent, acute - with a greater degree of concentration;
repeatability of pronounced symptoms is typical for the chronic form, but not for the acute form.

For a child, especially an infant, the presentation of symptoms is somewhat different from that of adults.

In infants, this disease is expressed in:

strong screaming and crying when excreting feces;
feces density;
the presence of mucus in the stool;
sleep disturbance;
absence of gases;
slight increase in body temperature;
increased anxiety and restlessness of the baby.

An older child may:

independently delay the emission of feces;
complain of discomfort and the sensation of a foreign object in the anus;
the child may refuse to go to the toilet or sit on the potty due to fear of pain.

Complications

Like most diseases, a disorder in the structure of the anal perineum entails consequences for the health of an adult or child. But it is worth noting that they do not appear in all patients, but depending on the individual course of the disease.

Complications of anal fissure are:

constant bleeding (not only during bowel movements);
spread of infection throughout the intestinal mucosa;
inflammation of the lining surrounding the rectum (consisting of fat cells);
(in men).

Diagnostics

Before the patient is given a final diagnosis, the doctor must carry out a number of diagnostic measures, which consist of:

examination of the anus. It is carried out so that the doctor can distinguish the form of the disease by external signs;
clinical tests;
research using special tools.

An examination will help the doctor determine the type of disease and prescribe the correct treatment. This is done because the acute and chronic forms of anal fissure differ in appearance.

An acute disease has:

the shape of a smooth slit, about two centimeters in length;
elastic edges;
clean bottom.

Chronic anal fissure is represented by:

in the form of a gap, but not straight, but in a zigzag;
compacted and uneven edges;
the bottom is scarred and with a grayish coating.

Instrumental research includes:

anoscopy - additionally using digital examination;
retroscopy – to identify possible diseases of the colon;
irrigoscopy - to exclude or confirm intestinal damage;
radiography.

Treatment

There are several ways to cure anal fissures:

medicinally;
surgical intervention.

Treatment with medications and ointments is aimed at:

relieving pain;
relief from orifice spasms;
normalization of feces;
healing.

When seeking help in the early stages of the disease, you can get rid of it by using special ointments or suppositories for anal fissures, which are prescribed by a doctor, and the patient can carry out therapy at home independently. Mild laxatives will help relieve constipation.

Surgery for anal fissure is performed only when other treatments have not helped the patient, as well as in cases of chronic type of disease. During the operation, the dense edges of the crack are removed and the bottom of the ulcer is cleaned. Such medical intervention will help speed up healing, after which the patient’s full recovery can be guaranteed. The duration of the operation is half an hour.

After undergoing any treatment method, a person is prescribed a special diet, during which the patient is prohibited from consuming:

fatty and fried foods;
hot spices, sauces and ketchups;
alcoholic drinks in any quantity.

For anal fissure, the diet should be enriched with:

fiber;
porridge;
fresh fruits and vegetables;
dried fruits - especially dried apricots, raisins, prunes and dates;
fermented milk products.

In addition, drink a lot of water and unsweetened green tea, at least two liters per day.

Anal fissure can be treated with folk remedies. Ointments, decoctions and tinctures are made from the herbs and plants listed below. Recipes consist of:

soft part of aloe;
mixtures of yarrow, centaury, St. John's wort and vegetable oil;
wild mallow and chamomile;
bran steamed in boiling water;
eggs and fish oil;
oak bark;
motherwort and plantain;
calendula and peony;
carrots, beets and badger fat;
sage

Folk remedies include taking sitz baths, which consist of:

Taking such baths should not exceed ten minutes a day. They need to be used daily until complete recovery.

Prevention

Preventive medications for anal fissure can completely prevent the occurrence of such a disorder.

Prevention consists of simple rules:

adhere to a healthy lifestyle, completely give up alcohol and nicotine;
The diet should consist of plenty of vitamins, fiber and other nutrients. You should especially monitor your diet if an anal fissure appears in a child;
do not restrain the urge to defecate;
maintaining personal hygiene of the genital organs;
timely treatment of other anal diseases;
physical activity, but not excessive;
devote about half an hour a day to walking (with a sedentary lifestyle);
if the process of defecation has not begun after spending five minutes on the toilet, it is better to postpone it for a while;
consume legumes, baked goods, and unrefined sunflower oil in small quantities;
food should not be very hot or not very cold;
drink plenty of fluids (at least two liters a day).

Is everything in the article correct from a medical point of view?

Answer only if you have proven medical knowledge

This is a common problem with which patients turn to a proctologist. The disease is in third place, second only to hemorrhoids and colitis. What is an anal fissure? This is a damage (rupture or ulcer) of the mucous membrane, which has a linear or ellipsoidal shape.

More often the defect is located along the back of the passage, somewhat less often - in the front, but it is almost never found in the lateral areas of the anus. Sometimes patients have so-called “kissing” cracks, which are simultaneously located on both the front and back walls.

Some patients, feeling pain during bowel movements, independently decide that they have hemorrhoids and begin to be treated with available means. This should not be done, because in some cases the condition can be aggravated by certain medications. To distinguish these two diseases from each other, you should know the main signs of anal fissure.

Symptoms of the disease

acute pain that occurs during bowel movements. Sometimes the pain is so severe that people are afraid to go to the toilet. Retention of feces leads to constipation, which causes hardening of the stool. Sometimes the pain lasts from several hours to several days and is relieved only with medications.
. Bleeding may be profuse, but most often a person will notice a few drops or streaks of blood.
sphincter spasm.

What types of cracks are there?

