Anal Fissure

WHAT YOU SHOULD KNOW:

An anal fissure is a cut or tear in the tissue inside your anus. An anal fissure may be acute or chronic. An acute anal fissure is usually small and shallow and often heals without treatment. A chronic fissure may last longer than a month and will usually require treatment. A chronic anal fissure comes back after treatment.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• Topical medicine for your anal fissure may give you a headache or make you feel lightheaded. Your skin may become red and you may also have a burning feeling on your anus. The botulinum toxin shot may hurt and may cause muscle weakness. It may also cause a painful infection of the tissue covering your anal muscles. You may also be less able to feel the area in and around your anus. Botulinum toxin or surgery may make you unable to control your bowel movements or passing gas. This is called incontinence. Surgery may also cause bleeding, an infection, or injury to your anal tissue. Even with treatment, your anal fissure may occur again.
  
  
• Without treatment, your anal fissure may deepen or become infected. You may develop an abnormal opening from your anus to nearby organs. Scar tissue may form in your anus and cause it to become narrow. Without treatment, you may have worse pain during bowel movements.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Medicines:

You may be given the following medicines:

• Stool softeners: Your caregiver may also give you medicine that makes your bowel movement softer. This helps prevent constipation. You will be less likely to strain and cause an anal fissure if you are not constipated.
  
  
• Pain medicine: Your caregiver may give you medicine to take away or decrease your pain. He will tell you how much to take and how often to take it. Take the medicine exactly as directed by your caregiver. Tell your caregiver if the pain medicine does not help or if your pain comes back too soon.
  
  
• Topical medicine: Topical medicine may help your anal muscle relax and increase blood flow to your anus. This medicine may contain anesthesia to help decrease your pain. Topical medicine may be put just inside your anus. Your caregiver will teach you the right way to use topical medicine.
  
  
• Botulinum toxin: This is medicine given as a shot into the skin around your anus. It helps your anal muscle relax. Ask your caregiver for more information about botulinum toxin shots.

Surgery:

You may need surgery if other treatments do not work. You may also need surgery if your anal fissure is very painful. Surgery is often used for chronic anal fissures. The most common surgery is called a lateral internal sphincterotomy (LIS). During surgery, a small part of your anal muscle is cut. This helps relax your anal muscle and decrease your pain. Sometimes, your caregiver may remove all or some of your anal fissure. This is called a fissurectomy.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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