21. Addenbrooke's Hospital FAQs About Surgery For Anal Fissures (internal Sphinctero The operation to treat anal fissures is called an internal sphincterotomy. In general, anal fissure surgery can be performed on a daycase basis, http://www.addenbrookes.org.uk/serv/clin/surg/colorectal/internsphinct1.html

Home A-Z About us News ... Colorectal home page Frequently asked questions (FAQs) about surgery for anal fissures (internal sphincterotomy) What is an anal fissure? A fissure is a split in the skin at the opening of the anus, which leaves exposed some of the muscle fibres of the anal canal. Pain results from the recurrent opening of the wound when the bowels are opened and it is often accompanied by bleeding. In addition, the inner circle of muscle in the anal canal (called the internal sphincter) goes into spasm: this makes the pain worse and can prevent healing. FAQs about anal fissures Why is surgery necessary for anal fissures? Surgery is required for some types of fissures that do not respond to simpler forms of treatment. What does the operation entail? The operation to treat anal fissures is called an internal sphincterotomy . It involves that a part of the internal sphincter muscle being cut. The cut relieves the tension of the muscle and allows the fissure to heal. Occasionally, a polyp can develop at the edge of a long-standing fissure, and this might be removed at the same time. It is not usually necessary to remove or suture the fissure itself. What can go wrong?

22. THE MERCK MANUAL--SECOND HOME EDITION, Anal Fissure In Ch. 130, Anal And Rectal An anal fissure is a tear or ulcer in the lining of the anus. anal fissures may be caused by an injury from a hard or large bowel movement. http://www.merck.com/mmhe/sec09/ch130/ch130c.html

var externalLinkWarning = "The link you have selected will take you to a site outside Merck and The Merck Manuals.*n*nThe Merck Manuals do not review or control the content of any non-Merck site. The Merck Manuals do not endorse and are not responsible for the accuracy, content, practices, or standards of any non-Merck sources."; Search The Second Home Edition , Online Version Search Index A B C D ... Z Sections Accidents and Injuries Blood Disorders Bone, Joint, and Muscle Disorders Brain, Spinal Cord, and Nerve Disorders ... Women's Health Issues Resources Anatomical Drawings Multimedia Pronunciations Weights and Measures ... , Online Version Section Digestive Disorders Chapter Anal and Rectal Disorders Topics Introduction Anal Fissure Anal Itching Anorectal Abscess Anorectal Fistula Foreign Objects ... Rectal Prolapse Anal Fissure Buy The Book Print This Topic Email This Topic Pronunciations anorectal Clostridium botulinum fistula proctitis ... sphincterotomy An anal fissure is a tear or ulcer in the lining of the anus. Anal fissures may be caused by an injury from a hard or large bowel movement. Uncommonly, they may also be caused by penetration of the anus during anal sex. Fissures cause the anal sphincter to go into spasm, which prevents healing. Fissures cause pain and bleeding, usually during or shortly after a bowel movement. The pain lasts for several minutes to several hours and then subsides until the next bowel movement. A doctor diagnoses a fissure by inspecting the anus.

23. THE MERCK MANUAL, Sec. 3, Ch. 35, Anorectal Disorders Although the precise etiology is unknown, anal fissures are believed to be caused by a traumatic laceration from a hard or large stool, with secondary http://www.merck.com/mrkshared/mmanual/section3/chapter35/35c.jsp

24. How To Care For Anal Fissures Postpartum - EHow.com How to Care for anal fissures PostpartumDue to the incredible pushing involved in bringing forth a new life, many women suffer from anal fissures and http://www.ehow.com/how_9824_care-anal-fissures.html

type="text/javascript"> Clear Instructions on How To Do (just about) Everything Web eHow.com Home > Building a Family How to Care for Anal Fissures Postpartum Due to the incredible pushing involved in bringing forth a new life, many women suffer from anal fissures and hemorrhoids postpartum. A consistent daily regimen of nutrition, good hygiene and exercise can help reduce the discomfort associated with an anal fissure. Steps: Avoid constipation. Eat a diet high in fiber and whole grains, with plenty of fresh fruit and vegetables. Drink 8 to 10 glasses of water a day. Exercise, even if it is just a brisk 10-minute walk. Exercise helps to increase blood flow. Place hemorrhoid pads on your sanitary napkin. Witch hazel is the main ingredient in most hemorrhoid pads and helps decrease swelling in skin tissue. Put 3 to 5 pads onto your sanitary napkin, so they are right against your rectum, and change them as often as you change the napkin. Use hemorrhoid pads in place of toilet paper, if toilet paper is too painful. Cleanse your rectal area thoroughly after each bowel movement. Use a peri-bottle after you have a bowel movement. Your birthing facility should provide you with one, but if they don't you can buy one at a pharmacy. It is simply a squirt bottle you fill with lukewarm water. Squirt the water on your anus after you have a bowel movement. Pat the area dry, or air-dry if it is too sensitive to use toilet paper or use hemorrhoid pads to cleanse the rectum.

