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If the fissure continues to expand and becomes infected due to faecal contact, certain pathogens could expand, directly affecting blood and weakening the immune system. Typically an anal fissure - a ripping or tear of the sphincter, may eventually heal itself, with proper maintenance and medication.

However, some fissures, particularly ones which have passed beyond the sphincter muscle, may require surgery. A dermis adhesive or "botulinum" - a toxin to produce a 'chemical sphincterotomy' may be used to heal the fissure. Or, the fissure may be removed entirely, permitting the area to heal naturally.

An anal fissure by itself would not typically carry morbidity/mortality statistics. It would more so be from subsequent infections.

Fissure repair surgery is generally done on an 'out-patient' basis, taking only a few hours in total to resolve. It is advisable to speak with a health-care provider regarding available options.

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Anal fissure?

DefinitionAn anal fissure is a small split or tear in the thin moist tissue (mucosa) lining the lower rectum (anus).Causes, incidence, and risk factorsAnal fissures are extremely common in young infants but may occur at any age. Studies suggest 80% of infants will have had an anal fissure by the end of the first year. The rate of anal fissures decreases rapidly with age. Fissures are much less common among school-aged children than infants.In adults, fissures may be caused by constipation, the passing of large, hard stools, or by prolonged diarrhea. In older adults, anal fissures may be caused by decreased blood flow to the area.Anal fissures are also common in women after childbirth and persons with Crohn's disease.SymptomsAnal fissures may cause painful bowel movements and bleeding. There may be blood on the outside of the stool or on the toilet tissue (or baby wipes) following a bowel movement.Other symptoms may include:A crack in the skin that can be seen when the area is stretched slightly (the fissure is almost always in the middle)ConstipationSigns and testsThe health care provider will perform a rectal exam and look at a sample of the rectal (anal) tissue.TreatmentMost fissures heal on their own and do not require treatment, aside from good diaper hygiene in babies.However, some fissures may require treatment. The following home care methods usually heal most anal fissures.Cleansing more gentlyDiet changes -- eating more bulk, substances that absorb water while in the intestinal tractMuscle relaxants applied to the skinNumbing cream, if pain interferes with normal bowel movementPetroleum jelly applied to the areaSitz bathStool softenersIf the anal fissues do not go away with home care methods, treatment may involve:Botox injections into muscle in the anus (anal sphincter)Minor surgery to relax the anal muscleExpectations (prognosis)Anal fissures generally heal quickly without further problems. However, people who develop fissures are more likely to have them in the future.ComplicationsOccasionally, a fissure becomes chronic and will not heal. Chronic fissures may require minor surgery to relax the sphincter.Calling your health care providerCall your health care provider if symptoms associated with anal fissure are present, or if the fissure does not heal appropriately with treatment.PreventionTo prevent anal fissures in infants, be sure to change diapers frequently.To prevent fissures at any age:Keep the anal area dryWipe with soft materials or a moistened cloth or cotton padPromptly treat any constipation or diarrheaAvoid irritating the rectumReferencesDanakas G. Anal fissure. In: Ferri FF, ed. Ferri's Clinical Advisor 2008: Instant Diagnosis and Treatment. 1st ed. Philadelphia, Pa: Mosby; 2008.