A Fissure means a long deep crack in something. Anal fissure means a minor tear in the thin, moist tissue that lines the anus, the last part of the large intestine. It may occur when you pass through hard feces. It can consistently cause pain and bleeding with bowel movements. It is seen mostly in people who are already suffering from constipation. Fissures are common but are usually baffled with other anal conditions, such as hemorrhoids.

                                                     The fissure is marked out as acute if it has been there for less than six weeks or chronic if it has been there for more than six weeks. Once a fissure develops, the internal anal sphincter ordinarily goes into twitch, causing additional separation of the split, compressing blood flow to the area, impairing healing, and causing aches.

• SYMPTOMS

A person might see the following symptoms through which he/she can identify whether they are having an Anal Fissure or not.

1. suffering after bowel movements
2. Constipation
3. Blood with the feces
4. An evident crack or cut in the anus or anal canal
5. Swelling and tingling that may be painful
6. Problem while peeing, frequent urination, or inability to pass urine
7. Foul odor discharge

• CAUSES

Fissures are a consequence of the extension of anal mucosa beyond its normal capacity. This normally happens when poop is hard to pass because of constipation. Once the tear happens, it leads to a frequent injury. 

1. Constipation with hard stool pass
2. Having low-fiber diet 
3. extreme diarrhea
4. Recent weight loss enucleation
5. natural childbirth
6. Minor damage caused by high-level mountain biking
7. Any inflammatory situation in the anal area

• PREVENTIVE MEASURES

1. Stay hydrated: Consume a good quantity of caffeine-free fluids throughout the day. (Too much alcohol and caffeine can lead to dehydration). Such as water, fresh juices, soups, water-rich fruits, etc.
2. Eat a fiber-rich diet: To keep away constipation, you must include 20 to 35 grams of fiber every day. You can slowly increase the amount of fiber by having more: Wheat bran, Oat bran, Whole grains, including brown rice, oatmeal, whole-grain pasta, cereals, and bread, Peas and beans, Citrus fruits, Prunes, and prune juice.
3. Try fiber supplements: if you can’t get sufficient fiber from food, you can try fiber supplements. It helps to soften poop and make you more orderly. To avoid gas and cramping, moderately raise the amount of any fiber supplement.
4. Over-the-counter laxatives may help: laxatives are any food or medicine consumed to get rid of solid waste of the body through excreta if eating more fiber in your diet does not. Before taking any laxatives, consult your doctor about what they recommend.
5. Don’t ignore your urge to go: avoiding or delaying bowel movements for later can lead to constipation; feces may become difficult to pass and end up causing pain and rip up.
6. Don’t exert pressure or sit on the toilet for too long: This can increase constraints in the anal canal.
7. Tenderly clean and dry your anal area after each bowel movement.
8. Avoid irritants to the skin, such as scented soaps or bubble baths.
9. Get care of chronic constipation or continuing diarrhea.
10. Sitz baths, or hip baths, can advance the healing of an anal fissure: By immersing the rectal area in a tub of warm water — two or three times a day for 10 to 15 minutes – it cleans the anus, improves blood flow, and relaxes the anal sphincter.

• TREATMENT

With Anal Fissure Treatment, it often heals within a few weeks if precautionary steps are followed to keep bowel movement easy for example hydration of the body, proper intake of roughage in the diet, exercise, etc.

Treatment of anal fissure consists of surgical as well as non-surgical methods. Surgical procedure is usually used for the treatment of chronic anal fissure, in which anal sphincter is stretched by operation. Non-surgical methods include usage of creams, ointments and laxatives.

NON-SURGICAL METHODS

1. Usage of external ointments or creams: nitroglycerin helps to increase blood supply to the fissure and promotes healing and helps relax the anal sphincter.
2. Usage of pain relieving creams: Lidocaine hydrochloride (Xylocaine) might be helpful for pain reduction.
3. Stool softeners: stool softeners can be prescribed by the doctor along with fiber supplements. This helps the passing of stool a lot easier leading to the recovery of a fissure.
4. Saltwater baths: if there is any irritation felt, then saltwater baths might help by cleaning and relieving any irritation. It also soothes the sphincter muscles which can contract.

    SURGICAL METHODS

1. Anal sphincterotomy: it is an operation conducted by a doctor to treat an anal fissure. It involves treating mucosal fissures from the anal canal. The anal sphincter is cut or stretched during the surgery, this helps to release the tension of the sphincter.
2. Laser sphincterotomy: this method is somewhat similar to anal sphincterotomy but instead of using a tool to cut laser is used to cut or stretch the anal sphincter. This also heals the fissure and gradually leaves a minor scar. 

• CONCLUSION

Anal fissures are a very common condition seen. It is important for a person to logically follow preventive measures to reduce the pain and irritation caused due to anal fissures. Ensuring adequate fiber and fluid intake, sitz baths, and use of topical analgesics is helpful in the removal of acute and chronic anal fissures. If still seen, anal fissures can be treated by surgical methods.