25. InteliHealth: Fissure Anal fissure — An anal fissure, also called an anorectal fissure, Anal fissure — Painful anal fissures can be a recurrent problem in people who suffer http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/9997.html

chrome_imgPreload('gifChr_mid_but_home_mo_1','http://img.intelihealth.com/i/C/Chr_mid_but_home-o.gif'); chrome_imgPreload('gifChr_mid_but_comm_mo_2','http://img.intelihealth.com/i/C/Chr_mid_but_comm-o.gif'); chrome_imgPreload('gifChr_mid_but_dental_mo_3','http://img.intelihealth.com/i/C/Chr_mid_but_dental-o.gif'); chrome_imgPreload('gifChr_mid_but_drug_mo_4','http://img.intelihealth.com/i/C/Chr_mid_but_drug-o.gif'); chrome_imgPreload('gifChr_mid_but_askexpert_mo_5','http://img.intelihealth.com/i/C/Chr_mid_but_askexpert-o.gif'); chrome_imgPreload('gifChr_mid_but_medical_mo_6','http://img.intelihealth.com/i/C/Chr_mid_but_medical-o.gif'); chrome_imgPreload('gifChr_mid_but_chats_mo_7','http://img.intelihealth.com/i/C/Chr_mid_but_chats-o.gif'); chrome_imgPreload('gifchr_mid_but_news_mo_8','http://img.intelihealth.com/i/c/chr_mid_but_news-o.gif'); chrome_imgPreload('gifChr_mid_but_privacy_mo_9','http://img.intelihealth.com/i/C/Chr_mid_but_privacy-o.gif'); Advertisement Anal Disorders What Is It? Symptoms Diagnosis Expected Duration ... Additional Info What Is It? The anus is the muscular canal through which stool passes out of the body. In adults, the anus is about an inch and a half long, and it has a lining that contains blood vessels, sensitive nerve endings and six to eight small anal glands. This article describes four disorders that cause anal pain and irritation:

26. InteliHealth: Anal Most anal fissures happen when a large, hard stool overstretches the anal opening and Less often, anal fissures develop because of prolonged diarrhea, http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/9396.html

chrome_imgPreload('gifChr_mid_but_home_mo_1','http://img.intelihealth.com/i/C/Chr_mid_but_home-o.gif'); chrome_imgPreload('gifChr_mid_but_comm_mo_2','http://img.intelihealth.com/i/C/Chr_mid_but_comm-o.gif'); chrome_imgPreload('gifChr_mid_but_dental_mo_3','http://img.intelihealth.com/i/C/Chr_mid_but_dental-o.gif'); chrome_imgPreload('gifChr_mid_but_drug_mo_4','http://img.intelihealth.com/i/C/Chr_mid_but_drug-o.gif'); chrome_imgPreload('gifChr_mid_but_askexpert_mo_5','http://img.intelihealth.com/i/C/Chr_mid_but_askexpert-o.gif'); chrome_imgPreload('gifChr_mid_but_medical_mo_6','http://img.intelihealth.com/i/C/Chr_mid_but_medical-o.gif'); chrome_imgPreload('gifChr_mid_but_chats_mo_7','http://img.intelihealth.com/i/C/Chr_mid_but_chats-o.gif'); chrome_imgPreload('gifchr_mid_but_news_mo_8','http://img.intelihealth.com/i/c/chr_mid_but_news-o.gif'); chrome_imgPreload('gifChr_mid_but_privacy_mo_9','http://img.intelihealth.com/i/C/Chr_mid_but_privacy-o.gif'); Advertisement Anal Disorders What Is It? Symptoms Diagnosis Expected Duration ... Additional Info What Is It? The anus is the muscular canal through which stool passes out of the body. In adults, the anus is about an inch and a half long, and it has a lining that contains blood vessels, sensitive nerve endings and six to eight small anal glands. This article describes four disorders that cause anal pain and irritation:

27. ANAL FISSURES From Haines Ely Szdrskin@peseta.ucdavis.edu One Therapy for anal fissures and Ulcers, NEJM 333(17) 11567, 1995. Anal sphincter hypertonicity is associated with painful anal fissures and ulcers. http://dermatology.cdlib.org/rxderm-archives/anal-fissures

