[5] Anal Fissure Flashcards
What is an anal fissue?
A tear in the mucosal lining of the anal canal
What is an anal fissure most commonly due to?
Trauma from defecation of hard stool
What can anal fissures be classified as?
Acute or chronic
Primary or secondary
What is considered to be an acute anal fissure?
Present for <6 weeks
What is considered to be a chronic anal fissure?
Present for >6 weeks
What is a primary anal fissure?
One occurring with no underlying disease
What is a secondary anal fissure?
One occurring due to an underlying disease, e.g. Inflammatory bowel disease
What are anal fissures usually caused by?
Inflammation or trauma to the anal canal
What are the major risk factors for anal fissures?
Constipation
Dehydration
Inflammatory bowel disease
Chronic diarrhoea
What are the symptoms of anal fissures?
Post-defecation pain
Bleeding
Itching
Describe the pain in anal fissures?
Intense pain post-defecation, which can last several hours
Pain can be far out of proportion to the size of the fissure
Describe the blood in anal fissures
Commonly bright red blood on wiping
What may be found on examination with anal fissures?
Fissures can be visible and/or palpable on DRE
What may be required for diagnosis of anal fissures?
Examination under anaesthesia
Why may examination under anaesthesia be required for the diagnosis of anal fissures?
Because often patients will refuse a DRE due to the intense pain