Anal fissure is a tear of any size in the anus. In case you have an anal fissure, in most cases you notice spot of bright red blood on the toilet tissue. 

The typical symptoms and signs of anal fissure is that kind of burn or painful sensation that occurs during or after defecation.

This kind of pain can last from a few seconds to a few hours. In case of severe condition or aggravation, the pain can cause a spasm of muscles or stinging sensation that surround the rectum, which can cause the pain to intensify.

Anal fissures heal rapidly but when it does not heal within a few weeks, then there is an underlying health condition that aggravates the fissure continually.

There are various ways that can cause an anal fissure or ulceration to occur and it’s usually treated based on the cause.

Constipation is one of the commonest causes of anal fissure. The passage of hard stool through anal canal can leave cracks around the anal muscular linings or sphincters in form of fissure. 

This kind of problem is usually manifested in individuals with chronic constipation or chronic diarrhea. This occurs due to the chronic tension of the muscular ring known as the internal anal sphincter that surrounds the anal canal.

If the internal anal sphincter is chronically tense, blood flow to this region is reduced. Reduced blood flow causes the lining of the anus to become more susceptible to tear. Reduced blood flow to your anus also makes it harder for a fissure to heal. 

This also explains why not all people with chronic constipation develop anal fissures because the tone of the internal anal sphincter largely determines if an anal fissure will develop when the anal canal is excessively stretched. 

The internal anal sphincter can become chronically tense due to possible neurological dysfunction or emotion stress as seen in some individuals with a hypertonic internal anal sphincter. In this case, you need to find ways to become emotionally well balanced. Other medications like application of nitroglycerin ointment and other conventional medical treatment offers temporally relief.

Emotional stress stimulates the autonomic nervous system with consequences that can lead to being chronically amped for a fight or flight response. One of the consequences is occurrence of a dysfunctional and tense gastrointestinal tract that also includes a taut internal anal sphincter.

For people with constipation, the best way to overcome this problem is to treat the underlying constipation through proper body hydration methods and other means that softens the bowel stool movements.

Other causes of anal fissure involve direct trauma to the anal canal such as anal intercourse, child birth and insertion of any foreign bodies into the anal canal can cause a fissure.

It should be strongly noted that some fissures can be caused by inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease. Fissures can develop when a person has syphilis, tuberculosis, a weak immune system, or anal cancer. This is why it is always very important to report to a health expert when you develop this problem. Many people tend to dodge hospital visits due to private location of the problem.

One of the clinical differences is that anal fissures that are caused by excessive stretching or a tight internal anal sphincter always occur at the north or south poles of the anal sphincter where as other causes of anal fissures often cause fissures along the sides of the anus. 

Other ways to overcome anal fissures is by use of Coconut oil. It is an excellent moisturizer for all of your body parts linings. Coconut oil also appears to have healing properties for wounds. 

It is also advisable to clean or wash your anus with warm water without the use of soap or other personal care products. Regular use of soap to clean your anus can cause the lining of the anal canal to become dry, predisposing it to tears when stretched excessively.

Dr Joseph Kamugisha is a resident oncologist in Jerusalem, Israel