ANAL FISSURES From: Haines Ely One of the neatest letters to the editor I have seen in a long time was written in the NEJM by Stephen R. Gorfine M.D.titled Topical Nitroglycerine Therapy for Anal Fissures and Ulcers, NEJM 333(17) 1156-7, 1995. Anal sphincter hypertonicity is associated with painful anal fissures and ulcers. A derangement of nitric oxide regulation may cause this spasticity. Nitroglycerine was applied as 200mg in an ointment and the investigators asked the fourty patients treated to rate their pain on a scale of one to ten. The mean pain scores before and after treatment were 4.8 and 1.4. The patients were instructed to apply the ointment QID. Fissures healed in two weeks in 30% of the patients, in four weeks or less in 70% of patients. Side effects were limitted to mild transient headaches.

28. Anal Fissure, UPMC | University Of Pittsburgh Medical Center, Pittsburgh, PA, US A comprehensive resource describing the causes, symptoms, diagnosis, and treatment of anal fissures from the health care experts at the University of http://analfissure.upmc.com/

Home Anal Fissure An anal fissure is a painful cut in the lining of the anus. The anus is the opening through which stool passes from the body. Tears generally occur just inside the opening. Read more Overview Diagnosis Treatment Options ... Contact UPMC Supplemental content provided by EBSCO Publishing Terms and Conditions

29. Encyclopaedia Topic : Anal Fissure, Section : References Glyceryl trinitrate for chronic anal fissure – healing or headache/ Results of a Nifedipine for local use in conservative treatment of anal fissures. http://www.nhsdirect.nhs.uk/en.asp?TopicID=26&AreaID=3010&LinkID=2414

30. Encyclopaedia Topic : Anal Fissure, Section : Treatment Some people require a minor surgical operation to cure a chronic anal fissure. The most commonly used operations to treat anal fissures are an internal http://www.nhsdirect.nhs.uk/en.asp?TopicID=26&AreaID=3761&LinkID=2836

31. Anal Fissures Usually caused by overstretching the anus, anal fissures can also be caused by irritable Bright red blood is also a common symptom of anal fissures. http://www.optimalhealthnetwork.com/pilot.asp?pg=Anal_Fissures

32. PRODIGY Guidance - Anal Fissure This guidance does not cover the treatment of atypical anal fissures associated with October 1998 written replacing previous guidance on Anal fissure. http://www.prodigy.nhs.uk/guidance.asp?gt=Anal fissure

33. Anal Fissure - Wikipedia, The Free Encyclopedia Most anal fissures are caused by stretching of the anal mucosa beyond its capability. anal fissures are common in women after childbirth and in infants. http://en.wikipedia.org/wiki/Anal_fissure

Wikimedia needs your help in the final days of its fund drive. See our fundraising page Over US$225,000 has been donated since the drive began on 19 August. Thank you for your generosity! Anal fissure From Wikipedia, the free encyclopedia. An anal fissure is an unnatural crack or tear in the anus , usually extending from the anal opening and the midline of the anus. Contents Causes Symptoms Prevention Treatment ... edit Causes Most anal fissures are caused by stretching of the anal mucosa beyond its capability. Various causes of this fissure include: Straining to defecate, especially if the stool is hard and dry Severe and chronic constipation Severe and chronic diarrhea Crohn's disease and Ulcerative colitis Rough anal sex Anal stretching Insertion of foreign objects into the anus Tight sphincter muscles Anal fissures are common in women after childbirth and in infants. edit Symptoms The symptoms of anal fissure include: Pain during, and even hours after, defecation Visible tear in the anus Blood in stool or on toilet paper Constipation edit Prevention In infants under one year old, frequent diaper change can prevent anal fissure. For adults, the following can help prevent fissure:

34. Berkeley Parents Network: Anal Fissure As someone who has struggled with anal fissures since the tender age of six months You don t mention the pain of an anal fissureI was in agonyso http://parents.berkeley.edu/recommend/medical/analfissure.html