An anal fissure can be acute if its appearance is no more than a month, and chronic if the pathology is present for more than this period. Acute and chronic cracks differ from each other not only in the time of existence, but also in morphological features.

If a person does not contact a specialist on time, this threatens the appearance of a chronic crack. When the process is recent, it is easily treated with conservative methods. An old fissure in the anus is difficult to treat, and patients often require surgical treatment.

With a recent crack, the doctor finds its even and smooth edges, and the sphincter muscles are visible through them. Chronic fissures in the anus are accompanied by the growth of connective tissue around the mucosal defect, its edges are rough and thickened. Later, cicatricial changes in the sphincter occur, and a protruding area is formed in the upper part of the fissure, the so-called sentinel tubercle.

Reasons for appearance

The main reason is constipation. Dense feces cause injury to the rectal mucosa, and straining only aggravates the problem.
Diarrhea. The crack appears due to irritation by liquid intestinal contents of the anal area, resulting in loosening of the mucous membrane and its damage.
Sphincter spasm. It plays a leading role in the mechanism of disease development. Because of the pain, tension in the muscles of the anus appears, which persists for a long period, sometimes until the next bowel movement. As a result of the spasm, the pain increases, the blood supply to this area is disrupted, which creates obstacles to the healing of the defect. It turns out to be a vicious circle.
Injuries to the anal mucosa by mechanical objects, including during medical procedures (colonoscopy, digital examination).
Anal sex.
Postpartum period. Why anal fissures appear in women who have given birth has not been precisely established. It is believed that damage to the intestinal mucosa occurs during the passage of the fetus through the birth canal. Also, during pushing, tension occurs in the pelvis, which is accompanied by injuries to the intestinal mucosa.

Features of secondary cracks

Most often they are the result of poor-quality treatment of an acute process.

However, if the patient has a secondary anal fissure, it may be caused by other intestinal diseases:

Crohn's disease;
polyps;
rectal fistulas;
ulcerative colitis;
diverticula.

Chronic anal fissures differ somewhat in clinical manifestations. The pain is not as intense as with an acute crack, and sometimes it is completely absent. But almost always there is a discharge of a small amount of blood and muscle spasm.

The disease is characterized by a cyclical course, the crack either disappears or appears again due to a violation of the diet, constipation, or physical activity. Therefore, with this pathology, it is not recommended to lift heavy objects and strain during bowel movements.

Therapeutic measures

They begin using conservative methods; surgical methods are resorted to in case of a chronic process or in the presence of complications. The main measures for cracks are as follows:

Diet. The most important thing in treating the disease is to prevent constipation. Therefore, food must contain a large amount of dietary fiber in order to move easily through the intestines. Patients are recommended to eat legumes, greens, vegetables, fruits, and whole grain bread. These foods help soften the stool and prevent it from hardening. Alcohol and spicy seasonings are excluded from the diet.
Enemas. If constipation does occur, it is not recommended to take laxatives: this can aggravate the process and slow down the healing process. In this case, it is better to do a cleansing enema with warm water. To do this, the tip is well lubricated with Vaseline and passed into the anus along the wall opposite to the one where the mucosal defect is located. Enemas help the bowel movement process without causing pain. As a result, the fear of bowel movement disappears, and tense muscles relax.
Washing. Be sure to carry out hygiene procedures after going to the toilet. To do this, the area of the anus is washed with cool water, sometimes even hygiene is carried out without using toilet paper. After the procedure, the skin is dried with a towel.
Sitz baths with disinfectants, this can be a warm solution of manganese or decoctions of anti-inflammatory herbs (chamomile, calendula, yarrow). This procedure helps to quickly relieve sphincter spasm, after which the healing process occurs faster. The duration of the bath is 15–20 minutes; treatment of anal fissures should be carried out using this method at least 3 times a day.

Drug treatment

For this purpose, ointments, creams and suppositories are used. To speed up healing and relieve pain, fissures in the anus are treated with the same drugs that are recommended for hemorrhoids. These are Proctosedil, Posterisan, Relief, Aurobin suppositories, suppositories with sea buckthorn, methyluracil.

Since the cause of the crack is a sphincter spasm, muscle relaxants are needed. An ointment with nitroglycerin is used, this drug quickly eliminates the spasm and the pain decreases. Calcium channel blockers (0.3% nifedipine ointment or 2% diltiazem ointment) are also used to relieve spasms. Suppositories with novocaine or anesthesin help relieve pain.

To speed up the healing of the mucous membrane, therapeutic microenemas are used. To do this, rosehip oil or sea buckthorn oil is mixed with chamomile infusion; for this you will need 30 ml of oil and herbal infusion. The drug is injected into the rectum and kept there for as long as possible.

Treatment options include Botox injections into the affected area. Botox acts in the same way as in cosmetology - it relaxes the muscles. Good results are also obtained with alcohol-novocaine blockades. In this case, anesthesia of the nerve occurs and pain is relieved. These measures can cure this disease within 2-3 weeks.

Surgical treatment

It is used in cases where there is no effect from conservative measures. The hardened areas of the crack are excised, leaving a fresh wound that heals quickly. For severe spasms of the anal sphincter, sphincterotomy surgery helps, which also leads to relaxation of the muscles in this area. After surgery, there is virtually no fecal incontinence, and the postoperative period is quite short.

Modern treatment methods: excision of the edges of the crack using a laser or radio waves.

The sooner you start treating this pathology, the better the result will be. You cannot make a diagnosis on your own and use medications such as hormonal ointments for treatment. You should also visit a doctor because the symptoms of a fissure and, but a different approach is used in their treatment.