ANUS FISSURE

Anus Fisura adalah sejenis penyakit yang mana adanya luka/robek bagian dinding dubur, penyebab utamanya banyak disebabkan oleh terlalu kerasnya kotoran saat BAB, disertai mengejen?dengan?kuat.

Akibatnya dinding dubur robek, dan kadang2 disertai dengan tetesan darah segar, juga dapat menyebabkan rasa nyeri/sakit yang berkepanjangan.

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ANAL FISSURE DETAILS

A fissure consists of a crack or tear in the vertical axis of the inner lining of the anal canal just above the anal verge.

Initially it is superficial but may deepen to reach the underlying muscle fibers.

Fissures usually occur in the posterior midline.

Fissures are often associated with secondary changes which may include a skin tag (also known as a sentinel pile though it is not actually ?piles?), hypertrophied anal papilla, and relative anal stenosis secondary to spasm of the muscle sphincter.

Anal fissure is a common and minor disorder but merits careful attention because it is painful and the treatment is simple and effective.

It has been proved beyond doubt that constipation is the basic and sole cause of initiation of a fissure. During the passage of hard stool, the posterior midline area of the anal canal which is rather poorly supported, so the connective tissue tends to get excessively stretched and may get abraded at places. The abrasion recurs and recurs and is converted into a frank longitudinal tear in the sensitive anal lining, the true fissure in ano.

CAUSES AND TYPES 

A fissure may arise from

1. Trauma to the anus (constipation is the most common cause, surgery, injection, rubber banding, sigmoidoscopy, colonoscopy, etc.),

2. Rarely, it may be a manifestation of a specific underlying disease state such as chlamydia, gonorrhea, herpes, syphilis, AIDS, tuberculosis, cancer, Crohn's disease, or ulcerative colitis.

Pain:

Sharp agonising pain starts when the individual passes stool. The pain is severe. Persist for an hour or more. It ceases suddenly. The sufferer is comfortable until the next action of bowel. The individual tends to be constipated rather than go through painful ordeal.

Bleeding

Small amount of bright red blood streaked on the stool.

Skin tag

A small skin tag may form at the lower end of fissure, which the patient can feel.

The symptoms are slow to develop and long lasting. They hardly ever disappear spontaneously. But many people suffer for months before going to see their Doctor.

DIAGNOSIS AND INVESTIGATIONS

The diagnosis can be made by inspection, palpation, and/or Proctoscopic examination by a Specialist Doctor.

The best way to prevent fissure is to keep stools soft so they pass easily, thus decreasing pressure and straining, and to empty bowels as soon as possible after the urge occurs. Increased fibre in the diet helps reduce constipation and straining by producing stools that are softer and easier to pass.? If the diet cannot be modified in this way, adding bulk laxatives may be necessary; they can prevent worsening of the condition.

Most of us have encountered an episode of burning anal pain during defecation once in a while. This is the stage of abrasion of the anal mucosa. But how many of us have really sought any medical treatment for it? The answer will be no in most cases. Because the episode is so trivial that very next day everything seems to settle and this holds true with the common masses also.

Most of the casual attacks of anal pain are either neglected or are treated by the family physicians with various preparatory creams and laxatives. ?

We can call these fissures as simple or superficial. It has long been recognized that simple fissures can be cured conservatively.

In addition, a person should not sit on the toilet for a long period of time.