Berkeley Parents Network Home Members Post a Msg Reviews ... Search Anal Fissure Berkeley Parents Network Reviews > Anal Fissure December 2003 A week or so after I delivered my baby (vaginal delivery, minor tearing healed quickly), I developed an anal fissure. I saw my primary care doctor, who said there was not really any treatment for it and it would go away on its own. And, she was right, it did go away, but then it came back. Then it went away. Then it came back. Then it went away. Then it came back. My baby is now 7 months old, and this is still happening every few weeks. Has anyone else experienced this? Will it eventually go away for good? Is there really no treatment, even for what seems to be a chronic condition? Recommendations received for physicians: Dr. Bitar Michael Verhille This happened to me when I was 17. I actually saw a proctologist who performed an outpatient procedure on me to heal the fissure, and release some pressure in the area, and the fissure never returned. I suggest seeing a specialist for another opinion. As someone who has struggled with anal fissures since the tender age of six months (I'm now 41), I feel qualified to give you some advice! Here's what you have to do: take hot sitz baths twice a day when you have a fissure, 5-10 minutes each time. Dose yourself with Metamucil, prunes, bran cereal, lots of water, etc. Avoid sharp foods like popcorn and seeds (i.e. rye bread). Once the fissure is no longer hurting or bleeding, you can stop the sitz baths but continue all the! other remedies for...well, about a year. The key is to completely, absolutely 100% avoid the possibility of a hard stool opening the fissure again. You have to be very dilligent. But if you can keep up the routine for a year, you probably won't have to deal with the problem again. Good luck!

35. The Doctors Book Of Home Remedies II Anal Fissures Since more fiber in your diet means looser stools, anal fissures are a sharp reminder If you ve tried selfhelp measures and still have anal fissures, http://www.mothernature.com/Library/Bookshelf/Books/48/3.cfm

New customer? Sign Up Current customer? Log In Home Vitamins Minerals ... Learning Center Search Products Library Ways To Shop Brands Health Concern Departments Free Catalog MotherNature.com's Best-of-the-Best Natural Products Catalog Is Here! Click Here to Get Your Free Copy Today. Chapter List For: The Doctors Book of Home Remedies II: Age Spots Aging Eyes Anal Fissures Angina ... The Doctors Book of Home Remedies II From the Rodale book, The Doctors Book of Home Remedies II: Anal Fissures When it comes to pain, embarrassment and inconvenience, these painful tears in the sensitive skin around your anus are truly a thorn in your (back)side. Fissures are usually caused by trying to pass hard, large stools. Since more fiber in your diet means looser stools, anal fissures are a sharp reminder to eat shredded wheat with newfound gusto. But here's how to fizzle your anal fissures. Go high on fiber. Maybe oat bran doesn't go down as easy as a thick, juicy steak, but consuming a high-fiber diet is the best way to soften stools. Besides eating more grains, you should also eat plenty of fresh fruits and vegetables, all of which are naturally high in fiber. "Fruits, vegetables and whole grains are the best remedy and preventive measure" for fissures, says J. Byron Gathright, Jr., M.D., chairman of the Department of Colon and Rectal Surgery at the Ochsner Clinic in New Orleans and president of the American Society of Colon and Rectal Surgeons. When to See the Doctor If you've tried self-help measures and still have anal fissures, or if you notice blood in your stool or experience any bleeding while trying to pass your stool, see your doctor as soon as possible. While some bleeding occurs because of hemorrhoids or trying to pass hard stools, rectal bleeding may be a warning sign of colon cancer or another serious problem. But you'll need a doctor's examination to find out the cause.

36. Anal Fissure Medical Information Anal fissure Information from Drugs.com. anal fissures are extremely common in young infants but may occur at any age. Studies suggest 80% of infants http://www.drugs.com/enc/anal_fissure.html

Home New Drugs Latest News Drug Interactions ... Forum Drugs.com - prescription drug and medicine information available on over 24,000 approved- medications and pharmaceuticals, including side effects and drug interactions. Log-in Register Advertisement Buy a Link Now Special Offers From our sponsors Categories Diabetes Gastro Center Weight Loss AIDS/HIV ... Sexual Health Advertisement Advanced Search Or click the first letter of a drug name: A B C D ... Z Anal fissure Injury Disease Nutrition Poison ... Rectum Anal fissure Definition An anal fissure is a small split or tear in the anal mucosa that may cause painful bowel movements and bleeding. There may be blood on the outside of the stool or on the toilet tissue following a bowel movement. Causes Anal 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. Most fissures heal on their own and do not require treatment, aside from good diaper hygiene. However, some fissures may require medical treatment. The incidence of anal fissures decreases rapidly with age. Fissures are much less common among school-aged children than among infants.

