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Anal fissure: Symptoms, causes & diagnosis

An anal fissure is a small tear or cut in the lining of the anus which can cause pain and/or bleeding.

Symptoms

Common symptoms include pain that is worse with bowel movements, burning in the anus,
bleeding when passing stools, itching and/or a tearing sensation. Patients may try to avoid
defecation because of the pain. Pain persists for some time after passing of stool.
Causes

Hard, dry stool can cause tear in the anal lining. The wound produced by the tear is known as
anal fissure. Other causes of a fissure include diarrhoea and inflammation of the anorectal area.

Anal fissures may be acute (recent onset) or chronic (present for a long time or recurring frequently).
An acute fissure is usually due to hard stool as discussed above while a chronic fissure may be either
due to over tight or spastic anal sphincter muscles, scarring due to recurrent acute fissure or
due to an underlying medical problem.

Diagnosis

Fissures are diagnosed by simple rectal examination. Additional testing may be recommended if
other medical problems such as inflammatory bowel disease or infections are considered as a cause.

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