Anal Fissure. An anal fissure, or fissure-in-ano, is a crack in the skin of the anal wall similar to a crack in the corner of the mouth. The fissure is actually draining pus, like the top of a boil, from underlying infected tissues, in the wall of the rectum itself.
The difficulties from fissures include abscess formation, and continual drainage, but from the standpoint of the man who owns one, a fissure’s most important feature is pain. Characteristic fissure pain accompanies and follows the bowel movement. While the smaller fissure might cause only a slight fleeting pain, a larger fissure often feels like a bowel movement of fire itself, which often continues after the bowel movement as an aching pain about the anus.
Bleeding often accompanies a fissure, but in small amounts and only on the toilet tissue. It may worry the fissure patient but more often it is the great pain which sends him to his doctor. Constipation with a fissure is common. People soon discover that pain is brought on by bowel movement and to prevent pain they unconsciously delay the next movement. This, of course,
EXTERNAL OPENING
Fig. 124. External fistula, resulting from abscess formation, is actually another outlet of the rectum, in addition to the anus.
brings about a harder, larger stool which is even more painful as it passes through the painfully-fissured anal outlet.
The basic care for anal fissure, as well as all anal diseases, begins with proper cleansing about the anus. Soap and water cleansing are probably more indicated and less used in the anal region than anywhere else on the body. Severe fissures need definite medical care by a doctor qualified to treat anal diseases. The most accepted of these treatments is a surgical procedure which completely removes the fissure along with the infected tissue above it. These are very successful operations and very gratifying to the anal fissure sufferer.