37. Colorectal Surgery - Anal Fissures anal fissures are small tears in the skin lining the anus that cause In more than 90 percent of patients, acute anal fissures heal without surgery. http://www.ucihealth.com/ColonRectal/AnalFissures.htm

Home Search Appointments Contact ... Maps to UCI Locations Toll Free Physician Referral 1-877-UCI-DOCS (824-3627) Anal fissures are small tears in the skin lining the anus that cause bleeding and severe pain during defecation. Diarrhea, inflammation of the anorectal area and hard, dry bowel movements may cause anal fissures. Treatment If the fissure is acute (recent onset), dietary changes (increasing fiber, decreasing fats) , bulking agents(psyllium), and increase in water consumption to avoid constipation may promote self-healing. Warm baths several times daily may also soothe and relax the anal muscles, thereby promoting healing of fissures and preventing the formation of new fissures. In more than 90 percent of patients, acute anal fissures heal without surgery. Chronic fissures (persisting for more than a month) must be re-examined by your physician to determine the cause of failure to heal. Chronic fissures are reliably healed by a simple outpatient operation if they fail to respond to conservative measures, which may include topical smooth muscle relaxants and Botox TM . Patients with complicating factors, such as inflammatory bowel disease (IBD) or anorectal infections, need specific treatment aimed at the underlying condition.

38. Anal Fissure And Fistulas: Health Topics: UI Health Care An anal fissure is a small tear in the lining of the anus. anal fissures are extremely painful. Pain is often most severe during bowel movements. http://www.uihealthcare.com/topics/digestivesystem/dige3495.html

Health Topics Category Index Health Topics for Digestive System James A. Clifton Center for Digestive Diseases Cancers of the Digestive System ... Liver Service Send comments and questions to staff@uihealthcare.com University of Iowa, Iowa City, Iowa Anal fissure and fistulas The anus, commonly called the rectum is the opening where bowel movements leave the body. An anal fissure is a small tear in the lining of the anus. An anal fistula is an abnormal tunnel from the anus to the skin near the anus. Passing large hard bowel movements or having diarrhea may cause an anal fissure. Anal fissures are extremely painful. Pain is often most severe during bowel movements. There may also be pain an hour or so after a bowel movement. This pain may last 2 to 4 hours. Spots of bright red blood in the stool may be noticed. There is often a hemorrhoid-like thickening of the skin at the lower end of the fissure. The fear of this pain may cause the person to not eliminate the stool when the urge occurs. When the bowel is not relieved by having a bowel movement at the time of the urge, constipation may occur. The treatment for a fistula is to increase fiber in the diet and drink plenty of liquids. Bran or psyllium seed preparations help to add fiber to the diet. Warm sitz baths for 10 to 20 minutes several times a day and after having a bowel movement also help. Suppositories can be used if these measures do not work. Anesthetic ointment or solutions often help relieve the discomfort, but repeated use of pain killing or numbing ointments can cause irritation or inflammation around the anus. Complete healing may take a few weeks, but the pain will disappear in a few days. In extreme cases, the fissure must be repaired surgically.

39. FamilyFun: Health Encyclopedia: Anal Fissures An excerpt on anal fissures from the Disney Encyclopedia of Baby and Child Care. http://familyfun.go.com/parenting/child/health/childhealth/dony79enc_anfiss/

Browse site by Classic Themes Barnyard Pals Cars and Trucks Fairy-Tale Princesses Pirates Under the Sea Search FamilyFun Tools My Great Idea Parent Problem Solver Field Guide to Parenting ... Solutions A to Z Anal Fissures A small tear or cracklike sore in the mucous lining of the anus, the outlet through which fecal waste passes, is known as an anal fissure. Fissures are the most common cause of rectal bleeding in infants and older children. While parents may be alarmed to see a blood stain in their child's stool or diaper, there is usually no need for concern. Anal fissures can be treated successfully and seldom become chronic. WHEN SHOULD I SUSPECT THAT MY CHILD HAS ANAL FISSURES? If you see blood in your child's stools or diaper, anal fissures are a possible cause. Your child also may be constipated, refuse to defecate or complain of pain when moving the bowels. WHAT CAUSES ANAL FISSURES? Anal fissures ususally are caused by constipation. They develop when stools are dry and hardened and moving the bowels requires exertion. As the child strains, the anus stretches and the mucous lining cracks like a split lip. The passing stools irritate the wound and cause the surrounding muscles (the sphincter muscles ) to go into spasms. Spasms are painful and can delay healing by leading to increased constipation.

40. Practice Parameters For The Management Of Anal Fissures (revised). Level of evidence Class II; Grade of recommendation B. anal fissures may be appropriately treated with topical nitrates because they can relieve pain; http://www.guideline.gov/summary/summary.aspx?view_id=1&doc_id=6506

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