Anal Fistula or Fissure

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Other names for Anal Fistula or Fissure

Anal fissure
Anorectal fistula
Anorectal tear
Perianal fistula
Rectal fissure

Synopsis of Anal Fistula or Fissure

Anal fistulas and anal fissures are two distinct conditions affecting the anal canal, but both can cause pain, bleeding, and discomfort during bowel movements.

An anal fissure is a small tear or crack in the lining of the anal canal, usually caused by trauma during the passage of hard or large stools, chronic diarrhea, or constipation. It results in sharp pain during bowel movements and may cause bleeding.

An anal fistula is an abnormal tunnel-like tract that forms between the anal canal and the skin near the anus. It often develops after an abscess (a collection of pus) fails to heal properly, leaving a passageway. Fistulas are frequently associated with infections or inflammatory conditions like Crohn’s disease.

While fissures often heal on their own or with conservative care, fistulas typically require surgical intervention to prevent recurring infections or abscesses.

Types:

Anal Fissures:

  • Acute fissure: Present for less than 6 weeks; likely to heal with conservative care.

  • Chronic fissure: Lasts longer than 6 weeks; may require medical treatment or surgery.

Anal Fistulas:

  • Simple fistula: A single tract connecting the anal canal to the skin.

  • Complex fistula: Multiple tracts or associated with inflammatory bowel disease (e.g., Crohn’s disease).

  • Transsphincteric fistula: Passes through the sphincter muscles, more complex to treat.

Common Causes:

Anal Fissure:

  • Passing hard stools or constipation: Most common cause.

  • Chronic diarrhea: Irritates the anal lining.

  • Childbirth trauma: Especially with vaginal deliveries.

  • Anal intercourse: May cause trauma to the anal lining.

  • Inflammatory bowel diseases (IBD): Crohn’s disease increases risk.

Anal Fistula:

  • Previous abscess: Infection in an anal gland leads to an abscess, which can form a fistula.

  • Crohn’s disease: Chronic intestinal inflammation increases fistula risk.

  • Tuberculosis, HIV, or other infections: Can cause fistula formation.

  • Trauma or surgery: Rarely leads to fistula development.

More Severe Causes (Complications):

  • Recurrent infections or abscesses: Particularly in fistulas, leading to chronic drainage or swelling.

  • Sepsis (rare): If infection spreads.

  • Chronic pain or bleeding: Can impair quality of life.

  • Incontinence risk (fistula surgeries): If the sphincter muscles are damaged during treatment.

  • Delayed healing: Especially in chronic fissures or in people with immune dysfunction.

When to See a Doctor:

  • Persistent anal pain, especially during or after bowel movements

  • Bleeding from the rectum or blood in stool

  • Swelling, redness, or discharge (pus) near the anus

  • Signs of infection (fever, chills) with anal symptoms

  • Chronic constipation or diarrhea causing anal discomfort

  • Known Crohn’s disease or other conditions with new perianal symptoms

Natural remedies for Anal Fistula or Fissure

Warm Sitz Baths: Soak the anal area in warm water for 10–15 minutes several times a day. Reduces pain, promotes healing, and soothes irritation.

High-Fiber Diet: Prevents constipation and promotes soft stools, reducing strain on the anal area. Include whole grains, fruits, vegetables, flaxseed, and psyllium.

Hydration: Drinking plenty of water softens stool and supports bowel health. Aim for 8–10 glasses daily.

Coconut Oil (Topical): Moisturizes and soothes the anal area, reducing pain and promoting healing of fissures. Apply gently after cleansing.

Aloe Vera Gel (Topical): Anti-inflammatory and soothing, aloe vera may support healing and reduce discomfort. Apply directly to the affected area.

Omega-3 Fatty Acids: Reduce inflammation and promote tissue healing. Include fish oil or flaxseed oil in the diet.

Magnesium Supplementation: Acts as a natural stool softener, reducing constipation and strain. Magnesium citrate or oxide forms can be used under guidance.

Turmeric (Curcumin): Anti-inflammatory and antimicrobial, turmeric may support healing in fissures or after fistula surgery. Consume as a supplement or in food.

Probiotics: Support gut health and prevent constipation or diarrhea, both of which can aggravate fissures or fistulas. Include fermented foods or supplements.

Avoid Straining During Bowel Movements: Use a stool softener if needed and adopt a squatting position to reduce pressure on the anal area.

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